Revista Brasileira De Cirurgia Cardiovascular最新文献

{"title":"The Rarity of Penetrating Ulcer with Intramural Hematoma of the Ascending Aorta","authors":"Joshua Patino, P. Roughneen","doi":"10.21470/1678-9741-2020-0498","DOIUrl":"https://doi.org/10.21470/1678-9741-2020-0498","url":null,"abstract":"We report a case of a 58-year-old man with multiple symptomatic penetrating atherosclerotic ulcers and concomitant intramural hematoma of the ascending aorta. The patient was successfully treated using a 24-mm Gelweave graft in the ascending aorta. He was discharged four days post operation and remains asymptomatic 14 months postoperatively. This case uniquely illustrates the rare entity of penetrating atherosclerotic ulcer with intramural hematoma, which presents in only 0.28% of all acute aortic syndrome cases.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41263755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vena Cava Filter Misplacement: A Killer Traveler","authors":"L. R. Garcia, A. Garzesi, A. S. Martins, M. L. Sobreira, F. Brito, M. Felício","doi":"10.21470/1678-9741-2021-0438","DOIUrl":"https://doi.org/10.21470/1678-9741-2021-0438","url":null,"abstract":"Inferior vena cava filter embolization is not uncommon and can reach 11.8%. However, device migration to the heart is not frequent and occurs in cases after inferior vena cava filter fracture. We present the case of a young woman who was submitted to a routine inferior vena cava filter placement three days before and presented with hemodynamic instability. Since the device was not retrievable, the surgical team opted for an open cardiac surgery under cardiopulmonary bypass to remove the inferior vena cava filter and avoid other further complications.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44905282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Analysis of 12 Years of Open Thoracoabdominal Aortic Aneurysm Repair in the Brazilian Public Health System","authors":"A. Anacleto, M. Morales, M. Teivelis, Marcelo Fiorelli Alexandrino da Silva, M. F. Portugal, C. Szlejf, Edson Amaro, N. Wolosker","doi":"10.21470/1678-9741-2021-0291","DOIUrl":"https://doi.org/10.21470/1678-9741-2021-0291","url":null,"abstract":"Introduction Although endovascular correction is a promising perspective, the gold-standard treatment for thoracoabdominal aortic aneurisms and type-B dissections with visceral involvement remains open surgery, particularly due to its well-established long-term durability. This study aims to describe and evaluate public data from patients treated for thoracoabdominal aortic aneurism in the Brazilian public health system in a 12-year interval. Methods Data from procedures performed between 2008 and 2019 were extracted from the national public database (Departamento de Informática do Sistema Único de Saúde, or DATASUS) using web scraping techniques. Procedures were evaluated regarding the yearly frequency of elective or urgency surgeries, in-hospital mortality, and governmental costs. All tests were done with a level of significance P<0.05. Results A total of 812 procedures were analyzed. Of all surgeries, 67.98% were elective cases. There were 328 in-hospital deaths (mortality of 40.39%). In-hospital mortality was lower in elective procedures (26.92%) than in urgency procedures (46.74%) (P=0.008). Total governmental expenditure was $3.127.051,56 — an average of $3.774,22 for elective surgery and $3.791,93 for emergency surgery (P=0.999). Conclusion The proportion of urgency procedures is higher than that recommended by international literature. Mortality was higher for urgent admissions, although governmental costs were equal for elective and urgent procedures; specialized referral centers should be considered by health policy makers.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47691384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Root and Distal Arch Management During Type A Aortic Dissection Repair: Expanding Horizons","authors":"K. Rathore, M. Newman","doi":"10.21470/1678-9741-2021-0178","DOIUrl":"https://doi.org/10.21470/1678-9741-2021-0178","url":null,"abstract":"The management of Type A aortic dissection has evolved over a period of a decade or so, and contemporary reports are suggesting a paradigm shift from a conservative approach to complete excision of the diseased aorta including root and distal arch. Improved cardiopulmonary bypass perfusion techniques, better understanding of the cerebral perfusion, and wide-ranging obtainability of prosthetic conduits gave surgical teams numerous choices. With improving outcomes and maturing surgical techniques, surgeons are performing extensive resections of the diseased aorta, but there is no standard protocol as far as the extent of the proximal and distal diseased aortic tissue resection is concerned. Aortic root replacement is associated with good early- and long-term outcomes and proffered solution in young and stable patients, for that reason many busy centres are endorsing total arch replacement in complex distal aortic dissections. This systemic review is discussing contemporary literature and associated pros and cons during surgical decision-making for these high-risk cases.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42775917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antioxidant Actions of Thymoquinone, Silymarin, and Curcumin on Experimental Aortic Ischemia-Reperfusion Model in Wistar Albino Rats","authors":"M. Yardimci, Mustafa Göz, M. S. Aydın, N. Kankılıç, Ebru Temiz","doi":"10.21470/1678-9741-2021-0462","DOIUrl":"https://doi.org/10.21470/1678-9741-2021-0462","url":null,"abstract":"Introduction Medical improvements are needed to prevent ischemia-reperfusion injury in thoracoabdominal aortic surgery. The aim of this study was to determine the antioxidant effects of thymoquinone, silymarin, and curcumin against ischemia-reperfusion injury associated with abdominal aorta. Methods Twenty-five Wistar albino rats were included in the study. Sham, control, and treatment (thymoquinone, silymarin, and curcumin) groups were set in equal numbers. Ischemia-reperfusion was applied by clamping (120 minutes) and de-clamping (60 minutes) the infrarenal aorta of all groups, except the sham group. Before reperfusion, thymoquinone, silymarin, and curcumin were given intraperitoneally to the treatment groups. After reperfusion, blood samples were taken from the right ventricle. Total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were studied in serum samples and histopathological examination was performed on the gastrocnemius muscle. Results There was a significant difference in TOS and OSI values between the control and sham groups. Both values were found higher in the control group than in the sham group (P<0.05). OSI values were found to be lower in the thymoquinone group compared to the control group (P<0.05). All three parameters were found to be lower in the silymarin group than in the control group (P<0.05). TAS and TOS levels were found to be higher in the curcumin group than in the control group (P<0.05). There was no histopathological difference between the groups. Conclusion Silymarin and thymoquinone administration decreases oxidative stress in experimental aortic ischemia-reperfusion injury. Antioxidant effect of curcumin was lower than silymarin and thymoquinone.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41830732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on Cardiothoracic Surgery: Experience of Alexandria (Egypt) Main University Hospital","authors":"H. Hemead, Mohamed Elsayed, W. Hassanein","doi":"10.21470/1678-9741-2020-0551","DOIUrl":"https://doi.org/10.21470/1678-9741-2020-0551","url":null,"abstract":"Introduction The current coronavirus pandemic has greatly strained the limited resources that had previously maintained the sustainability of the high-cost cardiothoracic surgeries in low-income countries like Egypt. Methods Hospital databases and patients’ records were reviewed to evaluate the impact of the pandemic on the workflow and waiting lists. Postoperative patients were contacted by telephone for follow-up, as well as preoperative patients whose operations were cancelled. Regular virtual meetings were held, and residents were asked to discuss the stresses, challenges, and their suggestions for the gradual resumption of services. Residents’ logbooks were evaluated to assess the disruption of the surgical exposure compared to 2019. Results While thoracic surgeries have continued to thrive, cardiac surgeries have witnessed the worst consequences, including cancellation of all surgeries, expansion of waiting lists, patients’ non-compliance with follow-up, and impaired surgical exposure of junior residents. Conclusion The gradual recovery of cardiac surgery services in Alexandria (Egypt) is being carefully planned, taking into consideration the backlog of cases and the shortage of screening kits. Careful tiering and triaging of patients by a multidisciplinary team, as well as seeking alternative assessment tools for trainees, are the main lines of our action plan.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45605499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison Between Treatment Strategies of Carotid Stenosis in Patients Undergoing Coronary Artery Bypass Grafting","authors":"F. Bassan, V. M. Azevedo, Ana Angélica Alves Pimenta Santos, R. B. D. Mello, A. Verdolin, R. Bassan","doi":"10.21470/1678-9741-2020-0425","DOIUrl":"https://doi.org/10.21470/1678-9741-2020-0425","url":null,"abstract":"Introduction In patients undergoing coronary artery bypass grafting (CABG), stroke is a major complication that increases morbidity and mortality. The presence of carotid stenosis (CS) increases risk of stroke, and the optimal treatment remains uncertain due to the lack of randomized clinical trials. The aim of this study is to compare three management approaches to CS in patients submitted to CABG. Methods From 2005 to 2015, 79 consecutive patients with significant CS submitted to CABG were retrospectively evaluated. Patients were divided in three groups, according to CS treatment: 17 underwent staged carotid endarterectomy (CEA)-CABG, 26 underwent synchronous CEA-CABG, and 36 underwent isolated CABG without carotid intervention. The primary outcomes were composed by 30-day postoperative acute myocardial infarction (MI), 30-day postoperative stroke, and death due to all causes during the follow-up. Results Patients were evaluated during an average 2.05 years (95% confidence interval = 1.51-2.60) of follow-up. Major adverse cardiac events, including death, postoperative MI, and postoperative stroke, occurred in 76.5% of the staged group, 34.6% of the synchronous group, and 33.3% of the isolated CABG group (P=0.007). As for MI, the rates were 29.4%, 3.85%, and 11.1% (P=0.045), respectively. There was no statistically significant difference in total mortality rates (35.3%, 30.8%, and 25.0%, respectively; P=0,72) and stroke (29.4%, 7.7%, and 8.3%, respectively; P=0,064) between groups. Conclusion Staged CEA-CABG is associated with higher major adverse cardiac events and MI rate when compared to the strategy of synchronous and isolated CABG, but without statistically difference in total mortality during the entire follow-up.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43851091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Need for Creating a Unified Knowledge of Cardiovascular Diseases in Latin America","authors":"Manuel Urina-Jassir, Maria Alejandra Jaimes-Reyes, Samuel Martínez-Vernaza, M. Urina-Triana","doi":"10.21470/1678-9741-2022-0954","DOIUrl":"https://doi.org/10.21470/1678-9741-2022-0954","url":null,"abstract":"Cardiovascular diseases (CVDs) have persistently been the principal cause of disease burden and mortality throughout the world as well as in Latin America (LATAM)[1,2]. Congruently, as CVDs continue to grow, the research production in this discipline has followed the same trend; global CVD publications have been increasing in the last decades[3,4]. However, as with other health-related topics, disparities in the quantity of research exist when comparing lowand middle-income countries with high-income nations[3,4]. Despite the simultaneous increasing trend in CVD research output in LATAM, this region is clearly behind in terms of publications when compared to North America or Europe. A bibliometric analysis of CVD papers in PubMed® identified that 4% of them were from LATAM, as opposed to 40% from European countries[5]. Even between Latin American countries, disparities also exist, with Argentina, Brazil, and Mexico being the most represented countries in published research in the region[5,6]. As a reader, when assessing collaborative or pooled studies such as clinical trials or systematic reviews, there seems to be a lower representation of the Latin American population, publications, and/or journals. This could possibly be explained due to language barriers, as Spanish or Portuguese publications are excluded in many cases from systematic reviews, or due to the lack of indexation of many Latin American medical journals in major international databases such as PubMed®/MEDLINE®[7,8]. In our recent experience, we identified that information about the Latin American population’s characteristics of infective endocarditis (IE) was lacking. Therefore, our approach was to conduct a systematic review including the two major international databases, as well as two regional Latin American databases. We identified and described compiled information on the major characteristics of IE that hopefully will be useful, or at least be a starting point for clinicians, researchers, and local guidelines[9]. Efforts to develop a unified knowledge, via systematic reviews, have also been conducted by other authors in the field of CVDs in LATAM[10,11]. For instance, Ciapponi et al.[10] DOI: 10.21470/1678-9741-2022-0954","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48338336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three Times Recurrent Takotsubo Syndrome: An Educational Presentation","authors":"Pedro Henrique R E Silva, Jairo Rosa E S, P. Evora","doi":"10.21470/1678-9741-2022-0951","DOIUrl":"https://doi.org/10.21470/1678-9741-2022-0951","url":null,"abstract":"1Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil. 2Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brasil. 3Department of Surgery and Anatomy, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil. DOI: 10.21470/1678-9741-2022-0951","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46222053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends regarding the profile of cardiac surgery patients during the first wave of COVID-19 pandemic in Greece","authors":"Antonios Roussakis, Konstantinos Boumpoulis, Ioannis Nenekidis, Aikaterini Gavalaki, K. Petsios, Stavros Dimopoulos, Ioannis Bisiadis, P. Rellia, K. Perreas","doi":"10.21470/1678-9741-2021-0015","DOIUrl":"https://doi.org/10.21470/1678-9741-2021-0015","url":null,"abstract":"Humanity faces one of the greatest healthcare challenges ever, due to the COVID-19 pandemic. According to WHO’s weekly operational report, published on 16th February 2021, we have 110,384,747 confirmed cases and 2,446,008 deaths globally (https://www.who.int/emergencies/diseases/novelcoronavirus-2019/situation-reports). SARS-CoV-2 has been highly infectious, and it did not take long to cross the borders of China and soon become a global health threat with implications of unpredictable magnitude[1]. Noticeably, the rate of new infections is still high, with more than 2.7 million new cases per week, and there is a great concern regarding public health events associated with SARS-CoV-2 variants. Concerning cardiac surgery units, there was a clear impact on the daily routine in different ways[2-5]. Many changes took place regarding admission procedures, aggressive infection mitigation strategies in the operating room and during surgical recovery, intensive care guidelines and restrictions. Also, a necessity rose to postpone elective cardiac surgeries, to manage healthcare workers’ resources differently, to deal with the increased risk of infection for both patients and health professionals, along with the exaggerated skepticism among patients, affecting their willingness to undergo a cardiac surgery. In an international survey during the first wave of the pandemic, with the participation of more than 600 cardiac surgeons from America, Europe, Asia, and Australia, a median reduction in the volume of cardiac surgery cases was 50% to 75%, as most centers postponed elective cases and more than one-third of the centers reported more than 50% reductions in intensive care capacity[6]. This led to modifications in policies and guidelines regarding cardiac surgery priority to confront the pandemic requirements and scarce resources. However, these recommendations should be considered on case-by-case basis with a clear need for regular updates[7-9]. The Onassis Cardiac Surgery Center (OCSC) is a tertiary hospital focused on the treatment of cardiac surgery and cardiology patients. The core period of the first wave of the Trends regarding the profile of cardiac surgery patients during the first wave of COVID-19 pandemic in Greece","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44753697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}