Revista Brasileira De Cirurgia Cardiovascular最新文献_第4页

Left Ventricular Assist Device Thrombosis: Combined Approach by Echocardiography and Logfiles Review for Diagnosis and Management 左心室辅助装置血栓形成:超声心动图和日志文件的联合诊断和治疗

4区医学

Revista Brasileira De Cirurgia Cardiovascular Pub Date : 2022-05-02 DOI: 10.21470/1678-9741-2021-0139

N. Vitale, T. Acquaviva, Teresa A P Quagliara, N. Bari, G. Capone, N. Marraudino, A. Milano

{"title":"Left Ventricular Assist Device Thrombosis: Combined Approach by Echocardiography and Logfiles Review for Diagnosis and Management","authors":"N. Vitale, T. Acquaviva, Teresa A P Quagliara, N. Bari, G. Capone, N. Marraudino, A. Milano","doi":"10.21470/1678-9741-2021-0139","DOIUrl":"https://doi.org/10.21470/1678-9741-2021-0139","url":null,"abstract":"Introduction Left ventricular assist devices are an established therapy for end-stage heart failure. Follow-up of these patients showed complications, such as thrombosis. Our objective was to evaluate the contribution of echocardiography — in association with HeartWare HVAD online logfiles reviews and lactate dehydrogenase titration — for diagnosis and treatment of thrombosis. Methods Seventeen episodes of thrombosis were diagnosed in 8/20 patients with HVAD. Diagnosis was made by trans-thoracic echocardiographic blood flow velocities, logfiles review of power consumption and pump flows, and titration of lactate dehydrogenase. Data were collected at baseline routine control (Group A), during thrombosis (Group B), after thrombolysis (Group C). Results Thrombolysis was successful in all cases; one patient died of cerebral haemorrhage. Echocardiographic maximal blood flow velocity near the inflow cannula was 598±42 cm/sec (Group B), 379.41±21 cm/sec (Group C), and 378.24±28 cm/sec (Group A) (P<0.00001). In eight (47%) cases, thrombi were visualized in the left ventricle by three-dimensional modality. Logfiles recordings of blood flows were 9.52±0.9 L/min (Group B), 4.02±0.4 L/min (Group C), and 4.04±0.4 L/min (Group A) (P<00001). Power consumption was 5.01±0.7 W (Group B), 3.45±0.2 W (Group C), and 3.46±0.2 W (Group A) (P<0.00001). Lactate dehydrogenase was 756±54 IU (Group B), 234±22 IU (Group A), and 257±36 IU (Group C) (P<0.00001). Conclusions Echocardiography of increased maximal velocity near the inflow cannula is a sign of HVAD obstruction. Logfile reviews provide a clear picture of HVAD obstruction. Combination of echocardiographic data and review of logfiles detects signs of left ventricular assist devices thrombosis leading to a successful treatment.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42963640","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}

引用次数: 1

Combined Heart and Kidney Transplantation: Initial Clinical Experience 心肾联合移植:初步临床经验

4区医学

Revista Brasileira De Cirurgia Cardiovascular Pub Date : 2022-05-02 DOI: 10.21470/1678-9741-2020-0720

F. Atik, Carolina de Castro Borges, M. Ulhoa, R. Chaves, Vitor Barzilai, R. Biondi, Tiago Martins de Almeida, Isabela Medeiros, H. Cardoso

{"title":"Combined Heart and Kidney Transplantation: Initial Clinical Experience","authors":"F. Atik, Carolina de Castro Borges, M. Ulhoa, R. Chaves, Vitor Barzilai, R. Biondi, Tiago Martins de Almeida, Isabela Medeiros, H. Cardoso","doi":"10.21470/1678-9741-2020-0720","DOIUrl":"https://doi.org/10.21470/1678-9741-2020-0720","url":null,"abstract":"Introduction Combined solid organ transplantation is infrequently performed in Brazil. The objective of this article is to present our initial experience with combined heart and kidney transplantation. Methods From January 2007 to December 2019, four patients were submitted to combined heart and kidney transplantation. Their mean age was 55.7±4.4 years, and three (75%) patients were males. All patients had Chagas cardiomyopathy, two were hospitalized and inotrope dependent, and all patients were on preoperative dialysis (median of 12 months prior to transplant). Results All patients survived and were in New York Heart Association functional class I at the latest follow-up (mean 34.7±17.5 months). Mean retarded kidney graft function was 22.9±9.7 days. One patient lost the kidney graft two years after the transplant due to Polyomavirus infection. Conclusion Our initial experience of combined heart and kidney transplantation was favorable in selected patients with advanced heart failure and end-stage kidney disease. It requires involvement of a dedicated multispecialty team throughout all the diagnostics and treatment steps.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42092760","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}

引用次数: 0

Transcatheter Edge-to-Edge Mitral Valve Repair in Functional Mitral Regurgitation. Does it Pass Muster? Still Leaving Plenty to Be Desired 功能性二尖瓣反流中经导管边缘对边缘二尖瓣修复术。它通过Muster吗？仍留下许多值得渴望的东西

4区医学

Revista Brasileira De Cirurgia Cardiovascular Pub Date : 2022-05-02 DOI: 10.21470/1678-9741-2022-0129

O. García-Villarreal

引用次数: 0

Proadrenomedullin in Patients with Preserved Left Ventricular Systolic Function Undergoing Coronary Artery Bypass Grafting 肾上腺髓质素原在冠状动脉搭桥术后左心室收缩功能保持的患者中的作用

4区医学

Revista Brasileira De Cirurgia Cardiovascular Pub Date : 2022-05-02 DOI: 10.21470/1678-9741-2020-0616

Joanna Stanisz-Kempa, Z. Gąsior, A. Kułach

{"title":"Proadrenomedullin in Patients with Preserved Left Ventricular Systolic Function Undergoing Coronary Artery Bypass Grafting","authors":"Joanna Stanisz-Kempa, Z. Gąsior, A. Kułach","doi":"10.21470/1678-9741-2020-0616","DOIUrl":"https://doi.org/10.21470/1678-9741-2020-0616","url":null,"abstract":"Introduction A potentially new marker of cardiovascular diseases — proadrenomedullin is the precursor of adrenomedullin, which is a multifunctional peptide hormone, produced in most of the tissues in response to cellular stress, ischemia, and hypoxia. Methods Ninety-three people, aged 51-79 years, were included in the study. Exclusion criteria were severe or corrected valvular disease, acute coronary syndrome, age ≥ 80 years, glomerular filtration rate < 45 ml/min, active infectious diseases, and cancer. The subjects were observed for adverse events, including reduced left ventricular ejection fraction (LVEF) by ≥ 10%, first incidence of atrial fibrillation (AF), and the necessity of using dopamine during hospitalization. Results Use of pressure amines, occurrence of the first AF episode, and left ventricular dysfunction defined by a decrease in LVEF by at least 10% compared to the value before surgery were reported in the perioperative period. No death, sudden cardiac arrest with effective resuscitation, non-ST-elevation myocardial infarction, ST-elevation myocardial infarction, or heart failure were observed. Significantly higher proadrenomedullin concentration was observed in the group with reduced postoperative LVEF (1.68 vs. 0.77 nmol/l, P=0.005). The relative risk of a decrease in ejection fraction in the group of patients with proadrenomedullin concentration ≥ 0.77 nmol/l was more than twelve-fold higher (95% confidence interval 1.69-888.33; P=0.013) than in the group of patients with a concentration of proadrenomedullin < 0.77 nmol/l. Conclusion The higher baseline concentration of proadrenomedullin has a predominantly predictive value of postoperative left ventricular systolic dysfunction.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44289679","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}

引用次数: 0

Lutembacher Syndrome with Sinus Venosus-Type Interatrial Communication: An Educational Presentation Lutembacher综合征伴静脉窦型房间通讯:教育报告

4区医学

Revista Brasileira De Cirurgia Cardiovascular Pub Date : 2022-04-18 DOI: 10.21470/1678-9741-2021-0323

A. Lordsleem, S. G. de Lima, L. S. Bezerra, E. B. Calado, Fábio Antônio A. Granja, B. Markman-Filho

引用次数: 1

Follow-up Results of Endovascular Aneurysm Repair Following Abdominal Visceral Debranching 腹腔内脏去分支术后血管内动脉瘤修复的随访结果

4区医学

Revista Brasileira De Cirurgia Cardiovascular Pub Date : 2022-04-18 DOI: 10.21470/1678-9741-2020-0705

D. Oztas, M. Uğurlucan, O. Sayin, F. Ekiz, Yilmaz Onal, M. O. Beyaz, M. Umutlu, Mert Meriç, B. Acunaş, U. Alpagut

{"title":"Follow-up Results of Endovascular Aneurysm Repair Following Abdominal Visceral Debranching","authors":"D. Oztas, M. Uğurlucan, O. Sayin, F. Ekiz, Yilmaz Onal, M. O. Beyaz, M. Umutlu, Mert Meriç, B. Acunaş, U. Alpagut","doi":"10.21470/1678-9741-2020-0705","DOIUrl":"https://doi.org/10.21470/1678-9741-2020-0705","url":null,"abstract":"Introduction The aim of this study is to present a series of six cases with thoracoabdominal aneurysm treated with hybrid technique in our center. Methods Between May 2015 and December 2018, the data of six patients with thoracoabdominal aneurysms and various comorbidities who underwent visceral debranching followed by endovascular aortic aneurysm repair were reviewed retrospectively. Results Patients’ mean age was 65.3±19.6 years. All of them were male. Comorbidities were old age, congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, previous surgical interventions, and/or esophageal hemangioma. Except for one patient who underwent coronary artery bypass grafting (inflow was taken from ascending aorta), debranching was performed from the right iliac artery. Debranching of four visceral arteries (superior mesenteric artery, celiac trunk, and bilateral renal right arteries) was performed in three patients, of three visceral arteries (superior mesenteric artery, celiac trunk, right renal artery) was performed in one, and of two visceral arteries (superior mesenteric artery, celiac trunk) was performed in two patients. Great saphenous vein and 6-mm polytetrafluoroethylene grafts were used in one and five patients, respectively, for debranching. Endovascular aneurysm repair was performed following debranching procedures as soon as the patients were stabilized. In total, three patients died at the early, mid, and long-term follow-up due to multiorgan failure, pneumonia, and unknown reasons. Conclusion Hybrid repair of thoracoabdominal aneurysms may be an alternative to fenestrated or branched endovascular stent grafts in patients with increased risk factors for open surgical thoracoabdominal aneurysm repair; however, the procedure requires experience and care.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44424791","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}

引用次数: 0

Surgical Removal of The Mechanical Valve Leaflet Dislocated into The Pulmonary Vein 机械瓣膜小叶脱位进入肺静脉的手术切除

4区医学

Revista Brasileira De Cirurgia Cardiovascular Pub Date : 2022-04-18 DOI: 10.21470/1678-9741-2021-0350

D. Zdravković, Igor S Zivkovic, V. Kovacevic, P. Milačić, M. Miličić

引用次数: 0

Selvester Score May Be a Predictor of ICD Therapies in Patients with Non-Ischemic Dilated Cardiomyopathy Selvester评分可能是非缺血性扩张型心肌病患者ICD治疗的预测指标

4区医学

Revista Brasileira De Cirurgia Cardiovascular Pub Date : 2022-04-18 DOI: 10.21470/1678-9741-2021-0112

M. Kuyumcu, M. Uzun, Y. Ozen, F. Aksoy, B. A. Uysal, E. Varol

{"title":"Selvester Score May Be a Predictor of ICD Therapies in Patients with Non-Ischemic Dilated Cardiomyopathy","authors":"M. Kuyumcu, M. Uzun, Y. Ozen, F. Aksoy, B. A. Uysal, E. Varol","doi":"10.21470/1678-9741-2021-0112","DOIUrl":"https://doi.org/10.21470/1678-9741-2021-0112","url":null,"abstract":"Introduction The benefit of implantable cardioverter-defibrillator (ICD) in patients with non-ischemic dilated cardiomyopathy (DCM) is still an issue under discussion. Studies examining the relationship between ventricular scar tissue and ICD shock with cardiac magnetic resonance (CMR) are promising. CMR studies have shown that ventricular scar tissue size and Selvester score show a correlation. In the light of this information, this study aimed to investigate the potential relationship between Selvester score and ICD therapies. Methods The study included 48 patients who had undergone ICD implantation with a diagnosis of DCM and who had undergone routine 6-month ICD control in outpatient clinic controls between December 2018 and October 2019. Selvester score and other data were compared between patients who received ICD therapy (n=10) and those who did not (n=38). Results Selvester score (P<0.001) was higher in ICD therapy group. Positive correlation was found between ICD shock therapy and Selvester score (P=0.002, r=0.843). Selvester score was detected as an independent predictor for ICD therapy after multiple linear regression analysis (P=0.004). Receiver operating characteristic curve analysis showed that Selvester score (P<0.001) was a significant predictor of ICD therapy. Selvester score cutoff points of 5 for were calculated to estimate ICD therapy, with a sensitivity of 100% and specifity of 81%. Conclusion In our study, it was found that a high Selvester score may be a predictor for ICD therapies in patients with DCM. As an inexpensive and non-invasive method, Selvester score can help in the decision-making in these patients.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46638338","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}

引用次数: 0

Surgery for Functional Tricuspid Regurgitation in Adult Atrial Septal Defect — An Increasing Subject in a Decreasing Matter 成人房间隔缺损功能性三尖瓣反流的手术治疗-在减少的问题中增加的主题

4区医学

Revista Brasileira De Cirurgia Cardiovascular Pub Date : 2022-04-18 DOI: 10.21470/1678-9741-2020-0503

A. Iosifescu, A. Popescu, Toma Andrei Iosifescu, Alina Teodora Timișescu, S. Maximeasa, V. Iliescu

{"title":"Surgery for Functional Tricuspid Regurgitation in Adult Atrial Septal Defect — An Increasing Subject in a Decreasing Matter","authors":"A. Iosifescu, A. Popescu, Toma Andrei Iosifescu, Alina Teodora Timișescu, S. Maximeasa, V. Iliescu","doi":"10.21470/1678-9741-2020-0503","DOIUrl":"https://doi.org/10.21470/1678-9741-2020-0503","url":null,"abstract":"Introduction Functional tricuspid regurgitation (TR) is known to complicate adult atrial septal defect (ASD), but its management is still under debate. We reviewed our experience in ASD surgery, focusing on associated functional TR and its treatment. Methods This retrospective study (2005-2019) included 206 consecutive adult ASD surgical cases without associated valve pathology, except functional TR. Variables were statistically compared on TR classes and surgery-defined groups. Results Mean age of the patients was 40.3±13 years; 19.9% had sinus venosus syndrome. TR severity was directly related to age, pulmonary systolic pressure, right ventricular and tricuspid annulus diameters, and heart failure class. TR ≥ 2 was found in 134 (65%) patients, while TR ≥ 3 in 56 (27.2%) patients. Tricuspid surgery was associated to shunt closure in 66 (32%) patients, almost all through valve repair; indication was directly related to age, right ventricular and tricuspid annulus diameters, and heart failure class ≥ 3. Tricuspid surgery was more efficient than isolated shunt closure in decreasing TR (79±23% vs. 36±26%; P=1.8 E-18). Device closure availability (last four years of the study) was associated with 1/3 reduction of surgical cases but increased the share of cases with TR>2 (> 51% vs. < 31%; P<0.05). Conclusion In the era of device closure, surgery for adult ASD is less frequent, but the share of significant TR cases is in net increase. To avoid long-term postoperative TR, we plead for valve repair in all patients with severe TR and for considering repair in moderate TR at risk of persistence.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48675296","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}

引用次数: 0

To Treat or Not to Treat? This Is the Question… About the Incidental Finding of Double Sinus of Valsalva Aneurysm in A 91-Year-Old Woman 治疗还是不治疗?这是一个关于偶然发现的双窦Valsalva动脉瘤在91岁妇女的问题

4区医学

Revista Brasileira De Cirurgia Cardiovascular Pub Date : 2022-04-18 DOI: 10.21470/1678-9741-2021-0403

L. Marco, G. Comentale, M. Bruno, V. Lanzillotti, M. Colletta, V. Russo, D. Pacini, G. Casella

引用次数: 0