Revista Brasileira De Cirurgia Cardiovascular最新文献

{"title":"A Retrospective Study of the Relationship Between Blood Transfusion and 30-Day Postoperative Outcomes in Patients Undergoing Isolated Off-Pump Coronary Artery Bypass Grafting","authors":"Liangyuan Lu, J. Che, W. Cheng, R. Dong, Jiapeng Huang, Zhanmin Yang, Jiakai Lu","doi":"10.21470/1678-9741-2021-0031","DOIUrl":"https://doi.org/10.21470/1678-9741-2021-0031","url":null,"abstract":"Introduction The objective of this single-center study it to retrospectively analyze the relationship between transfusion and 30-day postoperative outcomes in patients undergoing isolated off-pump coronary artery bypass grafting. Methods Perioperative data of 2,178 patients who underwent isolated off-pump coronary artery bypass grafting from 2018 to 2019 were collected. A 1:1 propensity score matching was performed to control for potential biases between patients who received blood transfusion and those who did not. After propensity score matching, we analyzed the clinical outcomes of transfusion and non-transfusion patients. Postoperative complications and the survival of patients within 30 days after surgery in both groups were analyzed. Kaplan-Meier survival curve and log-rank test were used for survival analysis. Results The total blood transfusion rate of all patients was 29%, including red blood cell (27.6%), plasma (7.3%), and platelet (1.9%). Four hundred and forty patients in each group were compared after propensity score matching. There were no significant differences in the incidence of stroke, myocardial infarction, atrial fibrillation, acute kidney function injury, and sternal wound infection of both groups (P>0.05). However, higher incidence of postoperative pulmonary infection and more mechanical ventilation time and days of stay in the intensive care unit and postoperative in-hospital stay were associated with blood transfusion (P<0.05). The 30-day cumulative survival rate of the transfusion group was lower than that of the control group (P<0.05). Conclusion Perioperative blood transfusion increases the risks of postoperative pulmonary infection and short-term mortality in off-pump coronary artery bypass grafting patients.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"663 - 673"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47209231","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":"Diagnostic Value of D-Dimer and INR in Patients Suspected to Have Prosthetic Valve Dysfunction","authors":"Reza Heidari Moghadam, N. Salehi, M. Rouzbahani, Parisa Janjani, S. Mahmoudi, Mohadeseh Izadpanah, F. Heydarpour, E. Shakiba","doi":"10.21470/1678-9741-2021-0230","DOIUrl":"https://doi.org/10.21470/1678-9741-2021-0230","url":null,"abstract":"Introduction Prosthetic valve dysfunction is a potentially critical complication of heart valve replacement. An easy and quickly applicable diagnostic procedure is required for recognizing the prosthetic valve dysfunction. The purpose of this study was to prospectively define the diagnostic value of D-dimer and INR level in predicting prosthetic valve dysfunction. Methods This cross-sectional study was performed in 70 patients suspected to have prosthetic valve dysfunction admitted to Imam Ali Hospital, affiliated with Kermanshah University of Medical Sciences (KUMS), Kermanshah Province, Iran. Cinefluoroscopy, as the gold standard diagnostic test, was used for the diagnosis of prosthetic valve dysfunction in enrolled patients. Two milliliters of blood from each patient were taken into a tube containing sodium citrate anticoagulant. To evaluate D-dimer, the cutoff value was set at 500 ng/ml. Also, to evaluate international normalized ratio (INR), the cutoff value was set at 2. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of the serum markers were used to describe predictive properties. Results Of 70 patients, 27 (38.6%) were male and 43 (61.4%) were female, and the mean age was 54.67±15.11 years (range, 18 to 80 years). Of 70 patients, 27 (38.6%) had prosthetic heart valve malfunction demonstrable by fluoroscopy, and 19 patients (27.1%) had D-dimer levels >500 ng/ml. Elevated D-dimer levels (>500 ng/ml) have been indicated to have sensitivity of 70.4%, and hence an NPV of 84.3%, specificity of 100%, PPV of 100%, NLR of 0.3, and the infinity value of PLR for predicting prosthetic valve dysfunction. There was a significant relationship between fluoroscopy and D-dimer test (P=0.001). A kappa coefficient value of 0.745 indicated a substantial agreement between D-dimer and fluoroscopy testing. Mixing test (combination of D-dimer and INR) showed to have 100% sensitivity, and hence a NPV of 69.8%, specificity of 69.8%, PPV of 51.8%, NLR of 1.41, and PLR of 1.44 for predicting prosthetic valve dysfunction. Conclusion D-dimer with moderate sensitivity and high specificity is an ideal marker for the diagnosis of prosthetic valve dysfunction in suspected patients. Enhanced plasma D-dimer level is not by itself diagnostic of a prosthetic valve dysfunction but may alert physicians to refer the patient for more detailed examination, preferably by fluoroscopy. Mixing test with 100% sensitivity can apply as a rule-out test.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"674 - 679"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42914494","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":"Coexisting Coronary and Carotid Artery Disease: What We Did, What Happened","authors":"M. R. Güney, Erhan Güler, Erkan Albay, T. Kehlibar, Mehmet Yılmaz, B. Ketenci","doi":"10.21470/1678-9741-2021-0127","DOIUrl":"https://doi.org/10.21470/1678-9741-2021-0127","url":null,"abstract":"Introduction There is no complete consensus on the three surgical methods and long-term consequences for coexisting coronary and carotid artery disease. We retrospectively evaluated the surgical results in this high-risk group in our clinic for a decade. Methods Between 2005 and 2015, 196 patients were treated for combined carotid and coronary artery disease. A total of 50 patients were operated on with the staged method, 40 of which had carotid endarterectomy (CEA) priority, and 10 had coronary artery bypass grafting (CABG) priority. CABG and CEA were simultaneously performed in 82 patients; and in 64 asymptomatic patients with unilateral carotid artery lesions and stenosis over 70%, only CABG was done (64 patients). Results were evaluated by uni-/multivariate analyses for perioperative, early, and late postoperative data. Results In the staged group, interval between the operations was 2.82±0.74 months. Perioperative and early postoperative (30 days) parameters did not differ between groups (P-value < 0.05). Postoperative follow-up time was averaged 94.9±38.3 months. Postoperative events were examined in three groups as (A) deaths (all cause), (B) cardiovascular events (non-fatal myocardial infarction, recurrent angina, congestive heart failure, palpitation), and (C) fatal neurological events (amaurosis fugax, transient ischemic attack, and stroke). When group C events were excluded, event-free actuarial survival rates were similar in all three methods (P=0.740). Actuarial survival rate was significantly different when all events were included (P=0.027). Neurological events increased markedly between months 34 and 66 (P=0.004). Conclusion Perioperative and early postoperative event-free survival rates were similar in all three methods. By the beginning of the 34th month, the only CABG group has been negatively separated due to neurological events. In the choice of methodology, “most threatened organ priority’’ was considered as clinical parameter.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"648 - 653"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49149295","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":"C-Reactive Protein to Albumin Ratio as A Novel Inflammatory-Based Marker for 30-Day Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement","authors":"F. Katkat, M. Kalyoncuoğlu, S. Ozcan, S. Tuğrul, Hanife Abanus, O. İnce, M. Ballı, I. Sahin, E. Okuyan","doi":"10.21470/1678-9741-2020-0482","DOIUrl":"https://doi.org/10.21470/1678-9741-2020-0482","url":null,"abstract":"Objective We aimed to investigate whether C-reactive protein to albumin ratio (CAR) predicts the early and late mortality in patients undergoing transcatheter aortic valve replacement (TAVR). Methods This study was retrospectively designed and includes 170 TAVR patients with a mean age of 78.4±7.1 years. Patients were divided into 2 groups as those who died and those who survived, taking into account the follow-up period. Complete blood count, serum CRP and serum albumin were obtained on admission. The CAR value of all patients was calculated and the relationship of CAR with early (≤30 days) and late mortality (>30 days) was evaluated. Results The median follow-up period was 19 [7-31] months (maximum 66 months). Early mortality was observed in 20 (11.8%) patients, whereas late mortality was observed in 39 (22.9%) patients, most of them male (61.1%, P=0.04). Non-survivors had greater CAR value, higher baseline serum CRP level and lower baseline albumin level than survivors (P<0.01, for all parameters). According to multivariate analysis models, CAR (HR: 1.020, P<0.01) and TVAR score (HR: 1.294, P<0.01) were found to be independent predictors of early mortality while CRP and albumin were not. The area under the curve (AUC) for CAR was 0.73 with a P <0.01. A CAR >15.6 predicted the early mortality with 80% sensitivity and 57% specificity. Conclusion The novel inflammatory marker CAR can be used as a reliable marker in predicting 30-day mortality in patients undergoing TAVR.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"37 1","pages":"292 - 300"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43511423","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":"Profile of Psychosocial Rehabilitation Centres for Persons with Substance Use Disorders in Bengaluru: A Cross-Sectional Study.","authors":"Thangaduraipandi Ramakrishnan, Sinu Ezhumalai, Dhanasekarapandian Ramasamy","doi":"10.1007/s40737-022-00265-9","DOIUrl":"10.1007/s40737-022-00265-9","url":null,"abstract":"<p><p>Substance use disorder is a major global health problem. There is limited information available about the pattern of utilization of psychosocial rehabilitation services (de-addiction service centres) for persons with substance use disorder. To study the profile of psychosocial rehabilitation centres (de-addiction service centres) for persons with substance use disorder in Bengaluru. To assess the staff profile, organisation profile, to examine the nature, types of treatment and psychosocial rehabilitation services offered by the de-addiction centers. Cross-sectional study design was used. Sample size: Out of 43 private organizations, 32 were eligible to participate. Out of 32, one-third (N=10) of the organizations participated in the study. Based on minimum standards of care manual for substance use disorders, an online questionnaire regarding organizational profile, staff pattern, nature and type of treatments, range of psychosocial rehabilitation services offered. Data was collected through online using google forms. Descriptive statistics such as frequency was used to analyse the data collected. All 10 organizations have a minimum one social worker, psychologist, nursing staff, and other supportive staff in the psychosocial rehabilitation centers. All the organizations have basic infrastructure and amenities as per minimum standards of care. Most organizations provide recovery oriented services, almost all organizations provide telephonic follow-up and home visit services. Most organizations provide psychosocial rehabilitation services. Most organization expressed need for training their counsellors on on group therapy and family therapy techniques. Most organisations possibly comply with a minimum standard of care and service, follow a twelve-step treatment approach, reintegrate the recovered clients in the community, provide an opportunity to work in their respective organisations. Most organisations have self-help (AA) groups, offer assistance programmes for family members, supportive educational groups and halfway-home care services.</p>","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"14 1","pages":"293-302"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89663640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SUPPLEMENT - Translation and Validation of the Boston Technical Performance Score in a Developing Country","authors":"","doi":"10.21470/1678-9741-2021-0485s","DOIUrl":"https://doi.org/10.21470/1678-9741-2021-0485s","url":null,"abstract":"","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68503872","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":"Permanent Pacemaker Post Cardiac Surgery: where do we Stand?","authors":"A. Harky, Francesca Gaetta, A. Noshirwani, Shubhi Gutpa, M. Kermali, A. Muir","doi":"10.21470/1678-9741-2020-0054","DOIUrl":"https://doi.org/10.21470/1678-9741-2020-0054","url":null,"abstract":"Cardiac arrhythmias and requirement for permanent pacemaker (PPM) post open-heart surgery are some of the complications that can contribute to significant morbidities postoperatively and delay in normal recovery if not treated promptly. The reported rate of a PPM following isolated, elective coronary artery bypass grafting is < 1%, while following aortic or mitral valve surgery it is reported to be < 5%. There are several perioperative factors that can contribute to the increased likelihood of PPM requirement including preoperative rhythm, severity and location of cardiac ischaemia, perioperative variables, and the cardiac procedures performed. Optimization of such factors can possibly lead to a lower rate of PPM and, therefore, a lower rate of complications. This literature review focuses on PPM following each procedural type and how to minimize it.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68503595","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":"Mario Vrandecic, Cardiovascular Surgeon, University Professor, Researcher, Entrepreneur, Businessman, and Leader way ahead of his time","authors":"L. F. Drumond","doi":"10.21470/1678-9741-2019-0610","DOIUrl":"https://doi.org/10.21470/1678-9741-2019-0610","url":null,"abstract":"","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"35 1","pages":"847 - 848"},"PeriodicalIF":0.0,"publicationDate":"2020-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47327937","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":"Giant Aneurysm of The Non-Coronary Sinus of Valsalva","authors":"M. Uğurlucan, Y. Yıldız, E. Guler, M. Ulukan, D. Oztas, E. Ata, A. Kahraman, K. Erkanlı, H. Turkoglu","doi":"10.21470/1678-9741-2019-0054","DOIUrl":"https://doi.org/10.21470/1678-9741-2019-0054","url":null,"abstract":"Aneurysms of the sinuses of Valsalva are defined as dilatation of the aortic root region between the aortic annulus and the sinotubular junction. Isolated aneurysms of the sinus of Valsalva are rare cardiovascular pathologies. They may be congenital, especially secondary to connective tissue disorders or in conjunction with congenital cardiac defects, or acquired such as secondary to infections or trauma. Small sized aneurysm without rupture in asymptomatic patients may be followed; however, latter cases require intervention and surgery is the gold standard treatment modality. In this report, a 41-year-old male patient was reported with giant aneurysm of the non-coronary sinus of Valsalva whom underwent aortic root sparing surgical aortic sinus of Valsalva reconstruction.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"35 1","pages":"589 - 592"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43095714","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":"Chylous Ascites Developing after Open Thoracoabdominal Aortic Aneurysm Repair in a Patient with Marfan Syndrome","authors":"H. Kara","doi":"10.21470/1678-9741-2019-0019","DOIUrl":"https://doi.org/10.21470/1678-9741-2019-0019","url":null,"abstract":"Chylous ascites is the pathologic accumulation of chylous fluid in the peritoneal cavity, caused by lymphomas, metastatic malignancies, and abdominal surgeries, rarely due to surgical trauma of the cisterna chyli or its major branches. A 24-year-old man with history of Marfan syndrome presented to our hospital with abdominal distention, abdominal pain, fluid in the incision region, and weakness. He had underwent an elective open aneurysm repair surgery nine days before for thoracoabdominal aortic aneurysm. Computed tomography revealed massive fluid collection in the abdominal cavity, which was drained surgically. He was diagnosed with chylous ascites and was discharged after conservative treatment.","PeriodicalId":54481,"journal":{"name":"Revista Brasileira De Cirurgia Cardiovascular","volume":"35 1","pages":"584 - 588"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42733897","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}