Brazilian journal of cardiovascular surgery最新文献

Echocardiographic Anatomical Risk Factors for Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Retrospective Cohort Study. 经导管主动脉瓣置换术后永久起搏器植入的超声心动图解剖危险因素：一项回顾性队列研究。

Brazilian journal of cardiovascular surgery Pub Date : 2025-07-02 DOI: 10.21470/1678-9741-2024-0127

Hugo Mantilla-Gutierrez, Jaime Cabrales, Víctor Herrera

{"title":"Echocardiographic Anatomical Risk Factors for Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Retrospective Cohort Study.","authors":"Hugo Mantilla-Gutierrez, Jaime Cabrales, Víctor Herrera","doi":"10.21470/1678-9741-2024-0127","DOIUrl":"https://doi.org/10.21470/1678-9741-2024-0127","url":null,"abstract":"Introduction: Transcatheter aortic valve replacement (TAVR) has revolutionized the management of patients with aortic valve disease. However, the need for pacemaker implantation remains a frequent complication. The objectives of this study were to estimate the incidence of permanent pacemaker implantation and to determine the associated risk factors.Methods: This is a retrospective cohort study of adults who underwent TAVR, developed cardiac conduction disease, and required permanent pacemaker implantation during hospitalization. Groups were compared according to post procedure pacemaker implantation or not; and recognized preoperative and echocardiographically identified anatomic factors related to the procedure were evaluated. A predictive model was generated using multiple logistic regression.Results: A total of 234 patients were included. The pacemaker implantation rate was 14%, and risk factors associated with this procedure were age (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.01 - 1.22), female sex (OR 0.11, 95% CI 0.01 - 0.61), body surface area > 1.51 m2 (OR 9.78, 95% CI 2.13 - 73.6), right bundle branch block (OR 22.5, 95% CI 2.62 - 242), first-degree atrioventricular block (OR 18.8, 95% CI 3.04 - 150), and implantation depth measured via echocardiography (OR 1.76, 95% CI 1.26 - 2.64). The model demonstrated good predictive capability with an area under the receiver operating characteristic curve of 0.934 (P < 0.001, 95% CI 0.878 - 0.988).Conclusion: A well-performing predictive model was developed with six independent risk factors for the need for pacemaker implantation after TAVR, based on factors related to anatomic echocardiographic measurements associated with classic risk factors.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 4","pages":"e20240127"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimizing Antibiotic Therapy and Circuit Management in Extracorporeal Membrane Oxygenation: A Comprehensive Narrative Review of Clinical Strategies and Evidence. 体外膜氧合优化抗生素治疗和循环管理：临床策略和证据的综合叙述综述。

Brazilian journal of cardiovascular surgery Pub Date : 2025-07-02 DOI: 10.21470/1678-9741-2024-0158

Ignazio Condello

{"title":"Optimizing Antibiotic Therapy and Circuit Management in Extracorporeal Membrane Oxygenation: A Comprehensive Narrative Review of Clinical Strategies and Evidence.","authors":"Ignazio Condello","doi":"10.21470/1678-9741-2024-0158","DOIUrl":"https://doi.org/10.21470/1678-9741-2024-0158","url":null,"abstract":"Introduction: Extracorporeal membrane oxygenation (ECMO) has emerged as a life-saving therapy for patients with severe respiratory and cardiac failure. However, the management of infections and circuit sequestration remains a significant challenge in ECMO patients. This narrative review aims to provide a comprehensive overview of current strategies and evidence related to antibiotics therapy and circuit management in ECMO.Methods: A systematic search was conducted in medical databases including PubMed® and Google Scholar to identify relevant studies published up to January 2022. Keywords such as \"antibiotics therapy ECMO\", \"circuit sequestration ECMO\", and related terms were used to retrieve articles. Studies focusing on infections acquired during ECMO, antibiotic dosing, circuit optimization, and outcomes were included.Results: The search yielded a total of 20 relevant studies encompassing various aspects of antibiotics therapy and circuit sequestration in ECMO patients. Key findings include the epidemiology of infections acquired during ECMO, optimal antibiotic dosing strategies, risk factors for circuit-related complications, and the impact of circuit changes on patient outcomes. Effective management of infections and circuit sequestration is essential to improve outcomes in ECMO patients.Conclusion: This review highlights the importance of tailored antibiotic therapy, vigilant circuit monitoring, and evidence-based practices to mitigate complications and optimize patient care during ECMO support. Further research is needed to refine existing strategies and enhance the overall management of ECMO-associated infections and circuit issues.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 4","pages":"e20240158"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bridging the Gap Between Research and Clinical Practice in Cardiac Tumors. 弥合心脏肿瘤研究与临床实践之间的差距。

Brazilian journal of cardiovascular surgery Pub Date : 2025-07-02 DOI: 10.21470/1678-9741-2024-0298

Basil Joy

引用次数: 0

Therapeutic Considerations of Post-Myocardial Infarction Ventricular Septal Defect in the Elderly - An Educational Presentation. 老年人心肌梗死后室间隔缺损的治疗考虑-一份教育报告。

Brazilian journal of cardiovascular surgery Pub Date : 2025-07-02 DOI: 10.21470/1678-9741-2024-0249

Omar Julián Chavarro-Alfonso, Rene Ricardo Díaz, Efraín Alonso Gómez

引用次数: 0

Survival Analysis in Adult Heart Transplantation: Correspondence. 成人心脏移植的生存分析：对应。

Brazilian journal of cardiovascular surgery Pub Date : 2025-07-02 DOI: 10.21470/1678-9741-2024-0310

Hinpetch Daungsupawong, Viroj Wiwanitkit

引用次数: 0

Between Science and Humanity: The Journey of Paulo Évora. 科学与人文之间：保罗之旅Évora。

Brazilian journal of cardiovascular surgery Pub Date : 2025-06-30 DOI: 10.21470/1678-9741-2025-0902

André Luppi, Henrique Murad

引用次数: 0

Evaluation of Systemic Microcirculatory Vessel Density in the Early Postoperative Period of Heart Valve Surgery: an Observational Study. 心脏瓣膜手术术后早期系统微循环血管密度的评价：一项观察性研究。

Brazilian journal of cardiovascular surgery Pub Date : 2025-06-18 DOI: 10.21470/1678-9741-2024-0039

Marcos Vinícius Fernandes, Andrea de Lorenzo, Eduardo Tibiriça

{"title":"Evaluation of Systemic Microcirculatory Vessel Density in the Early Postoperative Period of Heart Valve Surgery: an Observational Study.","authors":"Marcos Vinícius Fernandes, Andrea de Lorenzo, Eduardo Tibiriça","doi":"10.21470/1678-9741-2024-0039","DOIUrl":"10.21470/1678-9741-2024-0039","url":null,"abstract":"Introduction: The present study evaluated systemic microcirculatory alterations occurring in the early postoperative period of cardiopulmonary bypass-assisted heart valve surgery compared to preoperative parameters through noninvasive point-of-care microcirculatory imaging of the sublingual area using incident dark field imaging.Methods: This was a single-center cross-sectional observational study that included 23 patients aged 49 ± 13 years. Sublingual microcirculatory density and perfusion were evaluated using a handheld camera based on incident dark field imaging before surgery and in the early postoperative period.Results: The total number of capillary vessels (1029 ± 13, P=0.0006), total length of capillary vessels (29.4 ± 3.2 mm, P=0.0005), and capillary vessel density (16.8 ± 1.8 mm/mm2, P=0.0005) were all higher after surgery. On the other hand, the total number of noncapillary vessels (85 ± 34, P=0.05), total length of noncapillary vessels (1.9 ± 0.8 mm, P=0.07), and noncapillary vessel density (1.1 ± 0.5 mm/mm2, P=0.07) were similar before and after surgery. The total number of capillary vessels was higher after surgery (1109 ± 92) in patients who received milrinone infusion (P=0.002) but not in patients who did not receive milrinone (986 ± 129, P=0.05).Conclusion: After cardiac valve surgery, there was an improvement in microvascular parameters concerning capillary vessels and in the total number of microvessels. Moreover, significant positive correlations were found between the use of milrinone and these parameters. The study demonstrated the usefulness of handheld cameras for bedside evaluation of the microcirculation.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 4","pages":"e20240039"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Technical Performance Score: A Robust Predictor of Morbidity Following the Norwood Procedure at a Developing Country Institution. 技术性能评分：发展中国家机构诺伍德手术后发病率的可靠预测指标。

Brazilian journal of cardiovascular surgery Pub Date : 2025-06-18 DOI: 10.21470/1678-9741-2024-0442

Davi Freitas Tenório, Leonardo Augusto Miana, João Guilherme Vidal Meyer, Eric Shih Katsuyama, Christian Ken Fukunaga, Aida Luiza Ribeiro Turquetto, Luiza Patrick Amato, Marcelo Biscegli Jatene, Fabio B Jatene

{"title":"Technical Performance Score: A Robust Predictor of Morbidity Following the Norwood Procedure at a Developing Country Institution.","authors":"Davi Freitas Tenório, Leonardo Augusto Miana, João Guilherme Vidal Meyer, Eric Shih Katsuyama, Christian Ken Fukunaga, Aida Luiza Ribeiro Turquetto, Luiza Patrick Amato, Marcelo Biscegli Jatene, Fabio B Jatene","doi":"10.21470/1678-9741-2024-0442","DOIUrl":"10.21470/1678-9741-2024-0442","url":null,"abstract":"Introduction: The Norwood operation has transformed the approach to hypoplastic left heart syndrome and its variants. Given the complexity of this procedure, postoperative residual injuries are prevalent.Objective: To evaluate the impact of significant residual injuries on clinical outcomes and mortality in Norwood procedure patients at a high-volume tertiary center in a developing nation using the technical performance score (TPS).Methods: This single-center, retrospective study included patients who underwent the Norwood procedure between December 2018 and February 2023. Data on demographics, echocardiograms, complications, intensive care unit stay, and mortality were collected. Logistic regression and linear analyses assessed the impact of TPS on outcomes.Results: Of 69 patients, nine (13%) were excluded due to incomplete echocardiographic data, leaving 60 (87%) for TPS classification. Among them, 28 (47%) were male. TPS classification was as follows: 40 (66%) in class 1 (excellent), five (8.3%) in class 2 (adequate), and 15 (25%) in class 3 (inadequate), indicating significant residual lesions or need for reintervention. The 30-day mortality rate was 21.6%, increasing to 41.6% before the next stage. In TPS class 3, 30-day mortality was 33% vs. 17% in classes 1 and 2 (P = 0.27). Interstage mortality was 60% in class 3 compared to 35% in other groups (P = 0.13). Major complications were significantly higher in TPS class 3 (93% vs. 55.5%, P = 0.04).Conclusion: TPS effectively predicts major complications post-Norwood and serves as a valuable tool for improving patient outcomes.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 4","pages":"e20240442"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of Systemic Immune-Inflammation Index on Prognosis in Non-Functional Mitral Regurgitation Patients Undergoing Isolated Mitral Valve Replacement. 全身免疫炎症指数对非功能性二尖瓣返流患者行孤立二尖瓣置换术预后的影响。

Brazilian journal of cardiovascular surgery Pub Date : 2025-06-18 DOI: 10.21470/1678-9741-2023-0362

Busra Temel Yuksel, Mehmet Isık, Omer Tanyeli, Serkan Yıldırım, Niyazi GOrmus

{"title":"Effect of Systemic Immune-Inflammation Index on Prognosis in Non-Functional Mitral Regurgitation Patients Undergoing Isolated Mitral Valve Replacement.","authors":"Busra Temel Yuksel, Mehmet Isık, Omer Tanyeli, Serkan Yıldırım, Niyazi GOrmus","doi":"10.21470/1678-9741-2023-0362","DOIUrl":"10.21470/1678-9741-2023-0362","url":null,"abstract":"Objective: To investigate the effect of preoperative and postoperative systemic immune-inflammation index (SII) values on early prognosis in patients with nonfunctional mitral regurgitation etiology undergoing isolated mitral valve replacement (MVR).Methods: A total of 176 patients with isolated MVR performed from 2015 to 2021 were retrospectively investigated. The platelet, lymphocyte, and neutrophil counts were measured, and SII, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) values were calculated preoperatively and on the first and fourth days postoperatively. The correlations with postoperative 30-day early-term prognosis and mortality were investigated.Results: Mean age of the patients was 55.4 years, 69.9% were female, and 30.1% were male. At 30-day follow-up, 9% (n = 16) of patients died. There were significant positive correlations observed between age (P < 0.001), preoperative NLR (P = 0.003), preoperative SII (P = 0.02), and postoperative fourth day NLR (P < 0.001) values with 30-day mortality. Receiver operating characteristic analysis identified that age + preoperative SII (P < 0.001), age + preoperative NLR (P < 0.001), and age + postoperative fourth day NLR (P = 0.001) combinations were significant predictive factors for 30-day mortality. There was a significant positive correlation between postoperative fourth day SII value with intensive care unit (ICU) admission duration (P < 0.001, Ρ = 0.308).Conclusion: For non-functional, isolated MVR patients, preoperative and postoperative fourth day SII and NLR values were found to provide an idea about 30-day prognosis. Additionally, patients with high postoperative fourth day SII values were observed to have longer ICU stays.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 4","pages":"e20230362"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical Treatment of Pulmonary Artery Angiosarcoma - A Ten-Year Experience. 肺动脉血管肉瘤的外科治疗-十年经验。

Brazilian journal of cardiovascular surgery Pub Date : 2025-06-18 DOI: 10.21470/1678-9741-2023-0441

Alexander Edemskiy, Oksana Vasiltseva, Elena Kliver, Natalya Novikova, Dmitry Sirota, Alexander Chernyavskiy

{"title":"Surgical Treatment of Pulmonary Artery Angiosarcoma - A Ten-Year Experience.","authors":"Alexander Edemskiy, Oksana Vasiltseva, Elena Kliver, Natalya Novikova, Dmitry Sirota, Alexander Chernyavskiy","doi":"10.21470/1678-9741-2023-0441","DOIUrl":"10.21470/1678-9741-2023-0441","url":null,"abstract":"Introduction: Pulmonary artery angiosarcoma is a rare and extremely severe tumor. Our study summarizes the clinical data of patients treated for pulmonary artery angiosarcoma over the period of 2010-2020.Methods: We retrospectively analyzed cases of surgical treatment of patients with diagnosis of pulmonary artery angiosarcoma at our center. Data of operative findings, short-term follow-up, and the long-term results were reviewed where available.Results: The 30-day mortality rate was six (67%) out of nine patients. Three (33%) patients were discharged. Data on pulmonary vascular resistance in the earlyand long-term postoperative periods were assessed if possible. Certain computed tomography signs have been identified that can be used to suspect pulmonary artery angiosarcoma and make a differential diagnosis with chronic thromboembolic pulmonary hypertension.Conclusion: The surgical treatment of choice is pneumonectomy with contralateral pulmonary endarterectomy. Oncological vigilance regarding angiosarcoma in occlusive-stenotic lesions of the pulmonary artery is extremely important. Patients' assessment must be carried out in an expert cardiothoracic surgery center with the involvement of an oncological crew.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 4","pages":"e20230441"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0