Brazilian journal of cardiovascular surgery最新文献

{"title":"Are Blood Groups a Predictive Factor in Determining the Severity of Coronary Artery Disease in Patients Undergoing Coronary Heart Surgery?","authors":"Mumtaz Murat Yardımcı, Cengiz Guven","doi":"10.21470/1678-9741-2024-0280","DOIUrl":"10.21470/1678-9741-2024-0280","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated whether blood groups are predictive factors for the severity and postoperative mortality in patients with coronary artery disease (CAD) undergoing bypass surgery with extracorporeal circulatory support.</p><p><strong>Methods: </strong>A retrospective cohort study examined data from 4,002 patients who had coronary surgery for CAD between January 1st, 2014, and December 30th, 2020. The study recorded blood groups, demographic information, and and SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) scores for patients who died within the first month post-operation.</p><p><strong>Results: </strong>Multiple regression analysis showed significant associations with the SYNTAX score (P < 0.001). Individuals with blood group O had a 2.970 times decrease in their SYNTAX score, while those with blood group A showed a 0.260 times increase, and those with blood group B had a 1.895 times decrease. Analyzing the effect of blood groups on mortality, the risk of death was significantly higher compared to blood group O; in group A the risk of death was 2.65 times higher than in group O (P = 0.005, odds ratio [OR]: 2.65, 95% confidence interval [CI]: 1.35 - 5.19). In group B the risk of death was 2.29 times higher than in group O (P = 0.048, OR: 2.29, 95% CI: 1.01 - 5.23). The Rh factor did not affect either mortality or CAD severity.</p><p><strong>Conclusion: </strong>In patients undergoing coronary surgery, the SYNTAX score was found to be significantly lower in blood groups O and B. However, regarding mortality, both blood groups A and B carried a higher risk of death when compared to group O.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727260","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}

{"title":"Portable Smartphone-Based Thermal Imaging for Real-Time Assessment of Coronary Artery Bypass Grafting Graft Patency and Cardioplegia Distribution: A Feasibility Case Series.","authors":"Henrique Madureira da Rocha Coutinho, Eduardo Saito, Gustavo Kikuta, Bernardo Ferreira Americano Brasil, Pedro Ricardo Garcia Jazbik, Gabriel Bittencourt, Giovana Pedro, Nathalia Lino, Joaquim Henrique de Souza Coutinho, Rodolfo Acatauassú Nunes","doi":"10.21470/1678-9741-2025-0328","DOIUrl":"10.21470/1678-9741-2025-0328","url":null,"abstract":"<p><strong>Introduction: </strong>Intraoperative assessment of graft patency and cardioplegia distribution during coronary artery bypass grafting (CABG) is essential for surgical success but remains challenging in resource-limited settings. Conventional tools such as flow measurement or intraoperative angiography are often unavailable in public hospitals, where evaluation relies mainly on clinical judgment.</p><p><strong>Methods: </strong>We conducted a prospective observational case series of 10 CABG patients operated between February and July 2025 at a public university hospital. Myocardial temperature distribution during cardioplegia infusion and after grafting was monitored with a portable smartphone-based thermal camera (FLIR One Pro).</p><p><strong>Results: </strong>Thermal imaging documented cardioplegia distribution and graft patency in all cases. In one patient, heterogeneous distribution in the lateral wall was identified, leading to a change in surgical sequence and improved myocardial protection. All patients were weaned from bypass with stable rhythm, showed expected postoperative troponin kinetics, and had no new wall motion abnormalities on echocardiography.</p><p><strong>Conclusion: </strong>Portable thermal imaging is a feasible, safe, and inexpensive method for real-time intraoperative evaluation of cardioplegia distribution and graft patency in CABG. It may represent a valuable adjunct in resource-limited environments. Larger studies are needed to confirm these findings.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286056","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}

{"title":"The Leadership of the Brazilian Journal of Cardiovascular Surgery in the Digital Transformation of Cardiovascular Surgery.","authors":"Vivian Masutti Jonke, Henrique Murad, Andre Luppi","doi":"10.21470/1678-9741-2025-0454","DOIUrl":"10.21470/1678-9741-2025-0454","url":null,"abstract":"","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286080","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}

{"title":"Midterm Results of Neocuspidization of the Aortic Valve with Ozaki Technique in Adults.","authors":"Seguel S Enrique, Reyes M Rodrigo, González L Roberto, Rubilar P Héctor, Sepúlveda P Camila, Barril M Gustavo, Stockins L Aleck","doi":"10.21470/1678-9741-2024-0126","DOIUrl":"10.21470/1678-9741-2024-0126","url":null,"abstract":"<p><p>The neocuspidization technique using autologous pericardium (AVNeo®) is a recent alternative for aortic valve replacement in selected patients. Between 2019 and 2023, we applied it in 56 patients, evaluating surgical outcomes, survival, reintervention rates, and clinical and echocardiographic results. We analyzed its advantages, patient selection criteria, limitations, and management of bicuspid valves. We also assessed whether it is suitable for all patients and discussed the midterm outcomes observed. AVNeo® may offer a promising option, especially for younger patients, by preserving native anatomy and avoiding prosthetic materials, though long-term data and further research are still needed.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12599831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460618","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}

{"title":"Challenges to Open-Heart Surgery in Sub-Saharan Africa: A Narrative Review.","authors":"Victory Bassey Effiom, Abdullah K Alassiri, Victor Femi-Lawal, Eben-Ezer Genda, Jonas Lotanna Ibekwe, Achanga Bill-Smith Anyinkeng, Olalekan Kolawole Victor, Echieh C Peter","doi":"10.21470/1678-9741-2024-0351","DOIUrl":"10.21470/1678-9741-2024-0351","url":null,"abstract":"<p><p>The rising cardiovascular disease burden in Africa necessitates a strengthened healthcare system including enhanced access to cardiac surgery, the definitive treatment for several surgical cardiovascular diseases. Though open-heart surgery, the most invasive type of cardiac surgery, was already possible in Africa over five decades ago, with pioneering surgeons performing atrial septal defect repairs via surface cooling in Ghana as early as 1964, its development across the continent has been hindered by significant challenges. This study highlights the challenges faced by both established and nascent open-heart surgery programs across Africa. We further identify key areas for sustaining and expanding open-heart surgery programs, including robust training for surgeons and support staff, resource allocation, and enhanced capacity building. By systematically analyzing the landscape of open-heart surgery in Africa, this paper proposes a multifactorial approach to overcome these limitations and ensure equitable access to this life-saving intervention for a vastly underserved population.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12599830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460518","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}

{"title":"The Relationship Between Aortic Tissue Sirtuin 1 Levels and Type A Aortic Dissections and Ascending Aortic Aneurysms.","authors":"Mehmet Rum, Bulend Ketenci, Fatih Kizilyel, Bahar Sarikamis Johnson, Ulkan Celik, Berfin Ekin Gozukara Yildiz, Abdulkerim Ozhan","doi":"10.21470/1678-9741-2024-0218","DOIUrl":"10.21470/1678-9741-2024-0218","url":null,"abstract":"<p><strong>Introduction: </strong>Type A aortic dissections are pathologies with high mortality rates. Although ascending aortic aneurysms are typically planned for elective surgery, they are significant conditions in cardiovascular surgery due to their potential to cause type A aortic dissection. This study, which is the first to examine sirtuin 1 (SIRT1) in human ascending aortic tissues, aims to elucidate the relationship between ascending aortic pathologies and the SIRT1 protein.</p><p><strong>Methods: </strong>A case-control study was conducted using aortic tissues and demographic data from patients who underwent surgery for ascending aortic aneurysm and type A aortic dissection. Coronary artery bypass patients were selected as the control group. The groups were compared in terms of SIRT1 levels.</p><p><strong>Results: </strong>The study included a total of 46 patients (16 in the aneurysm group, 14 in the dissection group, and 16 in the control group). The SIRT1 protein level was the highest in the ascending aortic aneurysm group (214, interquartile range [IQR] 79 - 270), followed by the dissection group (172, IQR 148 - 224), and the lowest in the control group (104, IQR 78 - 123) (P = 0.014). SIRT1 level was found to be low in patients with coronary artery disease (P = 0.001), peripheral artery disease (P = 0.008), and hypertension (P = 0.023).</p><p><strong>Conclusions: </strong>Type A aortic dissections are associated with elevated SIRT1 levels in the tissue. Systemic atherosclerotic diseases, such as coronary and peripheral artery diseases, are associated with decreased SIRT1 levels. There is also a relationship between hypertension and sirtuin1 levels.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12661968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558567","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}

{"title":"Optimizing Saphenous Vein Harvesting with the No-Touch Technique Using LigaSure™ and Small Incisions: A Hybrid Approach for Coronary Artery Bypass Surgery.","authors":"Mauricio Peña Fernandez, Juan Contreras Reyes, Juan Carlos Bahamondes, Manuel Roque Cervetti","doi":"10.21470/1678-9741-2025-0001","DOIUrl":"10.21470/1678-9741-2025-0001","url":null,"abstract":"<p><p>Our technique described below offers a reproducible, cost-effective approach for no-touch saphenous vein harvesting that can be adopted by well-trained surgical teams. The hybrid no-touch technique, incorporating LigaSure™, small incisions, and pressurized closure, achieves excellent results with minimal major and local complications. Given the robust evidence supporting improved patency and outcomes, the no-touch approach should be considered a reliable and superior option for the second conduit in coronary artery bypass grafting procedures.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12661967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558545","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}

{"title":"Incidence and Predictors of Surgical Site Infection in Patients Undergoing Coronary Artery Bypass Grafting at a Reference Hospital in Brazil: Influence of Sex, Nutritional Risk, and Body Mass Index.","authors":"Giovana Alves Carvalho, Julia Souza Siqueira de Andrade, Bruno Mahler Mioto, Luiz Aparecido Bortolotto","doi":"10.21470/1678-9741-2025-0086","DOIUrl":"10.21470/1678-9741-2025-0086","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical site infection (SSI) following coronary artery bypass grafting (CABG) is a significant challenge that impacts quality of life and healthcare costs. Despite advances in surgical techniques and infection control measures, wound complications remain a major cause of morbidity and mortality. This study aimed to determine the incidence and factors associated with an increased risk of developing postoperative SSI in patients undergoing CABG.</p><p><strong>Methods: </strong>Retrospective cohort study with patients undergoing isolated CABG in a Brazilian hospital organization. Clinical data were collected through the hospital's information system. Univariate and multivariate analyses were used to determine risk factors associated with SSI. The analyses were performed using Jamovi® software, with a significance set at P < 0.05.</p><p><strong>Results: </strong>A total of 412 patients were enrolled in the study, comprising 292 (70.8%) men, with a mean age of 62.7 ± 8.6 years. A total of 54 (13.1%) patients developed SSI. After multivariate regression analysis, the odds ratios (OR) (95% confidence interval [CI]) of independent predictors of SSI were female sex (OR: 2.067; 95% CI: 1.030 - 4.148), higher preoperative body mass index (OR: 1.113; 95% CI: 1.038 - 1.194), nutritional risk (Nutritional Risk Screening 2002 score ≥ 3) (OR: 2.468; 95% CI: 1.034 - 5.886), and hospitalization time (OR: 1.057; 95% CI: 1.031 - 1.082).</p><p><strong>Conclusion: </strong>There are patient-related factors that increase the likelihood of developing an SSI after CABG. These findings suggest that addressing modifiable perioperative SSI risk factors may be beneficial in reducing SSI rates and enhancing postoperative recovery.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285986","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}

{"title":"Predictive Value of Uric Acid/Albumin Ratio for Postoperative Atrial Fibrillation Following Isolated Coronary Artery Bypass Surgery.","authors":"Ilhan Koyuncu, Saadet Aydın, Ecem Gurses, Fatih Sivri, Zeynep Yapan Emren, Ilker Gul","doi":"10.21470/1678-9741-2024-0348","DOIUrl":"10.21470/1678-9741-2024-0348","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative atrial fibrillation (POAF) is associated with an increased risk of morbidity and mortality. This study aims to investigate the predictive value of uric acid/albumin ratio (UAR) for POAF following isolated coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>This retrospective study screened patients who underwent isolated CABG between June 2017 and January 2024. POAF was diagnosed using standard clinical criteria. UAR was calculated by dividing the uric acid level by the albumin value.</p><p><strong>Results: </strong>This study included a total of 396 patients, who were categorized into two groups: POAF- and POAF+. Among them, 321 patients (mean age: 61.7 ± 10.8 years; 74.7% male) belonged to the POAF- group, while 75 patients (mean age: 71.3 ± 10.04 years; 68.1% male) were in the POAF+ group. While there were no significant differences observed between the groups in terms of sex, those in the POAF+ group were statistically older. The univariate and multivariate regression analyses revealed that age, C-reactive protein, hypertension, serum uric acid level, and UAR are independent risk factors for POAF. In the receiver operating characteristics analysis, the UAR (area under the curve [AUC]: 0.775) was found to be a better indicator compared to uric acid (AUC: 0.649) and serum albumin (AUC: 0.606), with a sensitivity of 70.5% and a specificity of 69.2%.</p><p><strong>Conclusion: </strong>UAR was shown to be an independent risk factor for POAF following isolated CABG.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222191","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}

{"title":"N-terminal Pro-brain Natriuretic Peptide as a Prognostic Biomarker for Cardiac Surgeries: A Systematic Review.","authors":"Barbara Giovanna Souza Silva Queiroz, Andressa Maranhão de Arruda, Lara Maria Moura de Sá Villa-Chan, Lays Sthefany Siqueira da Costa, José Gildo de Moura Monteiro, Ana Célia Oliveira Dos Santos","doi":"10.21470/1678-9741-2024-0417","DOIUrl":"10.21470/1678-9741-2024-0417","url":null,"abstract":"<p><strong>Introduction: </strong>N-terminal pro-brain natriuretic peptide (NT-proBNP) is a biomarker for heart stress and heart failure, with its production triggered by the stretching of cardiac fibers. This study investigates if elevated NT-proBNP levels can independently predict poor outcomes for patients undergoing heart surgery.</p><p><strong>Methods: </strong>A systematic review was performed in the PubMed®, Latin American and Caribbean Health Sciences Literature (or LILACS), Physiotherapy Evidence Database (PEDro), Web of Science, and Embase databases, with the following descriptors: \"NT-proBNP\" OR \"NTproBNP\" OR \"N- terminal pro-B-type natriuretic peptide\" OR \"N- terminal pro brain natriuretic peptide\" OR \"amino terminal pro brain natriuretic peptide\" AND \"Cardiovascular Surgical Procedures\" NOT \"Pediatric\" OR \"children\" NOT \"cancer\" OR \"oncology\" NOT \"animal*\". Articles that evaluated NT-proBNP and adverse outcomes in cardiac surgical patients were chosen. The levels of evidence and the strength of recommendation were assessed considering the Grading of Recommendations, Assessment, Development and Evaluation (or GRADE) system and validity by the PEDro scale. For systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (or PRISMA) criteria and the Population, Intervention, Comparison, Outcome (or PICO) strategy were followed.</p><p><strong>Results: </strong>Forty-seven articles were included, of which 17 were related to serious complications, including mortality.</p><p><strong>Conclusion: </strong>Preoperative NT-proBNP is a prognostic marker for mortality, length of stay in the postoperative intensive care unit, postoperative acute kidney injury, postoperative atrial fibrillation, postoperative low cardiac output, postoperative prolonged mechanical ventilation time, prolonged hospitalization time, unscheduled hospital readmission related to heart problems, and postoperative heart failure.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12599832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460701","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}