Brazilian journal of cardiovascular surgery最新文献

{"title":"Type A Aortic Dissection Following Heart Transplantation.","authors":"Alvaro Diego Peña, Eduardo Alberto Cadavid, Mayra Estacio, Alejandro Moreno-Angarita, Hector G Olaya, Stephany Olaya","doi":"10.21470/1678-9741-2023-0252","DOIUrl":"10.21470/1678-9741-2023-0252","url":null,"abstract":"<p><p>Cannulation strategies in aortic arch surgeries are a matter of immense discussion. Majority of time deep hypothermic circulatory arrest (DHCA) is the way out, but it does come with its set of demerits. Here we demonstrate a case with aortic arch dissection dealt with dual cannulation strategy in axillary and femoral artery without need for DHCA and ensuring complete neuroprotection of brain and spinal cord without hinderance of time factor. Inception of new ideas like this may decrease the need for DHCA and hence its drawbacks, thus decreasing the morbidity and mortality associated.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 5","pages":"e20230252"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11262033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749868","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":"Sutureless Aortic Valve Replacement vs. Transcatheter Aortic Valve Implantation in Patients with Small Aortic Annulus: Clinical and Hemodynamic Outcomes from a Multi-Institutional Study.","authors":"Lorenzo Di Bacco, Michele D'Alonzo, Marco Di Eusanio, Fabrizio Rosati, Marco Solinas, Massimo Baudo, Thierry Folliguet, Stefano Benussi, Theodor Fischlein, Claudio Muneretto","doi":"10.21470/1678-9741-2023-0155","DOIUrl":"10.21470/1678-9741-2023-0155","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare hemodynamic performances and clinical outcomes of patients with small aortic annulus (SAA) who underwent aortic valve replacement by means of sutureless aortic valve replacement (SUAVR) or transcatheter aortic valve implantation (TAVI).</p><p><strong>Methods: </strong>From 2015 to 2020, 622 consecutive patients with SAA underwent either SUAVR or TAVI. Through a 1:1 propensity score matching analysis, two homogeneous groups of 146 patients were formed. Primary endpoint: all cause-death at 36 months. Secondary endpoints: incidence of moderate to severe patient-prosthesis mismatch (PPM) and incidence of major adverse cardiovascular and cerebrovascular events (MACCEs).</p><p><strong>Results: </strong>All-cause death at three years was higher in the TAVI group (SUAVR 12.2% vs. TAVI 21.0%, P=0.058). Perioperatively, comparable hemodynamic performances were recorded in terms of indexed effective orifice area (SUAVR 1.12 ± 0.23 cm2/m2 vs. TAVI 1.17 ± 0.28 cm2/m2, P=0.265), mean transvalvular gradients (SUAVR 12.9 ± 5.3 mmHg vs. TAVI 12.2 ± 6.2 mmHg, P=0.332), and moderate-to-severe PPM (SUAVR 4.1% vs. TAVI 8.9%, P=0.096). TAVI group showed a higher cumulative incidence of MACCEs at 36 months (SUAVR 18.1% vs. TAVI 32.6%, P<0.001). Pacemaker implantation (PMI) and perivalvular leak ≥ 2 were significantly higher in TAVI group and identified as independent predictors of mortality (PMI: hazard ratio [HR] 3.05, 95% confidence interval [CI] 1.34-6.94, P=0.008; PPM: HR 2.72, 95% CI 1.25-5.94, P=0.012).</p><p><strong>Conclusion: </strong>In patients with SAA, SUAVR and TAVI showed comparable hemodynamic performances. Moreover, all-cause death and incidence of MACCEs at follow-up were significantly higher in TAVI group.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 4","pages":"e20230155"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749864","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":"Ascending Aortic Progression After Isolated Aortic Valve Replacement Among Patients with Bicuspid and Tricuspid Aortic Valves.","authors":"Hua-Jie Zheng, Xin Liu, San-Jiu Yu, Jun Li, Ping He, Wei Cheng","doi":"10.21470/1678-9741-2023-0438","DOIUrl":"10.21470/1678-9741-2023-0438","url":null,"abstract":"<p><strong>Objectives: </strong>The aims of the present study were to compare the long-term outcomes for ascending aortic dilatation and adverse aortic events after isolated aortic valve replacement between patients with bicuspid aortic valve (BAV) and tricuspid aortic valve ( TAV).</p><p><strong>Methods: </strong>This retrospective study included 310 patients who had undergone isolated aortic valve replacement with an ascending aorta diameter ≤ 45 mm between January 2010 and September 2021. The patients were divided into BAV group (n=90) and TAV group (n=220). The differences in the dilation rate of the ascending aorta and long-term outcomes were analyzed.</p><p><strong>Results: </strong>Overall survival was 89 ± 4% in the BAV group vs. 75 ± 6% in the TAV group at 10 years postoperatively (P=0.007), yet this difference disappeared after adjusting exclusively for age (P=0.343). The mean annual growth rate of the ascending aorta was similar between the two groups during follow-up (0.5 ± 0.6 mm/year vs. 0.4 ± 0.5 mm/year; P=0.498). Ten-year freedom from adverse aortic events was 98.1% in the BAV group vs. 95.0% in the TAV group (P=0.636). Multivariable analysis revealed preoperative ascending aorta diameter to be a significant predictor of adverse aortic events (hazard ratio: 1.76; 95% confidence interval: 1.33 to 2.38; P<0.001).</p><p><strong>Conclusion: </strong>Our study revealed that the long-term survival and the risks of adverse aortic events between BAV and TAV patients were similar after isolated aortic valve replacement. BAV was not a risk factor of adverse aortic events.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 4","pages":"e20230438"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749858","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":"Resection of Mycotic Iliac Artery Aneurysm with Extra-Anatomic Bypass: An Alternative to Aneurysmorrhaphy in Difficult Situations.","authors":"Vikas Deep Goyal, Gaurav Misra, Akhilesh Pahade, Neeraj Prajapati","doi":"10.21470/1678-9741-2023-0350","DOIUrl":"10.21470/1678-9741-2023-0350","url":null,"abstract":"<p><p>Mycotic aneurysms of the iliac and other large arteries are rare and are associated with increased morbidity and mortality. Treatment of mycotic aneurysms usually requires modification of the surgical technique done for cases of degenerative or atherosclerotic aneurysms. Degenerative and atherosclerotic fusiform aneurysms are usually managed with aneurysmorrhaphy using a prosthetic graft, which however is not ideal for mycotic aneurysms. Avoidance of prosthetic material at the site of mycotic aneurysm is a better option with higher chances of resolution of infection and favorable patient outcome.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 4","pages":"e20230350"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749863","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":"Minimally Invasive Coronary Artery Bypass Grafting in a Low-Risk Asian Cohort: A Propensity-Score Matched Study.","authors":"Zhi Xian Ong, Duoduo Wu, Jai Ajitchandra Sule, Guohao Chang, Faizus Sazzad, Haidong Luo, Peggy Hu, Theo Kofidis","doi":"10.21470/1678-9741-2022-0421","DOIUrl":"10.21470/1678-9741-2022-0421","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive coronary artery bypass grafting (MICS CABG) offers a new paradigm in coronary revascularization. This study aims to compare the outcomes of MICS CABG with those of conventional median sternotomy CABG (MS CABG) within a growing minimally invasive cardiac surgical program in Singapore.</p><p><strong>Methods: </strong>Propensity matching produced 111 patient pairs who underwent MICS CABG or MS CABG between January 2009 and February 2020 at the National University Heart Centre, Singapore. Minimally invasive direct coronary artery bypass surgery patients were matched to single- or double-graft MS CABG patients (Group 1). Multivessel MICS CABG patients were matched to MS CABG patients with equal number of grafts (Group 2).</p><p><strong>Results: </strong>Overall, MICS CABG patients experienced shorter postoperative length of stay (P<0.071). In Group 2, procedural duration (P<0.001) was longer among MICS CABG patients, but it did not translate to adverse postoperative events. Postoperative outcomes, including 30-day mortality, reopening for bleeding, new onset atrial fibrillation as well as neurological, pulmonary, renal, and infectious complications were comparable between MICS and MS CABG groups.</p><p><strong>Conclusion: </strong>MICS CABG is a safe and effective approach for surgical revascularization of coronary artery disease and trends toward a reduction in hospital stay.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 4","pages":"e20220421"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749861","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":"Celebrating 50 Years of Excellence: The Legacy of Cardiovascular Surgery in Brazil and the Role of BJCVS.","authors":"Andreia C Feitosa do Carmo, Camila Sáfadi Alves Gonçalves, Paulo Roberto B Evora","doi":"10.21470/1678-9741-2024-0992","DOIUrl":"10.21470/1678-9741-2024-0992","url":null,"abstract":"","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 3","pages":"e20240992"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11197855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452258","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 of Congenital Heart Surgery in Brazil: It is Time to Designate Pediatric Congenital Heart Surgery Subspecialty.","authors":"Valdester Cavalcante Pinto, Leonardo Augusto Miana, Fábio Binhara Navarro, Bruno da Costa Rocha, Renato Samy Assad, Marcos Aurélio Barboza de Oliveira, Fábio Said Salum, Ulisses Alexandre Croti, Beatriz Helena Sanches Furlanetto, Marcelo Biscegli Jatene, Luiz Fernando Caneo, Andrey José de Oliveira Monteiro, Fernando Ribeiro de Moraes, Fernando Antoniali, Pedro Rafael Salerno, Vinicius José da Silva Nina","doi":"10.21470/1678-9741-2024-0138","DOIUrl":"10.21470/1678-9741-2024-0138","url":null,"abstract":"<p><p>Congenital heart disease (CHD) affects eight to ten out of every 1,000 births, resulting in approximately 23,057 new cases in Brazil in 2022. About one in four children with CHD requires surgery or other procedures in the first year of life, and it is expected that approximately 81% of these children with CHD will survive until at least 35 years of age. Professionals choosing to specialize in CHD surgery face numerous challenges, not only related to mastering surgical techniques and the complexity of the diseases but also to the lack of recognition by medical societies as a separate subspecialty. Furthermore, families face difficulties when access to services capable of providing treatment for these children. To address these challenges, it is essential to have specialized hospitals, qualified professionals, updated technologies, sustainable industry, appropriate financing, quality assessment systems, and knowledge generation. The path to excellence involves specialization across all involved parties. As we reflect on the importance of Pediatric Cardiovascular Surgery and Congenital Heart Diseases establishing themselves as a subspecialty of Cardiovascular Surgery, it is essential to look beyond our borders to countries like the United States of America and United Kingdom, where this evolution is already a reality. This autonomy has led to significant advancements in research, education, and patient care outcomes, establishing a care model. By following this path in Brazil, we not only align our practice with the highest international standards but also demonstrate our maturity and the ability to meet the specific needs of patients with CHD and those with acquired childhood heart disease.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 4","pages":"e20240138"},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072450","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":"Evaluation of the Patients with Recurrent Angina After Coronary Artery Bypass Grafting.","authors":"Salih Salihi, Halil İbrahim Erkengel, Fatih Toptan, Bilhan Özalp, Hakan Saçlı, İbrahim Kara","doi":"10.21470/1678-9741-2023-0303","DOIUrl":"10.21470/1678-9741-2023-0303","url":null,"abstract":"<p><strong>Introduction: </strong>In this study, we aimed to evaluate the most common causes of recurrent angina after coronary artery bypass grafting (CABG) and our treatment approaches applied in these patients.</p><p><strong>Methods: </strong>We included all patients who underwent CABG, with or without percutaneous coronary intervention after CABG, at our hospital from September 2013 to December 2019. Patients were divided into two groups according to the time of onset of anginal pain after CABG. Forty-five patients (58.16 ± 8.78 years) had recurrent angina in the first postoperative year after CABG and were specified as group I (early recurrence). Group II (late recurrence) comprised 82 patients (58.05 ± 8.95 years) with angina after the first year of CABG.</p><p><strong>Results: </strong>The mean preoperative left ventricular ejection fraction was 53.22 ± 8.87% in group I, and 54.7 ± 8.58% in group II (P=0.38). No significant difference was registered between groups I and II regarding preoperative angiographic findings (P>0.05). Failed grafts were found in 27.7% (n=28/101) of the grafts in group I as compared to 26.8% (n=51/190) in group II (P>0.05). Twenty-four (53.3%) patients were treated medically in group I, compared with 54 (65.8%) patients in group II (P=0.098). There was a need for intervention in 46.6% (n=21) of group I patients, and in 34.1% (n=28) of group II patients.</p><p><strong>Conclusion: </strong>Recurrent angina is a complaint that should not be neglected because most of the patients with recurrent angina are diagnosed with either native coronary or graft pathology in coronary angiography performed.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 4","pages":"e20230303"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946439","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":"Hemadsorption to Contain Postoperative Cell-Free Hemoglobin and Haptoglobin Preservation for Extended Cardiopulmonary Bypass Time in Cardiac Surgery for Acute Kidney Injuries Prevention.","authors":"Ignazio Condello, Juan Blanco Morvillo, Flavio Fiore, Valentina Teora, Giuseppe Nasso, Giuseppe Speziale","doi":"10.21470/1678-9741-2023-0272","DOIUrl":"10.21470/1678-9741-2023-0272","url":null,"abstract":"<p><strong>Introduction: </strong>Prevention of acute kidney injury during cardiopulmonary bypass (CPB) is still a challenge and has been the object of numerous studies. The incidence of acute kidney injury in the context of CPB is related to a multifactorial etiology. The role of hemadsorption in relation to cell-free hemoglobin and haptoglobin preservation is not well defined in the literature on CPB during cardiac surgery procedures.</p><p><strong>Methods: </strong>This is a single-center pilot randomized report including 20 patients undergoing elective CPB procedures with an expected time > 120 minutes for each extracorporeal procedure. Patients were randomly allocated to either standard of care (n=10) or Jafron HA380 (n=10) during CPB. The primary outcome measured was the incidence of postoperative acute kidney injuries.</p><p><strong>Results: </strong>The Jafron study group vs. control group reported postoperative values for cell-free hemoglobin at 10 minutes after CPB (mg/L) (11.6 ± 0.6 vs. 29.9 ± 0.3) (P-value 0.021), haptoglobin 10 minutes after CPB (mg/dl) (129.16 ± 1.22 vs. 59.17 ± 1.49) (P-value 0.017), creatinine peak after CPB (mg/dL) (0.92 ± 0.17 vs. 1.32 ± 0.9) (P-value 0.030), and acute kidney injury after 48 hours (number of patients) (one vs. four) (P-value 0.027).</p><p><strong>Conclusion: </strong>This pilot study suggested that the use of Hemoperfusion Cartridge HA380 Jafron for extended CPB time for complex cardiac surgery procedures was safe and effective and is associated with a better postoperative preservation of haptoglobin with a reduction of cell-free hemoglobin values and less incidence of acute kidney injury, though larger studies are warranted to confirm our result.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 3","pages":"e20230272"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946221","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":"A Milestone in Cardiac Care: The Intra-Aortic Balloon Pump in Cardiac Surgery and Transplantation.","authors":"Alvaro Perazzo, Samuel Padovani Steffen, Fabio Antônio Gaiotto, Ronaldo Honorato Barros Santos, Fabio Biscegli Jatene, Roberto Lorusso","doi":"10.21470/1678-9741-2024-0991","DOIUrl":"10.21470/1678-9741-2024-0991","url":null,"abstract":"","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 2","pages":"e20240991"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11093515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946119","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}