Brazilian journal of cardiovascular surgery最新文献

{"title":"Comparative Analysis of Modified BT Shunt and Central Shunt in Pediatric Patients.","authors":"Mustafa Yilmaz, Başak Soran Turkcan, Ata Niyazi Ecevit, Yasemin Özdemir Şahan, Atakan Atalay","doi":"10.21470/1678-9741-2023-0376","DOIUrl":"10.21470/1678-9741-2023-0376","url":null,"abstract":"<p><strong>Introduction: </strong>Cyanotic congenital heart diseases constitute 40-45% of all congenital heart diseases. In patients who are not suitable for primary repair, modified BT (MBT) shunt and central shunt (CS) procedures are still frequently used.</p><p><strong>Methods: </strong>This study included 62 pediatric patients who underwent MBT shunt or CS via median sternotomy. Patients' demographic, echocardiographic, operative, and postoperative data were collected retrospectively. The patients were classified as single ventricle and bi-ventricle according to their cardiac anatomy, and the presence of prematurity and heterotaxy was noted. Procedure details of the patients who underwent endovascular intervention prior to the surgery were investigated, and operation data were accessed from the surgery notes. Data regarding postoperative follow-ups were obtained and comparatively analyzed.</p><p><strong>Results: </strong>Of the total 62 patients, 32 (51.6%) were newborns and 16 (25.8%) had a body weight < 3 kg. MBT shunt was applied to 48 patients (77.4%), while CS was applied to 14 patients (22.6%). There was no significant difference between the two surgical procedures in terms of requirement for urgent shunt or cardiopulmonary bypass, additional simultaneous surgical intervention, need for high postoperative inotropes, and in-hospital mortality (P>0.05). The rate of congestive heart failure in patients with in-hospital mortality was determined as 66.7% and it was significantly higher than in patients without heart failure (P<0.001).</p><p><strong>Conclusion: </strong>MBT shunt and CS are still frequently used in cyanotic patients. The use of small-diameter shunts, particularly when centrally located, can prevent the onset of congestive heart failure and lower mortality.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 3","pages":"e20230376"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946219","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":"Comparison of the Effects of Full Median Sternotomy vs. Mini-Incision on Postoperative Pain in Cardiac Surgery: A Meta-Analysis.","authors":"Antonio de Jesus Chaves, Paula Stelitano Avelino, Jackson Brandão Lopes","doi":"10.21470/1678-9741-2023-0154","DOIUrl":"10.21470/1678-9741-2023-0154","url":null,"abstract":"<p><strong>Introduction: </strong>It is not yet clear whether cardiac surgery by mini-incision (minimally invasive cardiac surgery [MICS]) is overall less painful than the conventional approach by full sternotomy (FS). A meta-analysis is necessary to investigate polled results on this topic.</p><p><strong>Methods: </strong>PubMed®/MEDLINE, Cochrane CENTRAL, Latin American and Caribbean Health Sciences Literature (or LILACS), and Scientific Electronic Library Online (or SciELO) were searched for all clinical trials, reported until 2022, comparing FS with MICS in coronary artery bypass grafting (CABG), mitral valve surgery (MVS), and aortic valve replacement (AVR), and postoperative pain outcome was analyzed. Main summary measures were the method of standardized mean differences (SMD) with a 95% confidence interval (CI) and P-values (considered statistically significant when < 0.05).</p><p><strong>Results: </strong>In AVR, the general estimate of postoperative pain effect favored MICS (SMD 0.87 [95% CI 0.04 to 1.71], P=0.04). However, in the sensitivity analysis, there was no difference between the groups (SMD 0.70 [95% CI -0.69 to 2.09], P=0.32). For MVS, it was not possible to perform a meta-analysis with the included studies, because they had different methodologies. In CABG, the general estimate of the effect of postoperative pain did not favor any of the approaches (SMD -0.40 [95% CI -1.07 to 0.26], P=0.23), which was confirmed by sensitivity analysis (SMD -0.02 [95% CI -0.71 to 0.67], P=0.95).</p><p><strong>Conclusion: </strong>MICS was not globally less painful than the FS approach. It seems that postoperative pain is more related to the degree of tissue retraction than to the size of the incision.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 4","pages":"e20230154"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946250","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":"Infant Barlow's Disease in Association with Atrial Septal Defect.","authors":"Isaac Azevedo Silva, Larissa Ales Leite Matos, Carolina Sant'Anna, Ulisses Alexandre Croti","doi":"10.21470/1678-9741-2023-0278","DOIUrl":"10.21470/1678-9741-2023-0278","url":null,"abstract":"<p><strong>Clinical data: </strong>Female, seven years old, referred to our service complaining about congestive heart failure symptoms due to mitral valve regurgitation and atrial septal defect. Technical description: Echocardiographic findings compatible with Barlow's disease and atrial septal defect, ostium secundum type.</p><p><strong>Operation: </strong>She was submitted to mitral valvuloplasty with chordal shortening and prosthetic posterior ring (Gregori-Braile®) along with patch atrioseptoplasty.</p><p><strong>Comments: </strong>Mitral valve regurgitation is a rare congenital heart disease and Barlow's disease is probably rarer. Mitral valve repair is the treatment of choice.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 4","pages":"e20230278"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946483","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":"ERRATUM.","authors":"","doi":"10.21470/1678-9741-2023-0212e","DOIUrl":"10.21470/1678-9741-2023-0212e","url":null,"abstract":"","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 2","pages":"e20230212e"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11093514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946124","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":"Effects of Preoperative Nutritional Status and Lymphocyte Count on the Development of Early-term Atrial Fibrillation After Coronary Artery Bypass Grafting: A Retrospective Study.","authors":"Seyhan Yilmaz, Sabür Zengin, Ahmet Cumhur Dulger","doi":"10.21470/1678-9741-2023-0366","DOIUrl":"10.21470/1678-9741-2023-0366","url":null,"abstract":"<p><strong>Introduction: </strong>Although there are publications in the literature stating that parameters related to the nutritional status of patients are associated with the clinical outcomes of those with coronary artery disease, it is also stated that there is insufficient data on the relationship between nutritional indices and long-term outcomes and major adverse cardiovascular events in patients undergoing isolated coronary artery bypass grafting.</p><p><strong>Methods: </strong>This retrospective study was conducted with patients who underwent isolated elective on-pump coronary artery bypass grafting in our hospital. Patients who underwent emergency coronary artery bypass grafting or those with known atrial fibrillation in the preoperative period were excluded. Patients were analyzed and compared in two groups according to the development of postoperative atrial fibrillation.</p><p><strong>Results: </strong>The data of 93 coronary artery bypass grafting patients (71 [76%] males) with a mean age of 62.86 ± 9.53 years included in the study were evaluated. Both groups had similar preoperative ejection fraction value, hemoglobin level, age, number of distal bypasses, and postoperative mortality rates. Although the mean cardiopulmonary bypass and aortic cross-clamping times were higher in Group 1, they were not statistically significant. In our study, the mean prognostic nutrition index value was 51.76 ± 3002.</p><p><strong>Conclusion: </strong>According to our study results, there was no statistically significant difference between prognostic nutrition index values and the development of atrial fibrillation after coronary artery bypass grafting, which is similar to some publications in the literature. We think that it would be beneficial to conduct randomized studies involving more patients on this subject.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 3","pages":"e20230366"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946220","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":"Atrial Fibrillation After Coronary Artery Bypass Grafting and Its Relationship with Hospital Complications in São Paulo State.","authors":"Adnaldo da Silveira Maia, Dayara Hoffmann Mayer, Renê Augusto Gonçalves E Silva, Andresa Fernandes Pérego, Pedro Esteban Ulloa Alvarado, Oscar Harold Torrico Lizarraga, Mercy Adriana Herrera Arcos, Matheus da Silveira Maia, Magaly Arrais Dos Santos, Omar Asdrubal Vilca Mejia","doi":"10.21470/1678-9741-2023-0270","DOIUrl":"10.21470/1678-9741-2023-0270","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial fibrillation is the main complication in the postoperative period of cardiovascular surgery. Its genesis is multifactorial, so its rapid identification to mitigate the associated risks is essential.</p><p><strong>Objective: </strong>To evaluate the incidence of atrial fibrillation in patients undergoing coronary artery bypass grafting (CABG) and its relationship with other complications in our setting.</p><p><strong>Methods: </strong>This is a multicenter, observational study involving patients undergoing isolated CABG between 2017 and 2019 with data from the Registro Paulista de Cirurgia Cardiovascular (or REPLICCAR II). Variables were prospectively collected in REDCap following the definitions given by version 2.73 of the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Data were collected with prior authorization from the local ethics committee and analyses performed in R software.</p><p><strong>Results: </strong>A total of 3,803 patients were included, of these 605 had postoperative atrial fibrillation (POAF). In order to adjust the groups, propensity score matching was used. Such analyses resulted in 605 patients in each group (without POAF vs. with POAF). Among patients with POAF, the mean age was 67.56 years, with a prevalence of males (73.6%, 445 patients). Patients belonging to the group with POAF had a mortality rate of 9.26% (P=0.007), longer ventilation time (P<0.001), pneumonia (P<0.001), and sepsis (P<0.001). In multiple analysis, acute renal dysfunction (P=0.032) and longer intensive care unit stay (P<0,001) were associated with the presence of POAF.</p><p><strong>Conclusion: </strong>POAF in CABG is associated with longer intensive care unit and hospital stay, as well as renal dysfunction, pneumonia, and in-hospital mortality.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 4","pages":"e20230270"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946293","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":"Atrial Fibrillation After Elective Isolated Coronary Artery Bypass Graft Surgery.","authors":"Mesut Engin, Ufuk Aydın, Yusuf Ata","doi":"10.21470/1678-9741-2023-0337","DOIUrl":"10.21470/1678-9741-2023-0337","url":null,"abstract":"","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 1","pages":"e20230337"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11092979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946114","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":"Cryoablation Catheter Used in the Surgical Treatment of Atrial Fibrillation May Treat Chest Tube Pain: Engin Technique.","authors":"Mesut Engin, Ufuk Aydın, Ahmet Kağan As, Yusuf Ata, Şenol Yavuz","doi":"10.21470/1678-9741-2023-0354","DOIUrl":"10.21470/1678-9741-2023-0354","url":null,"abstract":"<p><p>Postoperative pain after cardiac surgery plays an important role in the patient's recovery process. In particular, pain at the chest tube site can negatively affect the comfort and recovery of these patients. Effective pain control minimizes the risk of many complications. Oral and intravenous analgesics, epidural anesthesia, paravertebral block, and intercostal nerve blockade are used in chest tube pain control. We routinely use the surgical cryoablation method in the presence of atrial fibrillation in the preoperative period of cardiac surgery in our clinic. Here we aimed to describe our method of using the cryoablation catheter for intercostal nerve blockade.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 2","pages":"e20230354"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11093227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946120","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":"Functional Physical Analysis and Quality of Life in the Preoperative and Early Postoperative Periods of Cardiac Surgery and 30 Days After Hospital Discharge.","authors":"Luana Gehm da Silva, Danieli Maria Magnaguagno, Mariana Motta Dias da Silva, Audrey Borghi-Silva, Eliane Roseli Winkelmann","doi":"10.21470/1678-9741-2022-0453","DOIUrl":"10.21470/1678-9741-2022-0453","url":null,"abstract":"<p><strong>Introduction: </strong>The analysis of patients submitted to heart surgery at three assessment times has been insufficiently described in the literature.</p><p><strong>Objective: </strong>To analyze chest expansion, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), distance traveled on the six-minute walk test (6MWT), and quality of life in the preoperative period, fourth postoperative day (4th PO), and 30th day after hospital discharge (30th-day HD) in individuals submitted to elective heart surgery.</p><p><strong>Methods: </strong>A descriptive, analytical, cross-sectional study was conducted with 15 individuals submitted to elective heart surgery between 2016 and 2020 who did not undergo any type of physiotherapeutic intervention in Phase II of cardiac rehabilitation. The outcome variables were difference in chest expansion (axillary, nipple, and xiphoid), MIP, MEP, distance on 6MWT, and quality of life. The assessment times were preoperative period, 4th PO, and 30th-day HD.</p><p><strong>Results: </strong>Chest expansion diminished between the preoperative period and 4th PO, followed by an increase at 30th-day HD. MIP, MEP, and distance traveled on the 6MWT diminished between the preoperative period and 4th PO, with a return to preoperative values at 30th-day HD. General quality of life improved between the preoperative period and 4th PO and 30th-day HD. An improvement was found in the social domain between the preoperative period and the 30th-day HD.</p><p><strong>Conclusion: </strong>Heart surgery causes immediate physical deficit, but physical functioning can be recovered 30 days after hospital discharge, resulting in an improvement in quality of life one month after surgery.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 4","pages":"e20220453"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946482","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":"Computer-Assisted Transcatheter Mitral Valve Implantation for Valve-in-Valve Procedures.","authors":"Calixte de La Bourdonnaye, Miguel Castro, Clément Joly, Pascal Haigron, Jean-Philippe Verhoye, Amedeo Anselmi","doi":"10.21470/1678-9741-2023-0237","DOIUrl":"10.21470/1678-9741-2023-0237","url":null,"abstract":"<p><p>Transcatheter mitral valve-in-valve is an alternative to high-risk reoperation on a failing bioprosthesis. It entails specific challenges such as left ventricular outflow tract obstruction. We propose a patient-specific augmented imaging based on preoperative planning to assist the procedure. Valve-in-valve simulation was performed to represent the optimal level of implantation and the neo-left ventricular outflow tract. These data were combined with intraoperative images through a real-time 3D/2D registration tool. All data were collected retrospectively on one case (pre and per-procedure imaging). We present for the first time an intraoperative guidance tool in transcatheter mitral valve-in-valve procedure.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"39 4","pages":"e20230237"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946434","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}