Portuguese journal of cardiac thoracic and vascular surgery最新文献

{"title":"The Year Behind and the Year Ahead.","authors":"Filipe Ferreira Leite","doi":"10.48729/pjctvs.616","DOIUrl":"https://doi.org/10.48729/pjctvs.616","url":null,"abstract":"","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 4","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260374","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}

{"title":"Thoracic Surgery - notes for its history in Brazil (Part II): Lung transplantation.","authors":"Roger Normando, João Pedro Normando","doi":"10.48729/pjctvs.600","DOIUrl":"https://doi.org/10.48729/pjctvs.600","url":null,"abstract":"<p><p>Pulmonary transplantation arrived in Brazil after being well grounded in operative technique, in the use of anti-rejection drugs, as well as advances in pulmonary preservation, allowing longer ischemia time with less reperfusion injury. Consistent with this fact, there was advancement in understanding the mechanism of rejection and infection. The first Brazilian pulmonary transplant occurred in Porto Alegre, in May 1989. It was also the first in Latin America. The author was José de Jesus Peixoto Camargo, surgeon at the Pereira Filho Pavilion of the Santa Casa of Porto Alegre. It was a 27-year-old man, suffering from bronchiolitis obliterans, who received a left lung transplant and survived more than nine years, dying from infectious complications resulting from bronchiolitis and bronchiectasis, associated with pulmonary tuberculosis that he developed eight years after the transplant. From then on, more Brazilian centers created transplant programs. The implementation of each service incorporated infrastructure that guaranteed multidisciplinary care. The emphasis of these programs was due to: care for the donor, selection of recipients, adequate rehabilitation of candidates during the waiting time, anesthetic and surgical training in the management of pertinent technical peculiarities, highly qualified intensive care, and follow-up of a regulated, inflexible, and permanent postoperative protocol. Thus, one understands how we arrived at the current moment to be reported in the form of history. The historiographic material (method) collected by the authors was based on reading scientific texts, informative materials, and oral reports. It follows the methodological line of the previous article(Part I) whose events served to build the history of the specialty in Brazil, under the pioneering work of José de Jesus Peixoto Camargo.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 4","pages":"13-17"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260304","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}

{"title":"Unmasking an Anomalous Vein: Surgical Repair of Left Upper Pulmonary Vein Drainage into the Innominate Vein.","authors":"Maria Resende, Márcio Madeira, Cláudia Silva, Marta Marques, Miguel Abecasis","doi":"10.48729/pjctvs.592","DOIUrl":"https://doi.org/10.48729/pjctvs.592","url":null,"abstract":"<p><p>Partial anomalous pulmonary venous return (PAPVR) is a rare congenital anomaly characterized by one or more pulmonary veins draining into the systemic venous system. We present the case of a 51-year-old woman with PAPVR involving the left upper pulmonary vein (LUPV) draining into the left innominate vein via a vertical vein, diagnosed after investigation of progressive dyspnea and lower limb edema. The diagnosis was confirmed through contrast-enhanced CT and echocardiography. The patient underwent surgical correction of the anomalous return along with tricuspid valve repair. Postoperative recovery was uneventful. This case highlights the importance of recognizing PAPVR in adult patients presenting with unexplained right heart dilation or symptoms of right heart overload.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 4","pages":"47-49"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260283","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}

{"title":"Misconnected: Valve Failure from an Unexpected Chordal Insertion.","authors":"Catarina Novo, Mariana Campos, Paulo Neves, Miguel Guerra","doi":"10.48729/pjctvs.575","DOIUrl":"https://doi.org/10.48729/pjctvs.575","url":null,"abstract":"<p><p>A 64-year-old woman with no significant past medical history presented with heart failure symptoms secondary to severe mitral regurgitation. She was referred for mitral valve repair with the intention of valve preservation. Initial transthoracic echocardiography (TTE) suggested that the regurgitation was due to a ruptured chordae resulting in prolapse of the A2 segment. Intraoperative inspection following atriotomy revealed an aberrant chordae tendineae inserting anomalously into the left atrial wall, which was contributing to the A2 prolapse. The aberrant chordae was excised and replaced with polytetrafluoroethylene (Gore-Tex) neochords. A mitral annuloplasty ring was placed to complete the repair. Intraoperative transesophageal echocardiography confirmed excellent valve function with only minimal residual regurgitation. The patient had an uneventful recovery and was discharged on the fourth postoperative day. Aberrantly inserted chordae tendineae are an exceedingly rare finding and may lead to significant valvular dysfunction. Prompt surgical recognition and correction can result in successful valve preservation and excellent clinical outcomes.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 4","pages":"59-60"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260363","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}

{"title":"Modified Pectus Up and the Portuguese Case Series.","authors":"Luís Lourenço Graça, António Canotilho, Filipe Pagaimo, Gonçalo Morais, Bárbara Ferreira, Rita Lopes, Susana Lareiro, Rita Pancas","doi":"10.48729/pjctvs.544","DOIUrl":"https://doi.org/10.48729/pjctvs.544","url":null,"abstract":"<p><strong>Introduction: </strong>Pectus excavatum (PE) is the most common congenital chest wall deformity, with an incidence of 1 in 400 births. Surgical approaches vary depending on the severity of the condition. Recently, the taulinoplasty approach - \"Pectus Up®\" - was described as an alternative to lift the sternum through external traction, avoiding invading the mediastinum or pleural cavity. We describe our progressively modified taulinoplasty technique and case series.</p><p><strong>Materials and methods: </strong>From 2022 to 2024, 13 consecutive patients with pectus excavatum underwent surgical correction with a modified taulinoplasty (Pectus Up®) technique. Demographics, clinical characteristics, preoperative cardiorespiratory data and surgical outcomes were evaluated. The modifications introduced to the technique include preoperative stainless steel skin reaction testing, vertical skin incision, 3D-printed surgical guide and a partial chondrotomy of the costal cartilages involved in the deformity.</p><p><strong>Results: </strong>The average interference of the pectus excavatum in the quality of life was 7,2 (Likert scale of 0 to 10) and the most common symptom was fatigue on exertion (30,8%). No perioperative complications and no mortality were observed, and 84,6% of patients were discharged on second post-operative day. During a median follow-up of 20 months, there was one case of metal bar allergy requiring oral corticoid therapy, and one case of infection with suture dehiscence requiring oral antibiotic therapy, surgical debridement and negative pressure therapy. In both cases, the pectus bar was not removed. The average pain in the first year after surgery and aesthetic satisfaction were 3,7 and 8,6, respectively (scale 0 to 10).</p><p><strong>Conclusion: </strong>The implemented modifications result in a more \"standardized\" technique, which has been providing consistent and reproducible outcomes. This technique seems to be a valid therapeutic option for well selected patients.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 4","pages":"25-31"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260319","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}

{"title":"The Brazilian Lung Transplant Experience: Reflections and Parallels.","authors":"Fernando Palma Martelo","doi":"10.48729/pjctvs.626","DOIUrl":"https://doi.org/10.48729/pjctvs.626","url":null,"abstract":"","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 4","pages":"11-12"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260281","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}

{"title":"Management of Tricuspid Regurgitation in Patients with Rheumatic Mitral Disease.","authors":"R Kalasipudi, S Gupta, A Meghdadi, S Gupta, Y Abu-Omar, A Al-Akhtar, M El-Diasty","doi":"10.48729/pjctvs.604","DOIUrl":"10.48729/pjctvs.604","url":null,"abstract":"<p><strong>Background: </strong>Rheumatic heart disease (RHD) remains a major cause of cardiovascular morbidity and mortality in low and middle-income countries, with tricuspid regurgitation (TR) frequently complicating rheumatic mitral pathology. While mild TR often stabilizes after mitral correction, management of moderate and severe TR in this context remains controversial due to limited evidence and applicability of guidelines largely derived from degenerative etiologies. This review synthesizes current data on diagnostic strategies, surgical decision-making, and outcomes in rheumatic TR.</p><p><strong>Methods: </strong>A comprehensive literature search was performed across PubMed, Google Scholar, and OMNI databases (2010-2024) using the keywords \"rheumatic mitral disease,\" \"tricuspid regurgitation,\" and \"management.\" Eligible studies included clinical trials, case series, reviews, and meta-analyses focusing on TR associated with rheumatic mitral disease. Data was extracted and critically appraised for study design, population, and outcome relevance.</p><p><strong>Results: </strong>Evidence for managing TR in rheumatic mitral disease primarily stems from retrospective cohorts and small prospective studies, with few randomized trials. Predictors of TR progression include annular dilation (>21 mm/m²), right ventricular dysfunction, pulmonary hypertension, and atrial fibrillation. Mild TR generally regresses following mitral surgery and is managed conservatively. For moderate TR, concomitant repair may prevent late progression and improve hemodynamics, though risks of postoperative arrhythmia and pacemaker implantation persist. Severe TR warrants surgical correction, preferably rigid ring annuloplasty, while valve replacement is reserved for advanced calcific disease. Emerging transcatheter therapies show promise for high-risk patients but lack robust rheumatic-specific data.</p><p><strong>Conclusion: </strong>Optimal management of TR in rheumatic mitral disease requires individualized, Heart Team-based decision-making due to limited high-quality evidence. Future research should prioritize multicenter trials comparing repair, replacement, and transcatheter approaches, integrating advanced imaging for risk stratification and addressing access disparities in resource-limited settings.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 4","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260331","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}

{"title":"Unusual Multifocal Localizations of Hydatidosi.","authors":"Jacky Ifounga, Mohamed Bhairis, Massine El Hammoumi, El Hassane Kabiri","doi":"10.48729/pjctvs.547","DOIUrl":"https://doi.org/10.48729/pjctvs.547","url":null,"abstract":"<p><p>Hydatid disease is a major public health problem in Mediterranean countries, North Africa (including Morocco), Asia, Australia, New Zealand, and certain South American countries, where agricultural and pastoral practices remain largely traditional. This parasitic disease results from infection with the larval stage of Echinococcus granulosus. Diaphragmatic involvement is rare, even in regions where the disease is endemic. We present the case of a 31-year-old patient who had previously suffered from hepatic and renal hydatid infection and who developed multifocal disease affecting the lung parenchyma, diaphragmatic tissue, and pancreas two years after the initial diagnosis. The therapeutic management of the thoracic lesions consisted of surgery followed by prolonged administration of benzimidazole-based pharmacological treatment, specifically albendazole.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 4","pages":"51-54"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260279","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}

{"title":"Saving Subclavian Arteries with Percutaneous Approach: a Solution for Catheter Misplacement.","authors":"Catarina Pacheco, João Peixoto, Joana Cepeda, Marta Basto, Érico Costa","doi":"10.48729/pjctvs.536","DOIUrl":"https://doi.org/10.48729/pjctvs.536","url":null,"abstract":"<p><strong>Introduction: </strong>Inadvertent placement of a central venous catheter (CVC) into a major artery can lead to potentially devastating complications. In critically ill patients, the use of vascular closure devices is an attractive therapeutic option. We report two cases of catheter misplacement into cervical arteries managed with the Perclose ProStyle® system.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on adult patients admitted to the Intensive Care Unit (ICU) between July and December 2023 who underwent removal of a misplaced catheter using an endovascular approach.</p><p><strong>Results: </strong>Two patients were identified. One catheterization occurred in the operating room prior to ICU admission, and the other in the ICU. Misplacement was detected within six hours via chest radiography, and diagnosis was confirmed by computed tomography angiography (CTA). Catheters were removed using the Perclose ProStyle® device.</p><p><strong>Conclusion: </strong>The ProStyle® system was safe and effective in these patients. These cases highlight the importance of detailed procedural documentation during CVC placement. Additionally, periodic audits could help prevent technical errors and reinforce adherence to best clinical practices.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 4","pages":"55-58"},"PeriodicalIF":0.0,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260372","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}

{"title":"Advancing Endovascular Solutions for Complex Abdominal Aortic Aneurysms: Patient Selection, Imaging, and Device Innovations.","authors":"Mariana Martins-Lopes, Miguel Santos-Venâncio, João Rocha-Neves, Mário Marques-Vieira","doi":"10.48729/pjctvs.569","DOIUrl":"https://doi.org/10.48729/pjctvs.569","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic aneurysm (AAA) poses a significant health risk, with a prevalence of 4.8% and becomes a surgical concern when the diameter exceeds 5.5 cm due to the heightened risk of rupture. Endovascular aneurysm repair (EVAR) has emerged as the primary approach, especially for infrarenal AAAs, offering advantages over traditional open surgery. However, complex anatomies challenge standard EVAR, leading to the development of innovative endografts. This study reviews the literature on treating complex abdominal aortic aneurysms (C-AAAs), focusing on patient selection, preoperative imaging, and available devices.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted on C-AAAs, encompassing treatment options, patient selection criteria, and preoperative imaging. Searches in Pubmed and Google Scholar utilized keywords such as \"complex abdominal aortic aneurysm\", \"fenestrated endovascular aortic repair (FEVAR)\", \"branched endovascular aortic repair (BEVAR)\", \"Chimney endovascular aortic repair (chEVAR)\" and \"patient selection.\" Additional relevant articles were included through cross-referencing.</p><p><strong>Results: </strong>Patient selection for C-AAA endovascular treatment involves assessing rupture risk, operative mortality, life expectancy, and anatomical considerations. The impact of age on outcomes remains inconclusive across different studies. Preserving renal function is crucial, particularly in patients with renal anomalies, which require careful evaluation. Precise measurements guide decisions, considering factors like aortic tortuosity. Preoperative imaging, particularly computed tomography angiography (CTA), is vital, providing comprehensive anatomical information. Intraoperative fusion imaging enhances real-time assessment, contributing to procedural precision. Device selection, including FEVAR, BEVAR, and Chimney endovascular aortic repair, is tailored to individual anatomy, with custom-made, off-the-shelf, and physician-modified devices offering diverse options.</p><p><strong>Conclusion: </strong>The endovascular treatment of C-AAAs has undergone significant advancements, transforming therapeutic approaches. Optimal outcomes hinge on meticulous patient selection, comprehensive preoperative imaging, and tailored device selection. The evolution from traditional to innovative endografts reflects a paradigm shift. Ongoing research should refine risk assessment, optimize device modifications, and expand endovascular interventions' applicability for C-AAAs.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 4","pages":"41-46"},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260306","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}