Portuguese journal of cardiac thoracic and vascular surgery最新文献

{"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":"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":"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":"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":"Unusual Multifocal Localizations of Hydatidosi.","authors":"Jacky Ifounga, Mohamed Bhairis, Massine El Hammoumi, El Hassane Kabiri","doi":"10.48729/pjctvs.547","DOIUrl":"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":"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":"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}

{"title":"Evar Fast-Track, The Implementation Of A Safe And Cost-Effective Protocol.","authors":"Rita Calviño López-Villalta, Nilo Javier Mosquera Arochena","doi":"10.48729/pjctvs.568","DOIUrl":"10.48729/pjctvs.568","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate and confirm the cost effectiveness and safety of a fast-track protocol discharge of patients after elective EVAR.</p><p><strong>Material and methods: </strong>A total of 83 patients admitted for elective EVAR procedure were collected in a database. The experimental group included 40 patients treated after the establishment of a fast-track EVAR protocol (from April 2020 to April 2023) in our hospital. The control group included 43 patients, standard admission, treated before 2020 (from January 2017 to December 2019). We collected data on the length of hospital stay and the costs derived from it, the need for re-intervention and the occurrence of major adverse events. We did a follow-up after 30 days and six months after the intervention.</p><p><strong>Results: </strong>No differences were found in main demographic and clinical characteristics in both groups. There were no changes in clinical indication or surgical procedures between both groups. We observed a shorter hospital stay (2.3 vs 3.7 days p< 0.001), less need for monitoring in the resuscitation unit (0.2 vs 1.1 days p< 0.001) and lower rate of secondary intervention in the experimental group (fast-track group). In postoperative follow-up, the fast-track group also presented lower readmission rate for any reason (12.5% vs. 23.3%). The total cost per patient for the health system during the hospital admission was 1403.29 ± 820.3 euros in the experimental group and 3339.34 ± 2513.1 euros in the control group, resulting in a total saving per patient of 1936.05 euros (95% CI 2748.12 - 1123.97) in the fast-track group.</p><p><strong>Conclusions: </strong>The implementation of a fast-track protocol for patients undergoing elective EVAR, results in a shorter hospital stay lowering perioperative costs, without increasing adverse events or readmission rate following discharge. Therefore, its practice should be considered as standard of care in patients admitted for EVAR procedure.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 4","pages":"19-24"},"PeriodicalIF":0.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260355","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":"Intravascular Lithotripsy For Severe Peripheral Artery Calcification - A 3-Year Single Centre Experience.","authors":"Inês Gueifão, Ricardo Correia, Anita Quintas, Tiago Ribeiro, Joana Cardoso, Helena Fidalgo, Adriana Figueiredo, Maria Emília Ferreira","doi":"10.48729/pjctvs.528","DOIUrl":"https://doi.org/10.48729/pjctvs.528","url":null,"abstract":"<p><strong>Introduction: </strong>Severe arterial calcification is a challenging limitation in endovascular procedures leading to worse success rates and outcomes. Conventional balloon angioplasty may provide limited luminal gain, calling for adjunctive strategies of plaque modification, such as intravascular lithotripsy (IVL). The aim of this study is to describe our institutional experience with IVL in the treatment of peripheral artery disease (PAD).</p><p><strong>Materials and methods: </strong>A prospectively maintained database from a tertiary academic medical centre was retrospectively enquired from October 2021 to September 2024. The study included all patients who underwent IVL (Shockwave Medical, Inc., California, USA) for vessel preparation during endovascular treatment of PAD.</p><p><strong>Results: </strong>19 patients were included (79% male, median age 76 years) with a median follow-up period of 6 and total of 35 months. Most common risk factors were hypertension (90%), diabetes (68%), dislipidemia (63%) and ischaemic heart disease (63%). Clinical presentation was mostly chronic limb-threatening ischemia (Fontaine grade IV in 74% and Fontaine grade III in 10%). The target lesion undergoing IVL was most often femoropopliteal (68%). Intraprocedural lesion crossing was almost equally subintimal and intraluminal (53% vs. 47%) and definitive treatment was mostly performed with stenting (79%). Additionally, 3 patients (16%) underwent a hybrid procedure with femoral endarterectomy (11%) or femoro-femoral bypass (5%). There were no identified procedural complications. Major adverse limb events (MALE) included no reinterventions and 1 major amputation (5%), and the all-cause mortality rate was 16%. Regarding the 14 patients in Fontaine grade IV, the wound healing rate was 57%.</p><p><strong>Discussion/conclusion: </strong>IVL is a safe and effective adjunctive in vessel preparation during endovascular revascularisation procedures, particularly in the femoropopliteal sector. Procedure and/or device-related complications, MALE and mortality are infrequent. Further research is needed concerning aortoiliac and infrapopliteal sectors and comparison with other supplementary treatment alternatives.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 3","pages":"33-37"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515077","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":"Ten-Year Experience of a Tertiary Center with Giant Abdominal Aortic Aneurysms: A Retrospective Analysis.","authors":"Francisco Basílio, Andreia Coelho, João Peixoto, Luís Fernandes, Roberto Boal, Marta Machado, Patrícia Carvalho, Beatriz Guimarães","doi":"10.48729/pjctvs.529","DOIUrl":"https://doi.org/10.48729/pjctvs.529","url":null,"abstract":"<p><strong>Introduction: </strong>The risk of rupture for abdominal aortic aneurysms (AAAs) is primarily influenced by their diameter with the likelihood of rupture increasing exponentially as the aneurysm enlarges. Nowadays, giant AAAs are relatively rare in clinical practice due to earlier diagnosis and treatment. This study aimed to analyze the treatment and prognosis of giant aneurysms comparing with non-giant AAAs within our center´s prospective registry.</p><p><strong>Methods: </strong>We identified all AAAs treated at our center exceeding 9 cm in diameter from surgical records between January 1, 2013, and September 10, 2024. Demographic data, risk factors, anatomical characteristics, treatments, and outcomes were recorded. Furthermore, we analyzed and compared the anatomical features and outcomes of giant aneurysms with non-giant AAAs treated in our department (non-giant AAAs) from 2019 and 2023.</p><p><strong>Results: </strong>A total of 24 patients with giant AAAs were identified, with a mean age of 77 .46±9.03 years, and the majority were male (95.8%). Rupture was significantly more frequent in the giant AAAs cohort (54.2% vs. 9.6%, p<0.001). Additionally, Giant AAAs were significantly less likely to undergo endovascular aneurysm repair (EVAR) (33.33% vs. 75.53%, p < 0.001), but with a higher risk of reintervention due to complications at 30 days (18.18% vs. 1.18%, p < 0.001) and 1 year (18.18% vs. 3.53%, p < 0.001) in non-ruptured sub-group.</p><p><strong>Conclusion: </strong>Giant AAAs are predominantly ruptured at presentation and primarily managed with open surgical repair. When treated with EVAR, there was a higher risk of reintervention compared to non-giant AAAs.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 3","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515199","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":"Managing The Mitral Valve In HCM Surgery: Tips And Tricks.","authors":"Sara Ranchordás, Miguel Abecasis, Eduard Quintana","doi":"10.48729/pjctvs.574","DOIUrl":"https://doi.org/10.48729/pjctvs.574","url":null,"abstract":"<p><p>Mitral regurgitation (MR) in hypertrophic cardiomyopathy (HCM) patients is mainly due to systolic anterior motion (SAM) of the mitral valve (MV). However, other mechanisms contributing to mitral regurgitation may coexist as a result of further structural abnormalities. SAM might occur because of the increased septal thickness alone or due to simultaneous MV or subvalvular apparatus anomalies, such as mitral leaflet elongation, papillary muscle body anomalies, accessory papillary muscles or additional papillary muscle heads. Additionally, anomalous mitral chordae or the recently described mitral-aortic discontinuity (leading to a longer anterior mitral leaflet (AML)) can contribute to abnormal physiology. A closed aortomitral angle may also contribute. During intraoperative echocardiographic assessment, it is important to thoroughly evaluate the MV and the regurgitant jet to understand the mechanism(s) that cause MR in HCM patients. Although myectomy alone is frequently enough to correct SAM, concomitant MV procedures may be needed, especially when the septum is thin (<16-18 mm) and/or there is intrinsic MV disease. Detection of concomitant regurgitation mechanisms beyond SAM can eventually be identified preoperatively, either by direct structural detection (valve prolapse), by pharmacological palliation of SAM with vasopressors and negative inotropic agents or suspected by identification of anteriorly and centrally directed regurgitant mitral jets. Surgical techniques that can be employed to contribute to SAM elimination include plication/extension/retention plasty of the AML, resection/release/reorientation of papillary muscles, division of anomalous chordae, edge-to-edge repair, or, at times, prosthetic MV replacement. If there is structural MV disease concomitant to HCM, appropriately tailored techniques to address the MV may be used. Transoesophageal echocardiography at the end of the procedure should demonstrate elimination of SAM, resolution of LVOT obstruction, and appropriate coaptation of the MV leaflets and nearly resolution of MR. Provocation with inotropes can be used to ensure no latent obstruction persists.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 3","pages":"49-56"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515128","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}