Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular最新文献

{"title":"The Meeting","authors":"Alix Ohlin","doi":"10.5040/9781408164310.00000040","DOIUrl":"https://doi.org/10.5040/9781408164310.00000040","url":null,"abstract":"Hilbert University — There are two major theories of probability, one due to von Mises and the other due to Kolmogorov. The first requires the existence of a collective before probabilities can be defined. Its motivation is physical. The second postulates a probability space which is purely mathematical. It makes probability a branch of mathematics. We show that von Mises’ theory is more appropriate to application in quantum theory. Kolomogorov’s theory can lead to paradoxical results.","PeriodicalId":87136,"journal":{"name":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","volume":"97 1","pages":"100 - 107"},"PeriodicalIF":0.0,"publicationDate":"2021-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70509295","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":"Abstracts of the SPCCTV 4D Visions 20, 28-29 November 2020, Figueira da Foz, Portugal.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Oral communications about Cardiac Surgery, Thoracic Surgery and Vascular Surgery presented at the SPCCTV 4D Visions 20, 28-29 November 2020, Figueira da Foz, Portugal.</p>","PeriodicalId":87136,"journal":{"name":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","volume":"27 4","pages":"247-300"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38791818","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":"Multiple Vs Single Arterial Grafting In Coronary Surgery Among Diabetic Patients: A Meta-Analysis.","authors":"F. Saraiva, Joao Leite-Moreira, António S. Barros, A. Leite-Moreira, A. Lourenço","doi":"10.1093/ehjci/ehaa946.2673","DOIUrl":"https://doi.org/10.1093/ehjci/ehaa946.2673","url":null,"abstract":"Introduction The use of more than one arterial conduit in coronary surgery has been widely associated with better long-term results. Objectives We sought to investigate the benefits of Multiple Arterial Grafts (MAG) over Single Arterial Grafts (SAG), among diabetic patients, in short and long-term results throughout a meta-analysis of propensity score matching (PSM) studies. Materials and Methods MEDLINE and ISI Web of Science were used to find relevant literature (1960-2018). We included cohort studies with at least 200 patients and that reported one of these outcomes: long-term survival, early mortality or sternal wound infection (SWI). Survival was collected through hazard ratio (HR) along with their variance and the other endpoints using frequencies or odds ratio (OR) from the matched sample. Fixed effect models were used to compute statistical combined measures and 95% confidence intervals (CI). Results Eleven studies were included performing a total of 9670 diabetic patients: 4833 MAG and 4837 SAG (1:1 PSM in all studies). MAG group consisted in bilateral internal mammary artery (BIMA) in 8 studies; single IMA (SIMA)+radial artery (RA) in 5 studies; and one study reported several MAG approaches: BIMA+RA+Gastroepiploic artery (GEA), SIMA+RA+GEA, SIMA+GEA or BIMA+GEA. SAG group consisted in SIMA with or without saphenous vein graft in all studies, except for one that included also patients with GEA instead of SIMA. Ten studies reported long-term survival and mean follow-up time ranged from 5 to 12 years (max. follow-up 30y). Overall, MAG had significantly improved long-term survival compared with SAG (pooled HR=0.79, CI95%: 0.74-0.85,p<0.01). In-hospital mortality was reported by 6 studies (4202 patients: 2099 MAG and 2103 SAG) and occurred in 3.0% vs. 3.3% in MAG vs. SAG patients, respectively (pooled OR: 0.91, CI95%: 0.65-1.29,p=0.60). SWI was reported by 6 studies (4432 patients: 2216 MAG and 2216 SAG) and occurred in 2.8% vs. 2.2% in MAG vs. SAG patients, respectively (pooled OR: 1.31, CI95%: 0.90- 1.92,p=0.15). Excluding one article in which MAG group consisted in IMA+RA, the remaining 5 BIMA vs. SIMA studies reported an higher risk of SWI in MAG group (pooled OR: 1.63, CI95%: 1.07-2.49,p=0.02) Conclusions Considering PSM studies, MAG provides superior long-term survival compared to SAG in diabetic patients. This surgical technique does not implement additional risk regarding in- -hospital mortality, but MAG with BIMA was associated with a higher risk of SWI in this specific subgroup of patients.","PeriodicalId":87136,"journal":{"name":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","volume":"27 4 1","pages":"248"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjci/ehaa946.2673","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48236228","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":"Safety And Risk Factors For The Morbidity And Mortality Of Pneumonectomy: A Retrospective 10- Year Study In A Single Institution.","authors":"Joana Rei,&nbsp;Susana Lareiro,&nbsp;Pedro Fernandes,&nbsp;Patrícia Castro,&nbsp;Sara S Costa,&nbsp;José Miranda,&nbsp;Luís Vouga,&nbsp;Miguel Guerra","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>Pneumonectomy is a procedure with high post-operative morbidity and mortality. This study aims to assess and identify possible risk factors that can affect post-operative outcome, therefore determining the safety of pneumonectomy in specific groups.</p><p><strong>Methods: </strong>A total of 63 patients submitted to pneumonectomy at our centre, from February 2008 to February 2018, were included in our retrospective study. Age, gender, side of intervention, diagnosis, pre-operative symptoms, substance abuse and comorbidities were assessed. Early and late post-operative complications, as well as death were our major outcomes. We analysed the impact of preoperative variables on major outcomes using SPSS statistics.</p><p><strong>Results: </strong>We found a 9,8% surgery-related mortality and 1-year survival rate of 76,2%. The incidence of early complications in our population was of 35% while eleven patients (17,4%) developed late post-operative complications. No statistical difference was found when comparing survival time between genders or age groups. Right sided pneumonectomies seem to be associated with an higher mortality risk. No other association between risk factors and outcomes reached statistical significance in both univariate and multivariate analysis.</p><p><strong>Conclusions: </strong>Pneumonectomy is a viable option regardless of age whenever the patient has a good functional and cardiopulmonary status. Gender and diagnostic group do not seem to influence adverse event risk, although right-sided pneumonectomies show an increased risk for post-operative death. Care should be taken with patients submitted to neoadjuvant therapy. All patients should be encouraged to cease smoking as early as possible before surgery, given the increased risks for post-operative complications.</p>","PeriodicalId":87136,"journal":{"name":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","volume":"27 3","pages":"203-208"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38499343","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":"Complex Mediastinal Tumour In Pregnancy: Case Report.","authors":"Cristina Rodrigues,&nbsp;Daniel Cabral,&nbsp;Isabel Correia,&nbsp;Luísa Pinto,&nbsp;Mónica Centeno,&nbsp;Francisco Félix","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 19 years-old woman, on her 17th week of pregnancy presented to the emergency department with thoracic pain and vomiting. An empyema was diagnosed and she was transferred to a tertiary hospital for treatment. After drainage of the empyema a mediastinal mass was detected and a thoracic MRI revealed a multicystic lesion of the anterior mediastinum, causing cardiac and left lung compression, suggestive of a complicated teratoma. After a multidisciplinary discussion involving pulmonology, radiology, obstetrics and thoracic surgery, she was operated successfully by clamshell incision. A mature complicated teratoma was resected and a left pleurectomy/decortication performed. She was discharged on day 17 with no obstetrical or respiratory symptoms..</p>","PeriodicalId":87136,"journal":{"name":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","volume":"27 3","pages":"217-219"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38499347","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":"Complex Aortoiliac Pelvic And Visceral Revascularization.","authors":"António Pereira-Neves,&nbsp;João Rocha-Neves,&nbsp;Luís Duarte-Gamas,&nbsp;Alfredo Cerqueira,&nbsp;Ricardo Gouveia","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Aortoiliac occlusive disease (AIOD) remains an area of debate concerning open and endovascular treatment options. A case of a 63-year old female is reported, with previous known vascular intermittent claudication, that presented in the emergency room with acute ischemia of the right lower limb with 24-hours of evolution. The computer tomographic angiography unveiled occlusion of the superior mesenteric artery, occlusion of left common iliac artery (CIA), subocclusive stenosis of right CIA, occlusion of distal runoffs vessels in the right lower limb and diffuse aorto-iliac disease. The first approach was to place the patient under catheter directed thrombolysis (48h) which led to right pedal pulse recovery but the occlusion of left CIA remained. The patient was then electively submitted to Covered Endovascular Repair of Aortic Bifurcation (CERAB) with chimney to inferior mesenteric artery and with an additional bailout left iliac sandwich due to dissection. Distal pulses are still present after 18 months of follow-up. Endovascular techniques provide a low morbimortality option with similar symptomatic improvement, challenging open surgery as the standard of care even in complex AIOD.</p>","PeriodicalId":87136,"journal":{"name":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","volume":"27 3","pages":"231-233"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38500274","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":"Endometriosis Unusual Aetiology Of Inguinal Swelling.","authors":"Catarina Longras,&nbsp;Sandrina Figueiredo Braga,&nbsp;Celso Carrilho,&nbsp;Amílcar Mesquita","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 42 years-old female presented with right inguinal swelling with one year of evolution. Magnetic resonance imaging was suggestive of inguinal endometriosis adherent to femoral vessels. Due to the rarity of this pathology (prevalence 0.3-0.6%), clinical suspicion is essential. Surgical excision is the treatment of choice.</p>","PeriodicalId":87136,"journal":{"name":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","volume":"27 3","pages":"237"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38500279","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":"Endovascular Treatment Of A Symptomatic Thoracic Aorta Thrombi.","authors":"Pedro Pinto Sousa,&nbsp;Pedro Sá Pinto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Aortic mural thrombus is a rare condition with 0.45% incidence in the general population, being the thoracic aorta the most affected portion. In the absence of an atherosclerotic wall lesion, other specific conditions should be studied and excluded. The authors describe two clinical cases of a 64 years old male and a 48 years old female that despite a non- -atherosclerotic diseased aorta, had a thoracic mural thrombus which presented clinically with mesenteric and lower limb microembolization, respectively. Once presented with peripheral embolization, the aim should be to exclude the embolic source and prevent end organ malfunction. TEVAR has been developed as a therapeutic solution to exclude the embolic source, with a high rate of technical success and few comorbidities associated. Long term anti-coagulation is debatable but may prevent further embolization events.</p>","PeriodicalId":87136,"journal":{"name":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","volume":"27 3","pages":"227-230"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38500280","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":"Fibromuscular Dysplasia Of The Renal Arteries.","authors":"Luísa Amado Costa,&nbsp;Eduardo Rosa,&nbsp;João Leitão,&nbsp;Luís Vítor","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 48 year-old female patient presented with arterial hypertension. Computed tomography angiography revealed small stenoses alternating with areas of dilatation (due to small fusiform aneurysms) in the middle to distal portions of the main renal arteries, creating a \"string of beads\" appearance, findings in keeping with fibromuscular dysplasia.</p>","PeriodicalId":87136,"journal":{"name":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","volume":"27 3","pages":"239"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38498709","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":"Early And Midterm Outcomes Following Aortic Valve Replacement With Mechanical Versus Bioprosthetic Valves In Patients Aged 50 To 70 Years.","authors":"Rafael Rocha,&nbsp;Rui Cerqueira,&nbsp;Francisca A Saraiva,&nbsp;Soraia Moreira,&nbsp;António S Barros,&nbsp;Jorge Almeida,&nbsp;Mário J Amorim,&nbsp;André P Lourenço,&nbsp;Paulo Pinho,&nbsp;Adelino Leite-Moreira","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To compare 7-year survival and freedom from reoperation, as well as early clinical and hemodynamic outcomes, after surgical aortic valve replacement (SAVR) with mechanical or bioprosthetic valves in patients aged 50-70 years.</p><p><strong>Methods: </strong>single-center retrospective cohort study including adults aged 50-70 years who underwent SAVR in 2012 with a mechanical or bioprosthetic valve. Median follow-up was 7 years. Univariable analyses were performed using Kaplan-Meier curves and Log-Rank tests for survival and freedom from reoperation analyses. Multivariable time-to-event analyses were conducted using Cox Regression.</p><p><strong>Results: </strong>Of a total of 193 patients, 76 (39.4%) received mechanical valves and 117 (60.6%) received bioprosthetic valves. A trend for better survival was found for mechanical prostheses when adjusting for EuroSCORE II (HR: 0.35; 95%CI: 0.12-1.02, p=0.054), but using a backward stepwise Cox regression prosthesis type was not retained by the model as an independent predictor of survival. Moreover, mechanical prostheses showed trends for higher freedom from reoperation (100% vs. 95.5%, Log-Rank, p=0.076), higher median EuroSCORE II (2.52% vs. 1.95%, p=0.06) and early mortality (7.9% vs. 2.6%, p=0.086). However, after adjusting for EuroSCORE II, there was no significant difference in early mortality (OR: 2.3, 95%CI: 0.5-10.5, p=0.272). Regarding hemodynamic performance at follow-up echocardiogram, there were no differences other than left ventricular mass regression, which was not as pronounced in the mechanical group (-12% vs. -21%, p=0.002).</p><p><strong>Conclusion: </strong>Mechanical and bioprosthetic aortic valves prostheses showed similar mid-term survival in the 50-70 age group. Further prospective and larger studies are needed to provide evidence-based recommendations on this topic.</p>","PeriodicalId":87136,"journal":{"name":"Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular","volume":"27 3","pages":"179-189"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38499340","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}