Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular最新文献

{"title":"Short-term inspiratory muscle training potentiates the benefits of aerobic and resistance training in patients undergoing CABG in phase II cardiac rehabilitation program.","authors":"Bárbara Maria Hermes, Dannuey Machado Cardoso, Tiago José Nardi Gomes, Tamires Daros dos Santos, Marília Severo Vicente, Sérgio Nunes Pereira, Viviane Acunha Barbosa, Isabella Martins de Albuquerque","doi":"10.5935/1678-9741.20150043","DOIUrl":"10.5935/1678-9741.20150043","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficiency of short-term inspiratory muscle training program associated with combined aerobic and resistance exercise on respiratory muscle strength, functional capacity and quality of life in patients who underwent coronary artery bypass and are in the phase II cardiac rehabilitation program.</p><p><strong>Methods: </strong>A prospective, quasi-experimental study with 24 patients who underwent coronary artery bypass and were randomly assigned to two groups in the Phase II cardiac rehabilitation program: inspiratory muscle training program associated with combined training (aerobic and resistance) group (GCR + IMT, n=12) and combined training with respiratory exercises group (GCR, n=12), over a period of 12 weeks, with two sessions per week. Before and after intervention, the following measurements were obtained: maximal inspiratory and expiratory pressures (PImax and PEmax), peak oxygen consumption (peak VO2) and quality of life scores. Data were compared between pre- and post-intervention at baseline and the variation between the pre- and post-phase II cardiac rehabilitation program using the Student's t-test, except the categorical variables, which were compared using the Chi-square test. Values of P<0.05 were considered statistically significant.</p><p><strong>Results: </strong>Compared to GCR, the GCR + IMT group showed larger increments in PImax (P<0.001), PEmax (P<0.001), peak VO2 (P<0.001) and quality of life scores (P<0.001).</p><p><strong>Conclusion: </strong>The present study demonstrated that the addition of inspiratory muscle training, even when applied for a short period, may potentiate the effects of combined aerobic and resistance training, becoming a simple and inexpensive strategy for patients who underwent coronary artery bypass and are in phase II cardiac rehabilitation.</p>","PeriodicalId":87739,"journal":{"name":"Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular","volume":"30 4","pages":"474-81"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34375305","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 intraoperative diltiazem infusion on flow changes in arterial and venous grafts in coronary artery bypass graft surgery.","authors":"Ozan Erdem,&nbsp;Mehmet Erdem Memetoğlu,&nbsp;Ali İhsan Tekin,&nbsp;Ümit Arslan,&nbsp;Özgür Akkaya,&nbsp;Rasim Kutlu,&nbsp;İlhan Gölbaşı","doi":"10.5935/1678-9741.20150045","DOIUrl":"https://doi.org/10.5935/1678-9741.20150045","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to show the effects of intra-operative diltiazem infusion on flow in arterial and venous grafts in coronary artery bypass graft surgery.</p><p><strong>Methods: </strong>Hundred fourty patients with a total of 361 grafts [205 (57%) arterial and 156 (43%) venous] underwent isolated coronary surgery. All the grafts were measured by intraoperative transit time flow meter intra-operatively. Group A (n=70) consisted of patients who received diltiazem infusion (dose of 2.5 microgram/kg/min), and Group B (n=70) didn't receive diltiazem infusion.</p><p><strong>Results: </strong>Mean graft flow values of left internal mammary artery were 53 ml/min in Group A and 40 ml/min in Group B (P<0.001). Pulsatility index (PI) values of left internal mammary artery for Group A and Group B were 2.6 and 3.0 respectively (P<0.001). No statistically significant difference was found between venous graft parameters.</p><p><strong>Conclusion: </strong>We recommend an effect of diltiazem infusion in increasing graft flows in coronary artery bypass graft operations.</p>","PeriodicalId":87739,"journal":{"name":"Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular","volume":"30 4","pages":"459-65"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34470579","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":"Impact of respiratory infection in the results of cardiac surgery in a tertiary hospital in Brazil.","authors":"Isaac Newton Guimarães Andrade, Diego Torres Aladin de Araújo, Fernando Ribeiro de Moraes Neto","doi":"10.5935/1678-9741.20150038","DOIUrl":"10.5935/1678-9741.20150038","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of respiratory tract infection in the postoperative period of cardiac surgery in relation to mortality and to identify patients at higher risk of developing this complication.</p><p><strong>Methods: </strong>Cross-sectional observational study conducted at the Recovery of Cardiothoracic Surgery, using information from a database consisting of a total of 900 patients operated on in this hospital during the period from 01/07/2008 to 1/07/2009. We included patients whose medical records contained all the information required and undergoing elective surgery, totaling 109 patients with two excluded. Patients were divided into two groups, WITH and WITHOUT respiratory tract infection, as the development or respiratory tract infection in hospital, with patients in the group without respiratory tract infection, the result of randomization, using for the pairing of the groups the type of surgery performed. The outcome variables assessed were mortality, length of hospital stay and length of stay in intensive care unit. The means of quantitative variables were compared using the Wilcoxon and student t-test.</p><p><strong>Results: </strong>The groups were similar (average age P=0.17; sex P=0.94; surgery performed P=0.85-1.00) Mortality in the WITH respiratory tract infection group was significantly higher (P<0.0001). The times of hospitalization and intensive care unit were significantly higher in respiratory tract infection (P<0.0001). The presence of respiratory tract infection was associated with the development of other complications such as renal failure dialysis and stroke P<0.00001 and P=0.002 respectively.</p><p><strong>Conclusion: </strong>The development of respiratory tract infection postoperative cardiac surgery is related to higher mortality, longer periods of hospitalization and intensive care unit stay.</p>","PeriodicalId":87739,"journal":{"name":"Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular","volume":"30 3","pages":"360-4"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33956700","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":"Sternal wound tuberculosis following cardiac operations: a review.","authors":"Shi-Min Yuan","doi":"10.5935/1678-9741.20140102","DOIUrl":"https://doi.org/10.5935/1678-9741.20140102","url":null,"abstract":"<p><strong>Objective: </strong>The diagnosis and treatment of sternal wound infections with mycobacteria are challenging. Such an infection is often associated with a delayed diagnosis and improper treatment that may lead to a worsened clinical outcome. The present study is designed to highlight its clinical features so as to facilitate a prompt diagnosis and timely treatment.</p><p><strong>Methods: </strong>MEDLINE, Highwire Press, and Google search engine were searched for publications in the English language, with no time limit, reporting on sternal wound infection caused by tuberculosis after cardiac surgery.</p><p><strong>Results: </strong>A total of 12 articles reporting on 14 patients were included in this study. Coronary artery bypass grafting was the underlying surgical procedure in more than half of the cases. Purulent discharge and cold abscess were the two main presenting symptoms. Diagnosis of sternal wound infection was evidenced in all 14 patients by different investigations, with culture of samples being the most sensitive method of identifying the pathogen. Good response to first-line anti-tuberculous agents was noted. Almost all patients required surgical debridement/resection and, sometimes, sternal reconstruction. A delayed diagnosis of sternal wound infection may lead to repeated recurrences. A comparison between patients with sternal wound infection due to tuberculosis and non-tuberculous mycobacterial infections showed that the former infections took an even longer period of time. Comparisons also revealed patients with sternal tuberculosis infection had a significantly higher mortality than patients with sternal non-tuberculous infection (29.2% vs. 0%, P=0.051).</p><p><strong>Conclusion: </strong>Sternal infection caused by tuberculosis after cardiac surgery has a longer latency, better response to first-line drugs, and better outcomes in comparison with non-tuberculous sternal infection. Early diagnosis and early anti-tuberculous treatment can surely improve the patients' prognosis.</p>","PeriodicalId":87739,"journal":{"name":"Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular","volume":"30 4","pages":"489-93"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34375307","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":"Chronotropic incompetence in Chagas disease: effectiveness of blended sensor (volume/minute and accelerometer).","authors":"Antonio da Silva Menezes Junior, Aline Pereira da Silva, Giovana Gurian Batista Profahl, Catarine Ottobeli, Jutay Fernando Silva Louzeiro","doi":"10.5935/1678-9741.20150035","DOIUrl":"10.5935/1678-9741.20150035","url":null,"abstract":"<p><strong>Introduction: </strong>Technological progress of pacemakers has allowed the association of two or more sensors in one heart rate system response. The accelerometer sensor measures the intensity of the activity; it has a relatively rapid response to the beginning of it, however, it may present insufficient response to less strenuous or of less impact exercise. The minute ventilation sensor changes the pacing rate in response to changes in respiratory frequency in relation to tidal volume, allowing responses to situations of emotional stress and low impact exercises.</p><p><strong>Objective: </strong>To evaluate the cardiorespiratory response of the accelerometer with respect to the blended sensor (BS=accelerometer sensor+minute ventilation sensor) to exercise in chagasic patients undergoing cardiopulmonary exercise test.</p><p><strong>Methods: </strong>This was a prospective, observational, randomized, cross-sectional study. Patients who met the inclusion criteria were selected. The maximum heart rate of the sensor was programmed by age (220-age). The results were analyzed through t test with paired samples (P<0.05).</p><p><strong>Results: </strong>Sample was comprised of 44 patients, with a mean age of 66±10.4 years, 58% were female, 54% as first implant, in 74% were functional class I and 26% were functional class II, left ventricular ejection fraction was 58±7. As for the cardiopulmonary test, maximum expected heart rate and VO2 were not achieved in both the accelerometer sensor and the blended sensor, however, metabolic equivalent in the blended sensor was higher than the expected, all data with P<0.001.</p><p><strong>Conclusion: </strong>Even though the maximal heart rate was not reached, the blended sensor provided a physiological electrical sequence when compared to the accelerometer sensor, providing better physical fitness test in cardiopulmonary hemodynamics and greater efficiency.</p>","PeriodicalId":87739,"journal":{"name":"Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular","volume":"30 3","pages":"311-5"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33954694","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":"Transcatheter aortic valve implantation with balloon-expandable valve: early experience from China.","authors":"Qingsheng Lu,&nbsp;Yifei Pei,&nbsp;Hong Wu,&nbsp;Zhinong Wang,&nbsp;Jing Zaiping","doi":"10.5935/1678-9741.20150054","DOIUrl":"https://doi.org/10.5935/1678-9741.20150054","url":null,"abstract":"Objective The aim of the current study was to evaluate the early experience of the application of transcatheter aortic valve implantation with the balloon-expandable system in China. The transcatheter aortic valve implantation technology has been widely used for patients with inoperable severe aortic stenosis in the developed world. The application of transcatheter aortic valve implantation is still in the early stages of testing in China, particularly for the balloon-expandable valve procedure. Methods This was a retrospective study. All patients undergoing transcatheter aortic valve implantation with balloon-expandable system in our hospital between 2011 and 2014 were included. Edwards SAPIEN XT Transcatheter Heart Valve was used. The improvement of valve and heart function was evaluated as well as 30-day mortality and major complications according to the VARC-2 definition. Results A total of 10 transcatheter aortic valve implantation procedures with the balloon-expandable system were performed in our hospital, of which 9 were transfemoral and 1 was transapical. The median age was 76 years, and the median STS score and Logistic EuroSCORE (%) were 8.9 and 16.2. The implantation was successfully conducted in all patients, only 2 patients had mild paravalvular leak. There was no second valve implantation. Moreover, no 30-day mortality or complications was reported. Following the transcatheter aortic valve implantation procedure, the heart and valve functions had improved significantly. During the follow-up period of 3-34 months, one patient died of lung cancer 13 months after the operation. Conclusion This early experience has provided preliminary evidence for the safety and efficacy of transcatheter aortic valve implantation procedure with the balloon-expandable system in the developing world with an increasing aging population.","PeriodicalId":87739,"journal":{"name":"Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular","volume":"30 4","pages":"425-32"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5935/1678-9741.20150054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34470578","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":"Recommendations for starting a grown up congenital heart disease (GUCH) unit.","authors":"Fernando Tadeu Vasconcelos Amaral, Paulo Henrique Manso, André Schmidt, Ricardo Nilson Sgarbieri, Walter Villela de Andrade Vicente, Clovis Carbone Junior, Jane Somerville","doi":"10.5935/1678-9741.20150037","DOIUrl":"10.5935/1678-9741.20150037","url":null,"abstract":"<p><p>During the last decades, advances in diagnosis and treatment of congenital heart disease have allowed many individuals to reach adulthood. Due mainly to the great diagnostic diversity and to the co-morbidities usually present in this age group, these patients demand assistance in a multidisciplinary facility if an adequate attention is aimed. In this paper we reviewed, based in the international literature and also on the authors' experience, the structural conditions that should be available for these patients. We highlighted aspects like the facility characteristics, the criteria usually adopted for patient transfer from the paediatric setting, the composition of the medical and para- medical staff taking into account the specific problems, and also the model of outpatient and in-hospital assistance. We also emphasized the importance of patient data storage, the fundamental necessity of institutional support and also the compromise to offer professional training. The crucial relevance of clinical research is also approached, particularly the development of multicenter studies as an appropriate methodology for this heterogeneous patient population. </p>","PeriodicalId":87739,"journal":{"name":"Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular","volume":"30 3","pages":"373-9"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33956702","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":"Answer to \"Key points of reducing neurologic complications in frozen elephant trunk technique\".","authors":"Ricardo Ribeiro Dias,&nbsp;Jose Augusto Duncan","doi":"10.5935/1678-9741.20150057","DOIUrl":"https://doi.org/10.5935/1678-9741.20150057","url":null,"abstract":"Answer to \" Key points of reducing neurologic complications in frozen elephant trunk technique \" Dear Editor, We appreciated the comments of the colleagues regarding our role and we completely agree with the considerations related to the need of reducing morbidity. With this in mind, we can say that all points must be addressed in order to prevent morbidity and mortality in our patients. Recently, we started to operate on this type of surgery in a hybrid operating room, but in the beginning of the learning curve, we did not. Many years ago, when we first started placing stents in the descending aorta, in acute type B dis-sections, with a Brazilian short endovascular stent graft (9 cm length), which was very smooth and easy to handle, we learned how to do it without a guidewire, which is actually impossible with the current stent grafts. Nowadays, we use the guidewire in almost all cases. In the beginning of the \" Evita Open \" experience (the only stent graft available here in Brazil for the frozen elephant trunk procedure), the device had a soft but big \" ball \" at the end of the prosthesis so as not to harm the dissected layer of the aorta; and for chronic dissections with small true lu-men, the pull back traction was also an issue and sometimes it would take several minutes to release the prosthesis. They have changed and now we no longer face this problem. The stent graft length is not an issue, in my opinion. None was longer than 15 centimeters. In addition, when doing total endovascular procedures, we have covered the entire descending aorta in many cases and we did not have paraplegia. Cerebral fluid drainage as a spinal cord protection strategy is regularly used, but not for these operations. If you do not have a proximal hypertension hemodynamic situation, which happens in these controlled proximal brain perfusions, there is no reason for cerebral fluid drainage (the situation is completely different from the thoracoabdominal aorta operations). In conclusion, we can say that with a better and faster surgical procedure, we can regularly do this operation in less than 60 minutes of body circulatory arrest time and no longer have these devastating complications.","PeriodicalId":87739,"journal":{"name":"Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular","volume":"30 4","pages":"506"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34375314","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":"Cardiopulmonary bypass increases the risk of vasoplegic syndrome after coronary artery bypass grafting in patients with dialysis-dependent chronic renal failure.","authors":"Nelson Américo Hossne Junior, Matheus Miranda, Marcus Rodrigo Monteiro, João Nelson Rodrigues Branco, Guilherme Flora Vargas, José Osmar Medina de Abreu Pestana, Walter José Gomes","doi":"10.5935/1678-9741.20140092","DOIUrl":"10.5935/1678-9741.20140092","url":null,"abstract":"<p><strong>Objective: </strong>Coronary artery bypass grafting is currently the best treatment for dialysis patients with multivessel coronary artery involvement. Vasoplegic syndrome of inflammatory etiology constitutes an important postoperative complication, with highly negative impact on prognosis. Considering that these patients have an intrinsic inflammatory response exacerbation, our goal was to evaluate the incidence and mortality of vasoplegic syndrome after myocardial revascularization in this group.</p><p><strong>Methods: </strong>A retrospective, single-center study of 50 consecutive and non-selected dialysis patients who underwent myocardial revascularization in a tertiary university hospital, from 2007 to 2012. The patients were divided into 2 groups, according to the use of cardiopulmonary bypass or not (off-pump coronary artery bypass). The incidence and mortality of vasoplegic syndrome were analyzed. The subgroup of vasoplegic patients was studied separately.</p><p><strong>Results: </strong>There were no preoperative demographic differences between the cardiopulmonary bypass (n=20) and off-pump coronary artery bypass (n=30) group. Intraoperative data showed a greater number of distal coronary arteries anastomosis (2.8 vs. 1.8, P<0.0001) and higher transfusion rates (65% vs. 23%, P=0.008) in the cardiopulmonary bypass group. Vasoplegia incidence was statistically higher (P=0.0124) in the cardiopulmonary bypass group (30%) compared to the off-pump coronary artery bypass group (3%). Vasoplegia mortality was 50% in the cardiopulmonary bypass group and 0% in the off-pump coronary artery bypass group. The vasoplegic subgroup analysis showed no statistically significant clinical differences.</p><p><strong>Conclusion: </strong>Cardiopulmonary bypass increased the risk for developing postoperative vasoplegic syndrome after coronary artery bypass grafting in patients with dialysis-dependent chronic renal failure.</p>","PeriodicalId":87739,"journal":{"name":"Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular","volume":"30 4","pages":"482-8"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34375306","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":"Factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of repair of complete atrioventricular septal defect.","authors":"Marcelo Felipe Kozak,&nbsp;Ana Carolina Leiroz Ferreira Botelho Maisano Kozak,&nbsp;Carlos Henrique De Marchi,&nbsp;Sirio Hassem Sobrinho Junior,&nbsp;Ulisses Alexandre Croti,&nbsp;Airton Camacho Moscardini","doi":"10.5935/1678-9741.20150036","DOIUrl":"https://doi.org/10.5935/1678-9741.20150036","url":null,"abstract":"<p><strong>Introduction: </strong>Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defects.</p><p><strong>Objective: </strong>To determine factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of surgical repair of complete atrioventricular septal defect.</p><p><strong>Methods: </strong>We assessed the results of 53 consecutive patients 3 years-old and younger presenting with complete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. Median age was 6.7 months; median weight was 5.3 Kg; 86.8% had Down syndrome. At the time of preoperative evaluation, there were 26 cases with moderate or severe left atrioventricular valve regurgitation (49.1%). Abnormalities on the left atrioventricular valve were found in 11.3%; annuloplasty was performed in 34% of the patients.</p><p><strong>Results: </strong>At the time of postoperative evaluation, there were 21 cases with moderate or severe left atrioventricular valve regurgitation (39.6%). After performing a multivariate analysis, the only significant factor associated with moderate or severe left atrioventricular valve regurgitation was the absence of Down syndrome (P=0.03).</p><p><strong>Conclusion: </strong>Absence of Down syndrome was associated with moderate or severe postoperative left atrioventricular valve regurgitation after surgical repair of complete atrioventricular septal defect at our practice.</p>","PeriodicalId":87739,"journal":{"name":"Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular","volume":"30 3","pages":"304-10"},"PeriodicalIF":0.0,"publicationDate":"2015-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33954693","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}