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https://www.readbyqxmd.com/read/28977197/collaborative-quality-improvement-in-the-congenital-heart-defects-development-of-the-assist-consortium-and-a-preliminary-surgical-outcomes-report
#1
Fabio Carmona, Paulo Henrique Manso, Mariana Nicoletti Ferreira, Nana Miura Ikari, Marcelo Biscegli Jatene, Luciana Amato, Aida Luiza Turquetto, Luiz Fernando Caneo
OBJECTIVE: ASSIST is the first Brazilian initiative in building a collaborative quality improvement program in pediatric cardiology and congenital heart disease. The purposes of this manuscript are: (a) to describe the development of the ASSIST project, including the historical, philosophical, organizational, and infrastructural components that will facilitate collaborative quality improvement in congenital heart disease care; (b) to report past and ongoing challenges faced; and (c) to report the first preliminary data analysis...
July 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28876374/do-we-need-to-personalize-renal-function-assessment-in-the-stratification-of-patients-undergoing-cardiac-surgery
#2
Camila P S Arthur, Omar A V Mejia, Diogo Osternack, Marcelo Arruda Nakazone, Maxim Goncharov, Luiz A F Lisboa, Luís A O Dallan, Pablo M A Pomerantzeff, Fabio B Jatene
BACKGROUND: Renal dysfunction is an independent predictor of morbidity and mortality in cardiac surgery. For a better assessment of renal function, calculation of creatinine clearance (CC) may be necessary. OBJECTIVE: To objectively evaluate whether CC is a better risk predictor than serum creatinine (SC) in patients undergoing cardiac surgery. METHODS: Analysis of 3,285 patients registered in a prospective, consecutive and mandatory manner in the Sao Paulo Registry of Cardiovascular Surgery (REPLICCAR) between November 2013 and January 2015...
October 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28722266/second-generation-drug-eluting-stents-versus-bare-metal-stents-for-percutaneous-coronary-intervention-of-the-proximal-left-anterior-descending-artery-an-analysis-of-the-basket-prove-i-and-ii-trials
#3
Fernanda Marinho Mangione, Tor Biering-Sørensen, Kotaro Nochioka, Tannas Jatene, Odilson Marcos Silvestre, Kim Wadt Hansen, Rikke Sørensen, Jan Skov Jensen, Peter Godsk Jorgensen, Raban Jeger, Christoph Kaiser, Matthias Pfisterer, Søren Galatius
OBJECTIVES: To compare mid-term outcomes between patients undergoing proximal left anterior descending artery (LAD) percutaneous coronary intervention (PCI) with second generation drug-eluting stent (DES) or bare-metal stent (BMS). BACKGROUND: PCI with BMS and first-generation DES have shown to be safe options for the treatment of proximal LAD stenosis, however associated with considerable reintervention rates. Overall, second-generation DES has proven to be superior to BMS and first-generation DES, nevertheless, its effect for proximal LAD PCI has not previously been reported...
July 19, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28500413/impaired-pulmonary-function-is-an-additional-potential-mechanism-for-the-reduction-of-functional-capacity-in-clinically-stable-fontan-patients
#4
Aída L R Turquetto, Luiz F Canêo, Daniela R Agostinho, Patrícia A Oliveira, Maria Isabel C S Lopes, Patrícia F Trevizan, Frederico L A Fernandes, Maria A Binotto, Gabriela Liberato, Glaucia M P Tavares, Rodolfo A Neirotti, Marcelo B Jatene
Central factors negatively affect the functional capacity of Fontan patients (FP), but "non-cardiac" factors, such as pulmonary function, may contribute to their exercise intolerance. We studied the pulmonary function in asymptomatic FP and its correlations with their functional capacity. Pulmonary function and cardiopulmonary exercise tests were performed in a prospective study of 27 FP and 27 healthy controls (HC). Cardiovascular magnetic resonance was used to evaluate the Fontan circulation. The mean age at tests, the mean age at surgery, and the median follow-up time of FP were 20(±6), 8(±3), and 11(8-17) years, respectively...
June 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28492786/the-brazilian-registry-of-adult-patient-undergoing-cardiovascular-surgery-the-bypass-project-results-of-the-first-1-722-patients
#5
Walter J Gomes, Rita Simone Moreira, Alexandre Cabral Zilli, Luiz Carlos Bettiati, Fernando Augusto Marinho Dos Santos Figueira, Stephanie Steremberg Pires D' Azevedo, Marcelo José Ferreira Soares, Marcio Pimentel Fernandes, Roberto Vito Ardito, Renata Andrea Barberio Bogdan, Valquíria Pelisser Campagnucci, Diana Nakasako, Renato Abdala Karam Kalil, Clarissa Garcia Rodrigues, Anilton Bezerra Rodrigues, Marcelo Matos Cascudo, Fernando Antibas Atik, Elson Borges Lima, Vinicius José da Silva Nina, Renato Albuquerque Heluy, Lisandro Gonçalves Azeredo, Odilon Silva Henrique, José Teles de Mendonça, Katharina Kelly de Oliveira Gama Silva, Marcelo Pandolfo, José Dantas de Lima, Renato Max Faria, Jonas Pereira Dos Santos, Rodrigo Pereira Paez, Guilherme Henrique Biachi Coelho, Sergio Nunes Pereira, Roberta Senger, Enio Buffolo, Guido Marco Caputi, José Amalth do Espírito Santo, Juliana Aparecida Borges de Oliveira, Otavio Berwanger, Alexandre Biasi Cavalcanti, Fabio B Jatene
Objective: To report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients. Methods: Data collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1)...
March 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28333037/cerebral-hemodynamics-with-intra-aortic-balloon-pump-business-as-usual
#6
J R Caldas, R B Panerai, E Bor-Seng-Shu, J P Almeida, G S R Ferreira, L Camara, R C Nogueira, M L Oliveira, F B Jatene, T G Robinson, L A Hajjar
OBJECTIVE: Intra-aortic balloon pump (IABP) is commonly used as mechanical support after cardiac surgery or cardiac shock. Although its benefits for cardiac function have been well documented, its effects on cerebral circulation are still controversial. We hypothesized that transfer function analysis (TFA) and continuous estimates of dynamic cerebral autoregulation (CA) provide consistent results in the assessment of cerebral autoregulation in patients with IABP. APPROACH: Continuous recordings of blood pressure (BP, intra-arterial line), end-tidal CO2, heart rate and cerebral blood flow velocity (CBFV, transcranial Doppler) were obtained (i) 5 min with IABP ratio 1:3, (ii) 5 min, starting 1 min with the IABP-ON, and continuing for another 4 min without pump assistance (IABP-OFF)...
June 22, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28322416/effect-of-intensive-vs-moderate-alveolar-recruitment-strategies-added-to-lung-protective-ventilation-on-postoperative-pulmonary-complications-a-randomized-clinical-trial
#7
RANDOMIZED CONTROLLED TRIAL
Alcino Costa Leme, Ludhmila Abrahao Hajjar, Marcia S Volpe, Julia Tizue Fukushima, Roberta Ribeiro De Santis Santiago, Eduardo A Osawa, Juliano Pinheiro de Almeida, Aline Muller Gerent, Rafael Alves Franco, Maria Ignez Zanetti Feltrim, Emília Nozawa, Vera Regina de Moraes Coimbra, Rafael de Moraes Ianotti, Clarice Shiguemi Hashizume, Roberto Kalil Filho, Jose Otavio Costa Auler, Fabio Biscegli Jatene, Filomena Regina Barbosa Gomes Galas, Marcelo Britto Passos Amato
Importance: Perioperative lung-protective ventilation has been recommended to reduce pulmonary complications after cardiac surgery. The protective role of a small tidal volume (VT) has been established, whereas the added protection afforded by alveolar recruiting strategies remains controversial. Objective: To determine whether an intensive alveolar recruitment strategy could reduce postoperative pulmonary complications, when added to a protective ventilation with small VT...
April 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28076623/low-cost-simulator-for-heart-surgery-training
#8
Roberto Rocha e Silva, Artur Lourenção, Maxim Goncharov, Fabio B Jatene
Objective: Introduce the low-cost and easy to purchase simulator without biological material so that any institution may promote extensive cardiovascular surgery training both in a hospital setting and at home without large budgets. Methods: A transparent plastic box is placed in a wooden frame, which is held by the edges using elastic bands, with the bottom turned upwards, where an oval opening is made, "simulating" a thoracotomy. For basic exercises in the aorta, the model presented by our service in the 2015 Brazilian Congress of Cardiovascular Surgery: a silicone ice tray, where one can train to make aortic purse-string suture, aortotomy, aortorrhaphy and proximal and distal anastomoses...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27823597/frequency-of-deep-vein-thrombosis-and-or-pulmonary-embolism-after-coronary-artery-bypass-grafting-investigation-regardless-of-clinical-suspicion
#9
Vitor B Viana, Emanoel R Melo, Mario Terra-Filho, Luis A Dallan, Maria M Gonzalez, Ludhmila A Hajjar, Fabio B Jatene, Luiz A Cesar, Caio B Vianna
Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and/or pulmonary embolism (PE). Many surgeons and clinicians believe that VTE after coronary artery bypass grafting (CABG) has little clinical significance because it is seldom diagnosed. This study aimed to identify VTE after CABG, independent of clinical suspicion. In this prospective, observational, single-center study, 100 patients underwent computed tomographic pulmonary angiography (multidetector-64) and lower extremity venous compressive ultrasound after elective CABG...
January 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27556326/brazilian-registry-of-cardiovascular-surgery-in-adults-fully-operational
#10
EDITORIAL
Walter J Gomes, Renato A K Kalil, Fabio B Jatene
No abstract text is available yet for this article.
April 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27184152/the-use-of-a-high-power-laser-on-swine-mitral-valve-chordae-tendineae
#11
Nathali Cordeiro Pinto, M Cristina Chavantes, Denise Zezell, Alessandro Deana, Carolina Benetti, Rodrigo Labat Marcos, Luciana Almeida Lopes, Rodrigo A B Lopes Martins, Vera Demarchi Aiello, Fabio Biscegli Jatene, Pablo M A Pomerantzeff
Worldwide, rheumatic fever remains a significant cause of mitral valve insufficiency. It is responsible for approximately 90 % of early childhood valvular surgeries in Brazil. Elongated or flail chordae are frequently responsible and require surgical correction. The purpose of this study was to analyze and compare the histological tissues of the mitral valve chordae and the mechanical resistance generated by the chordae, both with and without the application of a high-power laser. Twenty normal porcine mitral valve chordae were measured and divided randomly into the following two groups: control group (not subjected to a high-power laser) and laser group (subjected to photonic irradiation)...
August 2016: Lasers in Medical Science
https://www.readbyqxmd.com/read/27163414/post-cardiotomy-ecmo-in-pediatric-and-congenital-heart-surgery-impact-of-team-training-and-equipment-in-the-results
#12
Leonardo Augusto Miana, Luiz Fernando Canêo, Carla Tanamati, Juliano Gomes Penha, Vanessa Alves Guimarães, Nana Miura, Filomena Regina Barbosa Gomes Galas, Marcelo Biscegli Jatene
INTRODUCTION: Post-cardiotomy myocardial dysfunction requiring mechanical circulatory support occurs in about 0.5% of cases. In our environment, the use of extracorporeal membrane oxygenation has been increasing in recent years. OBJECTIVE: To evaluate the impact of investment in professional training and improvement of equipment in the rate of weaning from extracorporeal membrane oxygenation and survival. METHODS: A retrospective study. Fifty-six pediatric and/or congenital heart patients underwent post-cardiotomy extracorporeal membrane oxygenation at our institution between November 1999 and July 2014...
July 2015: Revista Brasileira de Cirurgia Cardiovascular
https://www.readbyqxmd.com/read/27090771/transbaffle-multielectrode-mapping-of-atrial-flutter-post-double-switch-operation
#13
Shouvik Haldar, Andreu Porta-Sanchez, Erwin Oechslin, Eugene Downar, Lee Benson, Krishnakumar Nair
A 26-year-old woman with congenitally corrected transposition of the great arteries (ccTGA) had undergone a double-switch corrective surgery consisting of a Mustard procedure (bovine pericardial baffles and hemashield grafts) and arterial switch (Jatene technique). She subsequently developed drug refractory atrial flutter and underwent ablation. An Agilis sheath (St Jude Medical, USA) and a long BRK 1 needle was used for the transbaffle puncture guided by transoesophageal echocardiography. Activation maps of the systemic venous antrum (SVA) and then the PVA (Fig...
April 19, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/26994168/continuous-quality-improvement-programme-in-cardiovascular-surgery-the-latin-american-perspective
#14
EDITORIAL
Omar A Mejía, Luiz A Lisboa, Fabio B Jatene
No abstract text is available yet for this article.
July 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/26735597/experimental-study-and-early-clinical-application-of-a-sutureless-aortic-bioprosthesis
#15
Walter J Gomes, João Carlos Leal, Fabio Biscegli Jatene, Nelson A Hossne, Renata Gabaldi, Glaucia Basso Frazzato, Guilherme Agreli, Domingo M Braile
INTRODUCTION: The conventional aortic valve replacement is the treatment of choice for symptomatic severe aortic stenosis. Transcatheter technique is a viable alternative with promising results for inoperable patients. Sutureless bioprostheses have shown benefits in high-risk patients, such as reduction of aortic clamping and cardiopulmonary bypass, decreasing risks and adverse effects. OBJECTIVE: The objective of this study was to experimentally evaluate the implantation of a novel balloon-expandable aortic valve with sutureless bioprosthesis in sheep and report the early clinical application...
September 2015: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/26646462/effect-of-perioperative-goal-directed-hemodynamic-resuscitation-therapy-on-outcomes-following-cardiac-surgery-a-randomized-clinical-trial-and-systematic-review
#16
RANDOMIZED CONTROLLED TRIAL
Eduardo A Osawa, Andrew Rhodes, Giovanni Landoni, Filomena R B G Galas, Julia T Fukushima, Clarice H L Park, Juliano P Almeida, Rosana E Nakamura, Tania M V Strabelli, Brunna Pileggi, Alcino C Leme, Evgeny Fominskiy, Yasser Sakr, Marta Lima, Rafael A Franco, Raquel P C Chan, Marilde A Piccioni, Priscilla Mendes, Suéllen R Menezes, Tatiana Bruno, Fabio A Gaiotto, Luiz A Lisboa, Luiz A O Dallan, Alexandre C Hueb, Pablo M Pomerantzeff, Roberto Kalil Filho, Fabio B Jatene, Jose Otavio Costa Auler Junior, Ludhmila A Hajjar
OBJECTIVES: To evaluate the effects of goal-directed therapy on outcomes in high-risk patients undergoing cardiac surgery. DESIGN: A prospective randomized controlled trial and an updated metaanalysis of randomized trials published from inception up to May 1, 2015. SETTING: Surgical ICU within a tertiary referral university-affiliated teaching hospital. PATIENTS: One hundred twenty-six high-risk patients undergoing coronary artery bypass surgery or valve repair...
April 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26559982/palliative-senning-in-the-treatment-of-congenital-heart-disease-with-severe-pulmonary-hypertension
#17
Juliano Gomes da Penha, Leina Zorzanelli, Antonio Augusto Barbosa-Lopes, Edimar Atik, Leonardo Augusto Miana, Carla Tanamati, Luiz Fernando Caneo, Nana Miura, Vera Demarchi Aiello, Marcelo Biscegli Jatene
BACKGROUND: Transposition of the great arteries (TGA) is the most common cyanotic cardiopathy, with an incidence ranging between 0.2 and 0.4 per 1000 live births. Many patients not treated in the first few months of life may progress with severe pulmonary vascular disease. Treatment of these patients may include palliative surgery to redirect the flow at the atrial level. OBJECTIVE: Report our institutional experience with the palliative Senning procedure in children diagnosed with TGA and double outlet right ventricle with severe pulmonary vascular disease, and to evaluate the early and late clinical progression of the palliative Senning procedure...
October 2015: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/26556777/exercise-capacity-long-term-after-arterial-switch-operation-for-transposition-of-the-great-arteries
#18
Flávia Samos, Gabriela Fuenmayor, Carlos Hossri, Patrícia Elias, Leandro Ponce, Rogério Souza, Ieda Jatene
UNLABELLED: Transposition of the great arteries (TGA) is a congenital heart defect successfully corrected through arterial switch operation (ASO). Although this technique had significant impact in improving survival, little is known about the functional capacity of the operated patients long-term after surgery. OBJECTIVE: The aim of this study was to compare the functional capacity of children with TGA long-term after ASO with that of healthy children. DESIGN: Retrospective study...
March 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/26313725/surgery-of-the-aortic-root-should-we-go-for-the-valve-sparing-root-reconstruction-or-the-composite-graft-valve-replacement-is-still-the-first-choice-of-treatment-for-these-patients
#19
COMPARATIVE STUDY
Fernando de Azevedo Lamana, Ricardo Ribeiro Dias, Jose Augusto Duncan, Leandro Batisti de Faria, Luiz Marcelo Sa Malbouisson, Luciano de Figueiredo Borges, Charles Mady, Fábio Biscegli Jatene
OBJECTIVE: To compare the results of the root reconstruction with the aortic valve-sparing operation versus composite graft-valve replacement. METHODS: From January 2002 to October 2013, 324 patients underwent aortic root reconstruction. They were 263 composite graft-valve replacement and 61 aortic valve-sparing operation (43 reimplantation and 18 remodeling). Twenty-six percent of the patients were NYHA functional class III and IV; 9.6% had Marfan syndrome, and 12% had bicuspid aortic valve...
July 2015: Revista Brasileira de Cirurgia Cardiovascular
https://www.readbyqxmd.com/read/26312550/age-creatinine-and-ejection-fraction-score-in-brazil-comparison-with-inscor-and-the-euroscore
#20
Omar Asdrúbal Vilca Mejía, Bruna La Regina Matrangolo, David Provenzale Titinger, Leandro Batisti de Faria, Luís Roberto Palma Dallan, Filomena Regina Barbosa Galas, Luiz Augusto Ferreira Lisboa, Luís Alberto Oliveira Dallan, Fabio Biscegli Jatene
BACKGROUND: Risk scores for cardiac surgery cannot continue to be neglected. OBJECTIVE: To assess the performance of "Age, Creatinine and Ejection Fraction Score" (ACEF Score) to predict mortality in patients submitted to elective coronary artery bypass graft and/or heart valve surgery, and to compare it to other scores. METHODS: A prospective cohort study was carried out with the database of a Brazilian tertiary care center. A total of 2,565 patients submitted to elective surgeries between May 2007 and July 2009 were assessed...
November 2015: Arquivos Brasileiros de Cardiologia
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