Coronariopathy

BACKGROUND: Left hepatic trisectionectomy consists of the removal of liver segments 2, 3, 4, 5, and 8. This difficult surgical procedure may be required when the left liver and right anterior sector (segments 5 and 8) are involved. We present a video of a robotic anatomic left trisectionectomy with Glissonian approach to the left and right anterior sector pedicles. METHODS: A 77-year-old man presented at a routine ultrasound with a large liver mass. Magnetic resonance imaging showed a bulky hepatocellular carcinoma occupying liver segments 2, 3, 4, 5, and 8, with a portal tumor thrombus in the right anterior sector...

OBJECTIVE: The use of local anesthetics associated to vasoconstrictor agents in dentistry is thoroughly justified and is widely extended, but we cannot ignore the fact that anesthetic infiltration poses risk of complications throughout the dental treatment period. The objective of the present review is to document the reported effects the use of the local anesthetics most widely employed in dentistry, with or without association to vasoconstrictor agents may have in patients with any sort of cardiopathy...

No abstract text is available yet for this article.

BACKGROUND AND OBJECTIVES: Anesthesiologists are responsible for airway management whenever they assume the anesthesia of a patient. In this study, we compare the hemodynamic parameters of rigid laryngoscopy and lighted stylet in patients with coronariopathies. PATIENTS AND METHODS: This randomized clinical trial included 40 patients undergoing myocardial revascularization assigned into two groups: lighted stylet and rigid laryngoscope. Besides time of tracheal intubation in each group, heart rate, mean arterial pressure, changes in ST segment, and central venous pressure were evaluated during patient preparation, 1 minute and 5 minutes after anesthetic induction, and 1 minute after tracheal intubation...

BACKGROUND: There is a scarcity of cost-effectiveness analyses in the national literature comparing drug-eluting stents (DES) with bare-metal stents (BMS), at late follow-up. OBJECTIVE: To estimate the Incremental Cost-Effectiveness Ratio (ICER) between DES and BMS in uniarterial coronariopathy. METHODS: 217 patients (130 DES and 87 BMS), with 48 months of follow-up (mean = 26 months) were assessed. PRIMARY OUTCOME: cost per prevented restenosis, with effectiveness being defined as the decrease in major events...

The assessment of activated protein C resistance (APCR) caused by mutations in factor V (factor V Leiden) is an important risk factor for venous thromboembolism, of which role as the originator of arterial obstructions in situ is still a controversial subject. The clinical case of a young patient with history of coronariopathy, multiple cerebrovascular lesions and peripheral artery disease is reported. The diagnostic investigation showed APCR as the possible etiology.

BACKGROUND AND OBJECTIVES: Perioperative myocardial ischemia is commonly observed, and it can increase significantly postoperative morbidity and mortality. The cardioprotective properties of volatile anesthetics and opioids have been studied during several decades and currently constitute powerful tools in the management of patients with ischemic coronariopathy. The objective of this review was to provide the fundaments of myocardial protection by preconditioning. CONTENTS: The concepts of cellular damage secondary to ischemia and reperfusion, ischemic preconditioning (IPC), and anesthetic preconditioning (APC), as well as the mechanisms of myocardial protection, are discussed...

Diabetes has been associated with depression since Thomas Willis' work in 1684 (Rubin and Peyrot in Diabetes Metab Rev 18:173-175, 2002). The aim of this study is to identify social and clinical factors independently associated with depression in individuals with type 1 diabetes. We carried out a descriptive transversal study with 110 type 1 diabetes patients, administered a questionnaire and obtained demographical and diabetes-related data (number of years from diagnosis, initial admission at diagnosis, glycated hemoglobin, number of complications, insulin dose, number of insulin injections per day, admission for ketoacidosis or hypoglycemia at diagnosis, and specific diabetes complications such as nephropathy, retinopathy, peripheral neuropathy, coronariopathy, and amputation)...

BACKGROUND: The routine use of local anesthetics associated to vasoconstrictors for the dental treatment of patients with cardiopathies is still controversial, due to the risk of adverse cardiovascular effects. OBJECTIVE: To evaluate and compare the hemodynamic effects of the use of local anesthetics with a non-adrenergic vasoconstrictor in patients with ventricular arrhythmia, when compared to the use of anesthetics without vasoconstrictor. METHODS: A prospective randomized study evaluated 33 patients with positive serology for Chagas' disease and 32 patients with coronary artery disease that presented complex ventricular arrhythmia at Holter monitoring (>10 EV/h and NSVT), of which 21 were females, aged 54...

This study was aimed at revealing the relationship between the serum concentrations of lipoprotein(a) [Lp(a)], the coronary atherosclerotic disease (CAD) and the cerebral vasculopathies (CVP) in elderly patients. A group of 117 patients (66 women and 51 men, mean age 83 +/- 5.8 years) was investigated. Of them, 58 suffered from acute myocardial infarct (AMI) and 59 from ictus cerebri (IC). The parameters were compared with those obtained from a control-group of 88 old people without any recent clinical history of cerebrovasculopathy or atherosclerotic coronariopathy...

BACKGROUND: Obesity is one of the worlds greatest health problems. The Roux-en-Y gastric bypass is the gold standard treatment for severe obesity. Surgery in obese patients has an acceptable level of morbidity and mortality. The superobese patient, a subcategory of severe obese patients with a high surgical risk has not yet been analyzed as a group. METHODS: A retrospective and prospective cohort study was conducted enrolling 135 patients submitted to Roux-en-Y gastric bypass for treatment of severe obesity at the " Hospital das Clínicas" , Federal University of Pernambuco, Recife, PE, Brazil, between November 1997 and September 2003...

We report the case of a patient with dextrocardia and situs inversus totalis associated with obstructive coronariopathy in the anterior and posterior descending arteries, right coronary artery, first diagonal branch and left marginal branch. The patient underwent coronary artery bypass grafting surgery. This surgery has been rarely reported in literature and we found only one similar case in the national medical literature. The myocardial revascularization was carried out with the right mammary artery for the anterior descending artery...

Diabetes mellitus is a powerful risk factor for coronary artery disease. Diabetics demonstrate accelerated coronary atherosclerosis and worst prognosis following cardiac events. Although myocardial revascularization procedures result in more effective relieve of symptoms in patients with known coronary artery disease, there is no substantial evidence that this strategy improves outcome, except for specific situations. In addition, the benefit of myocardial revascularization is attenuated by the presence of metabolic abnormalities related to insulin resistance and other significant co-morbidities in diabetic patients...

OBJECTIVE: To analyze clinical laboratorial aspects of the presence of coronary disease in patients with aortic stenosis and evaluate the influence of risk factors in the development of obstructive coronary disease. METHODS: We studied 65 patients who had severe aortic stenosis with an indication for surgery, ages 51 to 85 years, 40 of them women. The coronary angiography assessment resulted in two groups: 26 (40%) with obstructive coronary disease and 39 (60%) with no coronary artery lesion...

OBJECTIVE: To correlate values of rate-pressure product (RPP) above 30,000 mmHg.bpm with or without significant obstructive coronary artery disease (CAD) in patients with positive exercise test. METHODS: A retrospective analysis of 246 patients that had been submitted to Exercise Treadmill Test (ETT) up to 30 days before coronary angiography on suspicion of obstructive disease. The 165 patients in which the ETT was positive were analyzed considering as positive the presence of horizontal or descending depression of the ST segment for at least 1 mm, 0...

Takotsubo Cardiomiopathy is a rare cause of acute left ventricular aneurysm, in the absence of coronariopathy, only recently described in world literature. Symptoms may be similar to those from acute myocardial infarction with typical thoracic pain. The image of dumbbell or Takotsubo (a device used in Japan to capture octopus) suggestive ventricular ballooning is characteristic of that new syndrome and there is usually the disappearing of dyskinetic movement up to the 18th day from the beginning of the symptoms, in average...

The Dialysis Outcomes and Practice Pattern Study (DOPPS) is an international observational study of treatment conditions and medical outcomes in hemodialysis patients. Prospective sampling has yielded long-term observational data from randomly selected groups of patients receiving treatment at representative, randomly selected hemodialysis units in each country. The data shown were collected at 20 hemodialysis units/centers in Spain. The data pertaining to Spain--Sp--refers to 575 patients and their comparison with those of the Euro-DOPPS countries--Eu--(Germany, France, United Kingdom, Italy and Spain), which encompass 3,038 patients, represent the formal goal of this paper...

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The QRS widening by ventricular conventional pacing impairs the systolic and diastolic functions and increases mitral regurgitation. The aim of this study was to compare conventional pacing to an alternative stimulation mode with a narrower QRS using two leads in the RV. Thirty-nine (25 men, 14 women; mean age 60.1 +/- 15.1 years) dilated cardiomyopathy patients (Chagas' disease [n = 17], coronariopathy [n = 9], AV ablation for tachycardiomyopathy [n = 3], and other [n = 10]) with cardiac failure (NYHA 3.1 +/- 0...

BACKGROUND: Coronary sulcus of the auricular lobe has been related to the presence of ischemic cardiopathy although the nature of this relation has not been well defined. The aim of the present study was to determine whether there is a relation between the sulcus and the classical coronary risk factors, or whether the association between coronariopathy and sulcus is independent of such factors. METHODS: Patients admitted into an intensive care unit (n = 222) were divided into two groups according to whether coronary sulcus was present and the following analysis were performed: 1) comparative study between the groups for the variables: age, sex, coronariopathy, hyperglycemia, hyperlipidemia, hypertension, index of body mass, and tobacco habit...