DSpace Community: Coleção voltada para a inserção de documentos da área de Cardiologia

Evolução Intra-hospitalar e Seguimento Pós-alta de Pacientes Idosos Atendidos com Insuficiência Cardíaca Congestiva na Unidade de Emergência

1998-01-01T00:00:00Z

Title: Evolução Intra-hospitalar e Seguimento Pós-alta de Pacientes Idosos Atendidos com Insuficiência Cardíaca Congestiva na Unidade de Emergência Authors: Villacorta, Humberto; Rocha, Nazareth de Novaes; Cardoso, Rosana; Gaspar, Sérgio; Maia, Eduardo Reis; Bonates, Therezil; Kopiler, Daniel; Dohmann, Hans Jurgen Fernando; Mesquita, Evandro Tinoco Abstract: Objetivo - Conhecer a evolução intra-hospitalar (IH) e pós-alta (PA) de uma população predominantemente idosa, com insuficiência cardíaca congestiva (ICC) na unidade de emergência (UE). Métodos - Durante 11 meses, foram selecionados 57 pacientes consecutivos com ICC, atendidos em EU, com idade média de 69+15 (27 a 94) anos, sendo 39 (68,4%) homens. O diagnóstico de ICC baseou-se nos critérios de Boston. Avaliou-se a evolução IH e PA num período médio de 5,7+2,7 (1 a 12) meses, procurando-se identificar vari áveis que se correlacionassem com a mortalidade e o me canismo de morte, avaliado pelo sistema ACME . Resultados - Oito (14%) pacientes faleceram na fase IH, sendo 7 por falência circulatória (FC), e 1 em pós-ope ratório (PO). Durante o seguimento ocorreram 9 (18,4%) óbitos, sendo 5 por FC, 2 mortes súbitas e 2 em PO (troca valvar mitral e ventriculectomia). A sobrevida dos pacien tes que tiveram alta foi de 82% e 66%, aos 6 meses e 1 ano, respectivamente. Sódio sérico <135mEq/l (p= 0,004) e sexo feminino (p= 0,038) foram preditores independentes de mortalidade. Conclusão - Pacientes idosos com ICC atendidos em UE apresentam mortalidade IH e PA elevadas e alta taxa de reinternação hospitalar. A maioria morre por falência circulatória decorrente da progressão da ICC. Description: p. 167-171.: il. p&b.

Use of Bipolar Radiofrequency for the Treatment of Atrial Fibrillation During Cardiac Surgery

2011-01-01T00:00:00Z

Title: Use of Bipolar Radiofrequency for the Treatment of Atrial Fibrillation During Cardiac Surgery Authors: Canale, Leonardo Secchin; Colafranceschi, Alexandre Siciliano; Monteiro, Andrey José de Oliveira; Coimbra, Marialda; Weksler, Clara; Koehler, Ernesto Chavez; Marques, Bruno Miranda; Mattos, Marco Antonio; Cruz Filho, Fernando Eugênio dos Santos; Sá, Roberto Luiz Menssing da Silva Abstract: Atrial fibrillation with tissue ablation device through bipolar radiofrequency in conjunction with cardiac surgery has proven to be an effective method to treat this arrhythmia. Objective: Describe the initial experience of the Instituto Nacional de Cardiologia in the surgical treatment of atrial fibrillation using bipolar radiofrequency device in patients undergoing cardiac surgery, reporting the results of postoperative follow-up of one year. Methods: Between January 2008 and March 2009, 47 consecutive patients (36 women), with mean age of 53.7 ± 10.6 years, with atrial fibrillation for a mean period of 34.6 months (3-192 months) underwent surgical ablation of this arrhythmia, through bipolar radiofrequency during the procedure which led to the indication of surgery. Eight of them showed intermittent atrial fibrillation and 39, continued. Eighty-one percent underwent valve surgery as the main procedure. This is a one-year postoperative retrospective, observational evaluation of clinical variables and 24-h Holter. Results: Out of the 47 patients, 40 survived one year. Out of these, 33 underwent 24 h Holter, at an average interval of 401 days after the surgery. The following rhythm distribution was found: 24 (73%) sinus, five (15%) atrial fibrillation, three (9%) atrial flutter and one (3%) junctional rhythm. Two cerebrovascular accidents were observed, one of which was associated with supraventricular arrhythmia. Conclusion: Surgical ablation of atrial fibrillation with bipolar radiofrequency device concomitant with cardiac surgery is an effective method for treating this arrhythmia. Description: p. 1-7.: il. color.

Tratamento cirúrgico de fibrilação atrial utilizando ablação com radiofrequência bipolar em doença mitral reumática

2011-01-01T00:00:00Z

Title: Tratamento cirúrgico de fibrilação atrial utilizando ablação com radiofrequência bipolar em doença mitral reumática Authors: Canale, Leonardo Secchin; Colafranceschi, Alexandre Siciliano; Monteiro, Andrey José de Oliveira; Marques, Bruno Miranda; Canale, Clara Secchin; Koehler, Ernesto Chavez; Cruz Filho, Fernando Eugênio dos Santos Abstract: To analyze the effectiveness of surgical treatment of atrial fibrillation (AF) using bipolar radiofrequency ablation during mitral valve procedures of rheumatic etiology in heart surgery. METHODS: We retrospectively reviewed medical registries of 53 patients submitted to atrial ablation with bipolar radiofrequency energy during mitral valve surgery. Thirty four (64%) patients were women and the age varied from 27 to 72 years old (average: 49.3 ± 10.7 years). Aortic and/or tricuspid procedures were also present in 36 (68%) patients. Average time of reported atrial fibrillation was 41 months (from 3 to 192 months). Type of AF was classified as: paroxysmal in 8 patients, persistent in 3, permanent in 42. Left atrium had an average size of 52.9 ± 8.5 mm. The surgeries in these series were: 47 mitral valve replacements and 6 mitral valve repairs. Eletrocardiografic follow up was 83% complete in 14 months. Data from 24h Holter were explored. RESULTS: Seven (13%) perioperative deaths were observed and survival after 14 months was 87%. Observed heart rhythm after 1 year of surgery was sinus rhythm in 25 (66%) patients, AF in 7 (18%), flutter in 7 (13%), junctional in 1 (3%). CONCLUSION: Bipolar radiofrequency ablation in patients submitted to mitral valve surgery of rheumatic etiology is effective in converting to sinus rhythm in 68% of patients after 14 months. Description: p. 565-572.: il. color.

Surgical Treatment of Atrial Fibrillation in Patients with Rheumatic Valve Disease

2017-01-01T00:00:00Z

Title: Surgical Treatment of Atrial Fibrillation in Patients with Rheumatic Valve Disease Authors: Chavez, Ernesto Koehler; Colafranceschi, Alexandre Siciliano; Monteiro, Andrey José de Oliveira; Canale, Leonardo Secchin; Mesquita, Evandro Tinoco; Weksler, Clara; Barbosa, Odilon Nogueira; Oliveira, Anderson Abstract: Objective: To assess heart rhythm and predictive factors associated with sinus rhythm after one year in patients with rheumatic valve disease undergoing concomitant surgical treatment of atrial fibrillation. Operative mortality, survival and occurrence of stroke after one year were also evaluated. Methods: Retrospective longitudinal observational study of 103 patients undergoing rheumatic mitral valve surgery and ablation of atrial fibrillation using uni- or bipolar radiofrequency between January 2013 and December 2014. Age, gender, functional class (NYHA), type of atrial fibrillation, EuroSCORE, duration of atrial fibrillation, stroke, left atrial size, left ventricular ejection fraction, cardiopulmonary bypass time, myocardial ischemia time and type of radiofrequency were investigated. Results: After one year, 66.3% of patients were in sinus rhythm. Sinus rhythm at hospital discharge, lower left atrial size in the preoperative period and bipolar radiofrequency were associated with a greater chance of sinus rhythm after one year. Operative mortality was 7.7%. Survival rate after one year was 92.3% and occurrence of stroke was 1%. Conclusion: Atrial fibrillation ablation surgery with surgical approach of rheumatic mitral valve resulted in 63.1% patients in sinus rhythm after one year. Discharge from hospital in sinus rhythm was a predictor of maintenance of this rhythm. Increased left atrium and use of unipolar radiofrequency were associated with lower chance of sinus rhythm. Operative mortality rate of 7.7% and survival and stroke-free survival contribute to excellent care results for this approach. Description: p. 202-209.: il. color.