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Id: biblio-1047212
Autor: Dias, Ricardo Ribeiro; Lisboa, Luiz Augusto Ferreira; Jatene, Fabio Biscegli.
Título: Procedimentos cardiovasculares híbridos / Hybrid cardiovascular procedures
Fonte: Rev. Soc. Cardiol. Estado de Säo Paulo;29(4):356-361, out.-dez. 2019. ilus.
Idioma: pt.
Resumo: O desenvolvimento das salas cirúrgicas híbridas permitiu que operações de abordagem cirúrgica convencional pudessem ser realizadas e complementadas com a abordagem percutânea e endovascular, criando uma nova forma de tratar os pacientes por meio de cirurgias híbridas. Os procedimentos híbridos permitem que cirurgiões e cardiologistas intervencionistas possam associar suas expertises para tratar, da melhor forma possível, os pacientes com doenças cada vez mais complexas e avançadas, com melhores resultados, reduzindo a morbidade e mortalidade perioperatória e permitindo recuperação mais rápida

The development of hybrid operating rooms allowed that conventional surgical approach operations could be performed and complemented with the percutaneous and endovascular approach, creating a new way of treating patients through hybrid surgeries. Hybrid procedures allow surgeons and interventional cardiologists to combine their expertise to best treat patients with increasingly complex and advanced diseases, with better outcomes, reducing perioperative morbidity and mortality and allowing faster recovery
Descritores: Procedimentos Cirúrgicos Cardíacos/métodos
Revascularização Miocárdica/métodos
-Salas Cirúrgicas
Aorta Torácica
Próteses e Implantes
Aortografia/métodos
Ponte de Artéria Coronária/métodos
Stents Farmacológicos
Intervenção Coronária Percutânea/métodos
Responsável: BR44.1 - Serviço de Biblioteca, Documentação Científica e Didática Prof. Dr. Luiz Venere Décourt


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Texto completo SciELO Cuba
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Id: lil-628189
Autor: Landell Cruz, Jaime; Villamil Calderón, Ramón; del Risco Suñet, Camilo; Pérez González, Roy.
Título: Trauma cardíaco penetrante: Estudio multicéntrico en la provincia Las Tunas / Penetrating heart trauma. I study multicéntrico in the county The Tunas
Fonte: Rev. cuba. cir;40(3):180-183, jul.-set. 2001.
Idioma: es.
Resumo: Se revisaron las historias clínicas de 70 pacientes con el diagnóstico de trauma cardíaco penetrante, los que fueron operados en el período de enero de 1994 a diciembre de 1998, en los hospitales quirúrgicos de la provincia de Las Tunas. El ecocardiograma fue positivo de hemopericardio en el 100 por ciento de los enfermos a los cuales se les realizó (20 pacientes); la aurícula izquierda fue la más afectada con 28 pacientes (40 por ciento), las complicaciones posoperatorias se presentaron en 22 enfermos (31,4 por ciento), 46 pacientes (65,8 por ciento) llegaron al Cuerpo de Guardia en Grado III o Extremis y 8 pacientes (11,4 por ciento) fallecieron(AU)

The medical histories of 70 patients with diagnosis of penetrating heart injury that were operated on at the surgical hospitals of Las Tunas from January, 1994, to December, 1998, were reviewed. Positive hemipericardium was observed in 100 percent of the patients who underwent echocardiography (20). The left auricle was the most affected with 28 patients (40 percent). Postoperative complications were observed in 22 patients (31.4 percent). 46 patients (65.8 percent) were received at the Emergency Department in Degree III or Extremis and 8 patients (11.4 percent) died(AU)
Descritores: Ferimentos Penetrantes/cirurgia
Serviço Hospitalar de Emergência
Traumatismos Cardíacos/cirurgia
Procedimentos Cirúrgicos Cardíacos/métodos
-Complicações Pós-Operatórias/mortalidade
Registros Médicos
Limites: Humanos
Responsável: CU1.1 - Biblioteca Médica Nacional


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Texto completo SciELO Brasil
Texto completo
Id: biblio-1001823
Autor: Marcondes, Sibia Soraya; Carrareto, Antônio Roberto; Zago-Gomes, Maria da Penha; Orletti, Maria do Perpétuo Socorro Vendramini; Novaes, Anisia Carla Zucoloto Loureiro.
Título: Evaluation of the use of blood in surgeries as a tool to change patterns for requesting blood product reserves
Fonte: Clinics;74:e652, 2019. tab.
Idioma: en.
Resumo: OBJECTIVES: Thirty to sixty percent of prepared blood products are not transfused. Blood reserves for surgeries lead to many unused blood products, which increases hospital costs. The aim of this study is to identify the request and use profiles of blood products for elective surgeries in different surgical specialties, the influence of surgery time and demographic, clinical, and laboratory variables on the number of red blood cells (RBCs) used and to calculate the rate of transfused patients (RTP) and cross-matched and transfused (C/T) RBCs. METHODS: Observational and prospective studies. Sociodemographic, clinical and quantitative data on the request and use of blood products were collected. The influence of the data on the use of RBCs was examined by binary logistic regression. Chi-square, one-way ANOVA and Kruskal-Wallis tests were utilized to compare the data among the specialties. RESULTS: In total, 822 procedures were included. Most of the requested blood products were not used, even 24 hours postoperatively. Of the 2,483 RBC units, 314 were transfused, leaving 87.6% unused; however, cardiac, digestive tract, vascular, gynecologic, urologic and thoracic surgery procedures transfused 50%, 25%, 16.5%, 11%, 9.5% and 8.1% of requested RBCs, respectively. The factors that influenced the transfusions were age, time of surgery and cardiac surgeries. The RTP was >10% in 22 surgical types and <1% in 24 surgical types, and 88% of samples presented a C/T ratio >2.5. CONCLUSION: The RTP and C/T ratios can guide RBC requests in the preoperative period. Knowing the standard of use of blood products and developing protocols enables the optimization of reserves, reduction of costs and improvement of care.
Descritores: Transfusão de Sangue
Procedimentos Cirúrgicos Eletivos
Transfusão de Eritrócitos/métodos
-Contagem de Plaquetas
Fatores de Tempo
Estudos Prospectivos
Estatística como Assunto
Transfusão de Eritrócitos/estatística & dados numéricos
Eritrócitos
Procedimentos Cirúrgicos Cardíacos
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Braile, Domingo M
Texto completo
Id: lil-741728
Autor: Braile, Domingo M.
Título: Adib Domingos Jatene (1929-2014) / Adib Domingos Jatene (1929-2014)
Fonte: Rev. bras. cir. cardiovasc;29(4):I-III, Oct-Dec/2014. graf.
Idioma: pt.
Descritores: Cardiologia/história
Cirurgiões/história
Procedimentos Cirúrgicos Cardíacos/história
Tipo de Publ: Comentário
Responsável: BR1.1 - BIREME


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Texto completo SciELO Uruguai
Texto completo
Id: biblio-1248118
Autor: Estigarribia Passaro, Jorge A.
Título: Fibrilación auricular posoperatoria: ¿un lobo con piel de cordero? / Postoperative atrial fibrillation: a wolf with lamb skin? / Fibrilação auricular pós-operatória: ¿um lobo com pele de cordeiro?
Fonte: Rev. urug. cardiol;36(1):e36105, abr. 2021. ilus, graf.
Idioma: es.
Resumo: Desde época temprana de la cirugía cardíaca (CC), la fibrilación auricular (FA) ha sido un acompañante frecuente del posoperatorio, y no es esperable su abatimiento en el futuro cercano. La interpretación de su significado clínico se ha modificado en los últimos años, tras conocerse su tendencia recurrente y su asociación con serias complicaciones inmediatas y a largo plazo. Esto deja entrever un nuevo desafío, dejando de ser un problema menor y de consideración puntual en el perioperatorio para constituir un tema de preocupación y seguimiento en el futuro alejado, aún con incertidumbres evolutivas y de manejo. La profilaxis efectiva de esta arritmia, una respuesta lógica al problema, es dificultosa por la multiplicidad de factores de riesgo y lo intrincado de su génesis, todavía no completamente dilucidada, sumadas a la edad creciente de los pacientes intervenidos, la complejidad mayor de los procedimientos, los posibles efectos colaterales de los fármacos empleados y la inexistencia de un algoritmo predictivo confiable que permita racionalizar las medidas preventivas. Además, muchas recomendaciones de las guías de práctica clínica actuales se basan en información obtenida en estudios realizados en la FA primaria, por lo que su adopción en el escenario de la CC ha sido menor a la deseable. Todos estos aspectos son objeto de análisis en esta revisión que finaliza con pautas de manejo práctico de la arritmia en el entorno perioperatorio.

Since an early age of heart surgery, atrial fibrillation has been a frequent companion of the postoperative period, and its decline is not to be expected in the near future. The interpretation of its clinical significance has changed in recent years, after knowing its recurrent trend and its association with serious immediate and long-term complications. This fact unveils a new challenge, as it is no longer a minor problem of consideration restricted to the perioperative period and has become a topic of concern and follow-up in the distant future, still with uncertainties as to its evolution and management. The effective prophylaxis of this arrhythmia, a logical response to the problem, has been difficult by the multiplicity of risk factors and the intricate of its genesis, not yet completely elucidated, added to the increasing age of the patients involved, the greater complexity of the procedures, the possible side effects of the drugs used and the absence of a reliable predictive algorithm that could allow to rationalize preventive measures. In addition, many recommendations from current clinical practice guidelines are based on information obtained from studies in primary atrial fibrillation, so their adoption in the heart surgery scenario has been less than desirable. All these aspects are analyzed in this review, which ends with directives for the practical management of the arrhythmia in the perioperative environment.

Desde os primeiros días da cirurgia cardíaca, a fibrilação atrial (FA) tem sido uma companheira frequente para o pós-operatório, e sua reduçao não é esperada em um futuro próximo. A interpretação de sua significância clínica mudou nos últimos anos, tendo conhecido sua tendência recorrente e sua associação com sérias complicações imediatas e de longo prazo. Este fato mostra um novo desafio, pois deixou de ser um pequeno problema e uma consideração oportuna no perioperatório para constituir um tema de preocupação e acompanhamento em um futuro distante, mesmo com incertezas quanto à sua evolução e gestão. A profilaxia efetiva dessa arritmia, uma resposta lógica ao problema, tem sido cercada pela multiplicidade de fatores de risco e pela intrincação de sua gênese ainda não completamente elucidada, juntamente com a idade crescente dos pacientes envolvidos, a maior complexidade dos procedimentos, os possíveis efeitos colaterais dos medicamentos utilizados e a ausência de um algoritmo preditivo confiável para racionalizar as medidas preventivas. Além disso, muitas recomendações das guias atuais de prática clínica são baseadas em informações obtidas em estudos conduzidos em FA primária, de modo que sua adoção no cenário da cirurgia cardíaca tem sido menos do que desejável. Todos esses aspectos são analisados nesta revisão, que termina com diretrizes práticas de gestão para arritmia no ambiente perioperatório.
Descritores: Fibrilação Atrial/etiologia
Fibrilação Atrial/terapia
Fibrilação Atrial/epidemiologia
Procedimentos Cirúrgicos Cardíacos/efeitos adversos
-Período Pós-Operatório
Fibrilação Atrial/complicações
Incidência
Fatores de Risco
Administração de Caso
Acidente Vascular Cerebral/etiologia
Limites: Humanos
Tipo de Publ: Revisão
Responsável: UY1.1 - BINAME - Biblioteca Nacional de Medicina


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Id: lil-796121
Autor: Cavalcante, Candice Torres de Melo Bezerra; Souza, Nayana Maria Gomes de; Pinto Júnior, Valdester Cavalcante; Branco, Klébia Magalhães Pereira Castello; Pompeu, Ronald Guedes; Teles, Andreia Consuelo de Oliveira; Cavalcante, Rodrigo Cardoso; Andrade, Giselle Viana de.
Título: Analysis of surgical mortality for congenital heart defects using rachs-1 risk score in a brazilian single center
Fonte: Rev. bras. cir. cardiovasc = Braz. j. cardiovasc. surg. (impr.);31(3):219-225, May.-June 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Introduction: Risk Adjustment for Congenital Heart Surgery 1 (RACHS-1) score is a simple model that can be easily applied and has been widely used for mortality comparison among pediatric cardiovascular services. It is based on the categorization of several surgical palliative or corrective procedures, which have similar mortality in the treatment of congenital heart disease. Objective: To analyze the in-hospital mortality in pediatric patients (<18 years) submitted to cardiac surgery for congenital heart disease based on RACHS-1 score, during a 12-year period. Methods: A retrospective date analysis was performed from January 2003 to December 2014. The survey was divided in two periods of six years long each, to check for any improvement in the results. We evaluated the numbers of procedures performed, complexity of surgery and hospital mortality. Results: Three thousand and two hundred and one surgeries were performed. Of these, 3071 were able to be classified according to the score RACHS-1. Among the patients, 51.7% were male and 47.5% were younger than one year of age. The most common RACHS-1 category was 3 (35.5%). The mortality was 1.8%, 5.5%, 14.9%, 32.5% and 68.6% for category 1, 2, 3, 4 and 6, respectively. There was a significant increase in the number of surgeries (48%) and a significant reduction in the mortality in the last period analysed (13.3% in period I and 10.4% in period II; P=0.014). Conclusion: RACHS-1 score was a useful score for mortality risk in our service, although we are aware that other factors have an impact on the total mortality.
Descritores: Mortalidade Hospitalar
Risco Ajustado/métodos
Cardiopatias Congênitas/cirurgia
Cardiopatias Congênitas/mortalidade
Procedimentos Cirúrgicos Cardíacos/mortalidade
-Brasil
Estudos Retrospectivos
Fatores de Risco
Sensibilidade e Especificidade
Centros de Atenção Terciária/estatística & dados numéricos
Procedimentos Cirúrgicos Cardíacos/estatística & dados numéricos
Limites: Humanos
Masculino
Feminino
Recém-Nascido
Lactente
Pré-Escolar
Criança
Adolescente
Responsável: BR1.1 - BIREME


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Texto completo
Id: lil-796128
Autor: Costa, Mário Augusto Cray da; Krum, Lucas Kraeski; Geraldino, Juliana da Silva; Schafranski, Marcelo Derbli; Gomes, Ricardo Zanetti; Reis, Elise Souza dos Santos.
Título: Anticoagulation quality and complications of using vitamin k antagonists in the cardiac surgery outpatient clinic
Fonte: Rev. bras. cir. cardiovasc = Braz. j. cardiovasc. surg. (impr.);31(3):239-245, May.-June 2016. tab.
Idioma: en.
Resumo: ABSTRACT Introduction: In patients with mechanical prosthetic heart valves or atrial fibrillation requiring anticoagulation to prevent thromboembolic events, several factors influence adherence and anticoagulation complications. Objective: To evaluate the factors that interfere with the quality and complications of anticoagulation with vitamin K antagonists. Methods: A retrospective cohort study of 100 patients, in the period from 2011 to 2014, was performed. Anticoagulation conditions in the last year, regarding the presence of complications (embolisms/bleeding) and inadequate treatment were assessed: achievement of less than 8 annual prothrombin times and International Normalized Ratio outside therapeutic target in more than 40% of prothrombin times. Results: There were 31 complications (22 minor bleeding without hospitalization and 9 major complications: 7 bleeding with hospitalization and two emboli); 70 were with International Normalized Ratio outside the target in more than 40% of the tests and 36 with insufficient number of prothrombin times. Socioeconomic factors, anticoagulant type and anticoagulation reason had no relationship with complications or with inadequate treatment. There were more complications in patients with longer duration of anticoagulation (P=0.001). Women had more International Normalized Ratio outside the target range (OR 2.61, CI:1.0-6.5; P=0.04). Patients with lower number of annual prothrombin times had longer times of anticoagulation (P=0.03), less annual consultations (P=0.02) and less dose adjustments (P=0.003). Patients with longer duration of anticoagulation have more complications (P=0.001). Conclusion: There was a high rate of major complications and International Normalized Ratio was outside the goal. Less annual prothrombin times was related to longer duration of anticoagulation, less annual consultations and less dose adjustments. More major complications occurred in patients with longer duration of anticoagulation.
Descritores: Complicações Pós-Operatórias/etiologia
Vitamina K/antagonistas & inibidores
Hemorragia Pós-Operatória/etiologia
Instituições de Assistência Ambulatorial/estatística & dados numéricos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos
-Tempo de Protrombina/estatística & dados numéricos
Fibrilação Atrial/complicações
Fatores Socioeconômicos
Tromboembolia/complicações
Tromboembolia/etiologia
Fatores de Tempo
Vitamina K/efeitos adversos
Varfarina/efeitos adversos
Coeficiente Internacional Normatizado/estatística & dados numéricos
Procedimentos Cirúrgicos Cardíacos/estatística & dados numéricos
Anticoagulantes/efeitos adversos
Limites: Humanos
Masculino
Feminino
Idoso
Responsável: BR1.1 - BIREME


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Texto completo SciELO Brasil
Texto completo
Id: biblio-829747
Autor: Fortes, João Vyctor Silva; Silva, Mayara Gabrielle Barbosa e; Baldez, Thiago Eduardo Pereira; Costa, Marina de Albuquerque Gonçalves; Silva, Luan Nascimento da; Pinheiro, Renata Silva; Fecks, Zullma Sampaio; Borges, Daniel Lago.
Título: Mortality risk after cardiac surgery: application of Inscor in a University Hospital in Brazil's northeast
Fonte: Rev. bras. cir. cardiovasc = Braz. j. cardiovasc. surg. (impr.);31(5):396-399, Sept.-Oct. 2016. tab.
Idioma: en.
Resumo: Abstract Objective: To apply the InsCor in patients undergoing cardiac surgery in a university hospital in Brazil's northeast. Methods: It is a retrospective, quantitative and analytical study, carried out at the University Hospital of the Federal University of Maranhão. InsCor is a remodeling of two risk score models. It evaluates the prediction of mortality through variables such as gender, age, type of surgery or reoperation, exams, and preoperative events. Data from January to December 2015 were collected, using a Physical Therapy Evaluation Form and medical records. Quantitative variables were expressed as mean and standard deviation and qualitative variables as absolute and relative frequencies. Fisher's exact and Kruskal-Wallis tests were applied, considering significant differences when P value was < 0.05. Calibration was performed by Hosmer-Lemeshow test. Results: One hundred and forty-eight patients were included. Thirty-six percent were female, with mean age of 54.7±15.8 years and mean body mass index (BMI) equal to 25.6 kg/m2. The most frequent surgery was coronary artery bypass grafting (51.3%). According to InsCor, 73.6% of the patients had low risk, 20.3% medium risk, and only 6.1% high risk. In this sample, 11 (7.4%) patients died. The percentage of death in patients classified as low, medium and high risk was 6.3, 7.1% and 11.1%, respectively. Conclusion: InsCor presented easy applicability due to the reduced number of variables analyzed and it showed satisfactory prediction of mortality in this sample of cardiac surgery patients.
Descritores: Mortalidade Hospitalar
Procedimentos Cirúrgicos Cardíacos/mortalidade
-Brasil
Estudos Retrospectivos
Fatores de Risco
Curva ROC
Medição de Risco
Hospitais Universitários
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Texto completo
Id: biblio-829749
Autor: Gonçalves, Luciana de Brito; Jesus, Natanael Moura Teixeira de; Gonçalves, Maiara de Brito; Dias, Lidiane Cristina Gomes; Deiró, Tereza Cristina Bomfim de Jesus.
Título: Preoperative nutritional status and clinical complications in the postoperative period of cardiac surgeries
Fonte: Rev. bras. cir. cardiovasc = Braz. j. cardiovasc. surg. (impr.);31(5):371-380, Sept.-Oct. 2016. tab, graf.
Idioma: en.
Resumo: Abstract Objective: This study aims to assess the preoperative nutritional status of patients and the role it plays in the occurrence of clinical complications in the postoperative period of major elective cardiac surgeries. Methods: Cross-sectional study comprising 72 patients aged 20 years or older, who underwent elective cardiac surgery. The preoperative nutritional assessment consisted of nutritional screening, anthropometry (including the measurement of the adductor pollicis muscle thickness) and biochemical tests. The patients were monitored for up to 10 days after the surgery in order to control the occurrence of postoperative complications. The R software, version 3.0.2, was used to statistically analyze the data. Results: Clinical complications were found in 62.5% (n=42) of the studied samples and complications of non-infectious nature were most often found. Serum albumin appeared to be associated with renal complications (P=0.026) in the nutritional status indicators analyzed herein. The adductor pollicis muscle thickness was associated with infectious complications and presented mean of 9.39±2.32 mm in the non-dominant hand (P=0.030). No significant correlation was found between the other indicators and the clinical complications. Conclusion: The adductor pollicis muscle thickness and the serum albumin seemed be associated with clinical complications in the postoperative period of cardiac surgeries.
Descritores: Complicações Pós-Operatórias
Estado Nutricional
Procedimentos Cirúrgicos Cardíacos/efeitos adversos
-Avaliação Nutricional
Estudos Transversais
Fatores de Risco
Procedimentos Cirúrgicos Eletivos/efeitos adversos
Período Pré-Operatório
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


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Texto completo
Id: biblio-843449
Autor: Silva, Roberto Rocha e; Lourenção Jr, Artur; Goncharov, Maxim; Jatene, Fabio B.
Título: Low cost simulator for heart surgery training
Fonte: Rev. bras. cir. cardiovasc = Braz. j. cardiovasc. surg. (impr.);31(6):449-453, Nov.-Dec. 2016. tab, graf.
Idioma: en.
Resumo: Abstract 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. Simulators for the training of valve replacement and valvoplasty, atrial septal defect repair and aortic diseases were added. These simulators are based on sewage pipes obtained in construction material stores and the silicone trays and ethyl vinyl acetate tissue were obtained in utility stores, all of them at a very low cost. Results: The models were manufactured using inert materials easily found in regular stores and do not present contamination risk. They may be used in any environment and maybe stored without any difficulties. This training enabled young surgeons to familiarize and train different surgical techniques, including procedures for aortic diseases. In a subjective assessment, these surgeons reported that the training period led to improved surgical techniques in the surgical field. Conclusion: The model described in this protocol is effective and low-cost when compared to existing simulators, enabling a large array of cardiovascular surgery training.
Descritores: Materiais de Ensino/economia
Educação de Pós-Graduação em Medicina/métodos
Procedimentos Cirúrgicos Cardíacos/economia
Procedimentos Cirúrgicos Cardíacos/educação
Modelos Cardiovasculares
-Educação de Pós-Graduação em Medicina/economia
Limites: Humanos
Responsável: BR1.1 - BIREME



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