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[PMID]: 29381721 [Au] Autor: von Babo M; Chmiel C; Müggler SA; Rakusa J; Schuppli C; Meier P; Fischler M; Urner M [Ad] Endereço: Department of Internal Medicine, Waid City Hospital, Zurich, Switzerland. [Ti] Título: Transfusion practice in anemic, non-bleeding patients: Cross-sectional survey of physicians working in general internal medicine teaching hospitals in Switzerland. [So] Source: PLoS One;13(1):e0191752, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Transfusion practice might significantly influence patient morbidity and mortality. Between European countries, transfusion practice of red blood cells (RBC) greatly differs. Only sparse data are available on transfusion practice of general internal medicine physicians in Switzerland. METHODS: In this cross-sectional survey, physicians working in general medicine teaching hospitals in Switzerland were investigated regarding their self-reported transfusion practice in anemic patients without acute bleeding. The definition of anemia, transfusion triggers, knowledge on RBC transfusion, and implementation of guidelines were assessed. RESULTS: 560 physicians of 71 hospitals (64%) responded to the survey. Anemia was defined at very diverging hemoglobin values (by 38% at a hemoglobin <130 g/L for men and by 57% at <120 g/L in non-pregnant women). 62% and 43% respectively, did not define anemia in men and in women according to the World Health Organization. Fifty percent reported not to transfuse RBC according to international guidelines. Following factors were indicated to influence the decision to transfuse: educational background of the physicians, geographical region of employment, severity of anemia, and presence of known coronary artery disease. 60% indicated that their knowledge on Transfusion-related Acute Lung Injury (TRALI) did not influence transfusion practice. 50% of physicians stated that no local transfusion guidelines exist and 84% supported the development of national recommendations on transfusion in non-acutely bleeding, anemic patients. CONCLUSION: This study highlights the lack of adherence to current transfusion guidelines in Switzerland. Identifying and subsequently correcting this deficit in knowledge translation may have a significant impact on patient care. [Mh] Termos MeSH primário: Transfusão de Sangue/utilização Medicina Geral Hospitais de Ensino/organização & administração Padrões de Prática Médica [Mh] Termos MeSH secundário: Estudos Transversais Seres Humanos Medicina Interna Suíça [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180309 [Lr] Data última revisão: 180309 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180131 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0191752

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[PMID]: 29318368 [Au] Autor: Mirlohi MS; Yaghooti H; Shirali S; Aminasnafi A; Olapour S [Ad] Endereço: Hyperlipidemia Research Center, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. [Ti] Título: Increased levels of advanced glycation end products positively correlate with iron overload and oxidative stress markers in patients with ß-thalassemia major. [So] Source: Ann Hematol;97(4):679-684, 2018 Apr. [Is] ISSN: 1432-0584 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: The impaired biosynthesis of the ß-globin chain in ß-thalassemia leads to the accumulation of unpaired alpha globin chains, failure in hemoglobin formation, and iron overload due to frequent blood transfusion. Iron excess causes oxidative stress and massive tissue injuries. Advanced glycation end products (AGEs) are harmful agents, and their production accelerates in oxidative conditions. This study was conducted on 45 patients with major ß-thalassemia who received frequent blood transfusions and chelation therapy and were compared to 40 healthy subjects. Metabolic parameters including glycemic and iron indices, hepatic and renal functions tests, oxidative stress markers, and AGEs (carboxymethyl-lysine and pentosidine) levels were measured. All parameters were significantly increased in ß-thalassemia compared to the control except for glutathione levels. Blood glucose, iron, serum ferritin, non-transferrin-bound iron (NTBI), MDA, soluble form of low-density lipoprotein receptor, glutathione peroxidase, total reactive oxygen species (ROS), and AGE levels were significantly higher in the ß-thalassemia patients. Iron and ferritin showed a significant positive correlation with pentosidine (P < 0.01) but not with carboxymethyl-lysine. The NTBI was markedly increased in the ß-thalassemia patients, and its levels correlated significantly with both carboxymethyl-lysine and pentosidine (P < 0.05). Our findings confirm the oxidative status generated by the iron overload in ß-thalassemia major patients and highlight the enhanced formation of AGEs, which may play an important role in the pathogenesis of ß-thalassemia major. [Mh] Termos MeSH primário: Transfusão de Sangue Produtos Finais de Glicação Avançada/sangue Sobrecarga de Ferro/etiologia Estresse Oxidativo Reação Transfusional/fisiopatologia Talassemia beta/sangue [Mh] Termos MeSH secundário: Adolescente Adulto Biomarcadores/sangue Terapia por Quelação/efeitos adversos Terapia Combinada/efeitos adversos Estudos Transversais Desferroxamina/uso terapêutico Feminino Seres Humanos Irã (Geográfico) Sobrecarga de Ferro/prevenção & controle Masculino Piridonas/uso terapêutico Receptores Depuradores Classe E/sangue Adulto Jovem Talassemia beta/terapia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Biomarkers); 0 (Glycation End Products, Advanced); 0 (OLR1 protein, human); 0 (Pyridones); 0 (Scavenger Receptors, Class E); 2BTY8KH53L (deferiprone); J06Y7MXW4D (Deferoxamine) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180309 [Lr] Data última revisão: 180309 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180111 [St] Status: MEDLINE [do] DOI: 10.1007/s00277-017-3223-3

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[PMID]: 29268646 [Au] Autor: Kaserer A; Stein P; Spahn GH; Spahn DR [Ad] Endereço: 1 Institut für Anästhesiologie, Universität und Universitätsspital Zürich, Zürich. [Ti] Título: Patient Blood Management: Der Standard heute.. [So] Source: Ther Umsch;74(7):369-376, 2017. [Is] ISSN: 0040-5930 [Cp] País de publicação: Switzerland [La] Idioma: ger [Mh] Termos MeSH primário: Anemia Ferropriva/terapia Anemia/terapia Transfusão de Sangue/normas Cuidados Intraoperatórios/normas Monitorização Intraoperatória/métodos [Mh] Termos MeSH secundário: Anemia/diagnóstico Anemia Ferropriva/diagnóstico Medicina Baseada em Evidências Seres Humanos Ferro Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: E1UOL152H7 (Iron) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180308 [Lr] Data última revisão: 180308 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171223 [St] Status: MEDLINE [do] DOI: 10.1024/0040-5930/a000928

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[PMID]: 29293197 [Au] Autor: DeLisle J [Ad] Endereço: BloodCenter of Wisconsin, Milwaukee, Wisconsin. Julie DeLisle, MSN, RN, is the transfusion safety and blood management officer for BloodCenter of Wisconsin, where she works with health care organizations on blood management initiatives. [Ti] Título: Is This a Blood Transfusion Reaction? Don't Hesitate; Check It Out. [So] Source: J Infus Nurs;41(1):43-51, 2018 Jan/Feb. [Is] ISSN: 1539-0667 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Blood transfusions can be lifesaving. The majority are completed without incident. However, every transfusion recipient runs the risk of developing a transfusion reaction or adverse event. These reactions can be acute, occurring during or soon after transfusion, or delayed, occurring days to weeks later. Nurses need to be able to recognize and respond to these reactions appropriately. [Mh] Termos MeSH primário: Transfusão de Sangue Reação Transfusional/enfermagem [Mh] Termos MeSH secundário: Transfusão de Sangue/enfermagem Seres Humanos Recursos Humanos de Enfermagem no Hospital [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: N [Da] Data de entrada para processamento: 180103 [St] Status: MEDLINE [do] DOI: 10.1097/NAN.0000000000000261

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[PMID]: 29465551 [Au] Autor: Wang KL; Ma SF; Pang LY; Zhang MN; Hu LY; Liu MJ; Zou LP [Ad] Endereço: Department of Pediatrics, Chinese PLA General Hospital, Beijing, China. [Ti] Título: Sirolimus alternative to blood transfusion as a life saver in blue rubber bleb nevus syndrome: A case report. [So] Source: Medicine (Baltimore);97(8):e9453, 2018 Feb. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: Blue rubber bleb nevus syndrome (BRBNS) is a rare disease characterized by multiple venous malformations. The gastrointestinal bleeding and secondary iron deficiency anemia are the most common complications. There are currently no effective treatments for BRBNS. Here, we report a case of successful treatment with a small dose of sirolimus of a BRBN patient with a de novo gene mutation. PATIENT CONCERNS: A 12-year-old female was admitted to our hospital with multiple hemangiomas for 12 years. The patient often displayed melena; she recently received transfusion of 2 units of red blood cells once every 2 weeks. Multiple fist-sized hemangiomas were piled up on both sides and back of the neck, and were also noted on the arms, legs, chest, back, and on the tip of the tongue. The laboratory findings demonstrated severe anemia. Blood sample sequencing detected a heterozygous de novo mutation c.2545C > Tin the TEK gene. DIAGNOSES: Based on these findings, final diagnosis of Blue rubber bleb nevus syndrome (BRBNS) was made. INTERVENTIONS: After the diagnosis, low-dose sirolimus was orally administered. OUTCOMES: The patient's hemoglobin was increased after treatment with sirolimus for 1 month. Since the initial treatment with sirolimus, she had not received any blood transfusions. The skin and mucosal hemangioma decreased significantly, and new digestive tract hemorrhage, muscle hematoma, or adverse drug reactions were not observed. LESSONS: we report a case of a mutation in exon 15 of the TEK gene leading to BRBN. It was successfully treated with a small dose of sirolimus as an alternative to blood transfusion in order to save the of BRBN patient's life. [Mh] Termos MeSH primário: Neoplasias Gastrointestinais/tratamento farmacológico Imunossupressores/administração & dosagem Nevo Azul/tratamento farmacológico Sirolimo/administração & dosagem Neoplasias Cutâneas/tratamento farmacológico [Mh] Termos MeSH secundário: Transfusão de Sangue Criança Feminino Neoplasias Gastrointestinais/diagnóstico Neoplasias Gastrointestinais/genética Seres Humanos Mutação Nevo Azul/diagnóstico Nevo Azul/genética Neoplasias Cutâneas/diagnóstico Neoplasias Cutâneas/genética Resultado do Tratamento [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Immunosuppressive Agents); W36ZG6FT64 (Sirolimus) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180302 [Lr] Data última revisão: 180302 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180222 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009453

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[PMID]: 29424510 [Au] Autor: Solórzano-Vázquez JF; Hernández-Higareda S; Segura-Zavala JM; OsegueraTorres LF; De la Rosa-Hernández SS [Ti] Título: [Blood loss and use of blood products in cases of cesarean hysterectomy for placenta accrete]. [Ti] Título: Pérdida sanguínea e indicación de hemoderivados en pacientes con cesárea-histerectomía por acretismo placentario.. [So] Source: Ginecol Obstet Mex;84(8):491-7, 2016 08. [Is] ISSN: 0300-9041 [Cp] País de publicação: Mexico [La] Idioma: spa [Ab] Resumo: Background: Placenta accreta (abnormal insertion of the placenta or part of the myometrium ) endangers the lives of pregnant women. It is a public health problem because it can be complicated by obstetric hemorrhage , the latter being the main cause of maternal death worldwide. Objetive: To estimate the blood loss and the use of blood products in patients who underwent cesarean ­ hysterectomy for placenta accreta. Material and methods: A descriptive study was conducted in HGO UMAE CMNO IMSS in patients who underwent cesarean ­ hysterectomy for placenta accreta in a period of 4 years. Results: 106 cases of placenta accreta were studied, 23% had a massive bleeding of > 3000 cc. Packed red blood cells were transfused in 68% of events, fresh frozen plasma in platelet concentrates 29% and 6%. The history of uterine curettage was observed in 64 % and cesarean section 1 or 2 occasions in 76 % of cases. Conclusion: An early detection of placenta accreta in patients with risk factors to avoid emergency surgery is desired. Being prepared with blood products and appropriate use is a cornerstone in the management of this condition. The average blood loss was determined in cases of accreta in cesarean hysterectomy was 2523 milliliters. [Mh] Termos MeSH primário: Perda Sanguínea Cirúrgica Cesárea/métodos Histerectomia/métodos Placenta Acreta/cirurgia [Mh] Termos MeSH secundário: Adulto Transfusão de Sangue/métodos Feminino Seres Humanos México Gravidez Estudos Retrospectivos Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180301 [Lr] Data última revisão: 180301 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180210 [St] Status: MEDLINE

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[PMID]: 27774615 [Au] Autor: Kinnunen EM; De Feo M; Reichart D; Tauriainen T; Gatti G; Onorati F; Maschietto L; Bancone C; Fiorentino F; Chocron S; Bounader K; Dalén M; Svenarud P; Faggian G; Franzese I; Santarpino G; Fischlein T; Maselli D; Dominici C; Nardella S; Gherli R; Musumeci F; Rubino AS; Mignosa C; Mariscalco G; Serraino FG; Santini F; Salsano A; Nicolini F; Gherli T; Zanobini M; Saccocci M; Ruggieri VG; Philippe Verhoye J; Perrotti A; Biancari F [Ad] Endereço: Department of Surgery, Oulu University Hospital, Oulu, Finland. [Ti] Título: Incidence and prognostic impact of bleeding and transfusion after coronary surgery in low-risk patients. [So] Source: Transfusion;57(1):178-186, 2017 01. [Is] ISSN: 1537-2995 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Excessive bleeding and blood transfusion are associated with adverse outcome after cardiac surgery, but their mechanistic effects are difficult to disentangle in patients with increased operative risk. This study aimed to evaluate the incidence and prognostic impact of bleeding and transfusion of blood products in low-risk patients undergoing coronary artery bypass grafting (CABG). STUDY DESIGN AND METHODS: Sixteen tertiary European centers of cardiac surgery contributed to the prospective European registry of CABG (E-CABG). The severity of bleeding was defined by the E-CABG bleeding severity classification and universal definition of perioperative bleeding (UDPB) classification. RESULTS: Of 1213 patients with EuroSCORE II of less than 2% (mean, 1.1 ± 0.4%), 18.5% suffered from mild bleeding (E-CABG bleeding Grade 1) and 3.4% experienced severe bleeding (E-CABG bleeding Grade 2-3). Similarly, 19.7% had UDPB Class 2 and 5.9% had UDPB Classes 3 and 4. Mild and severe bleeding defined by the E-CABG and UDPB classifications were associated with an increased risk of several adverse events as adjusted by multiple covariates. The risk of death, stroke, and acute kidney injury was particularly increased in patients with severe bleeding. CONCLUSION: Severe bleeding is rather uncommon in low-risk patients undergoing CABG, but it is associated with an increased risk of major adverse events. Prevention of excessive perioperative bleeding and patient blood management may improve the outcome of cardiac surgery also in low-risk patients. [Mh] Termos MeSH primário: Transfusão de Sangue Ponte de Artéria Coronária/efeitos adversos Hemorragia Pós-Operatória/epidemiologia Hemorragia Pós-Operatória/terapia Sistema de Registros [Mh] Termos MeSH secundário: Idoso Europa (Continente)/epidemiologia Feminino Seres Humanos Incidência Masculino Meia-Idade Hemorragia Pós-Operatória/diagnóstico Prognóstico Estudos Prospectivos Fatores de Risco Centros de Atenção Terciária [Pt] Tipo de publicação: CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 180302 [Lr] Data última revisão: 180302 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161025 [St] Status: MEDLINE [do] DOI: 10.1111/trf.13885

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[PMID]: 27774608 [Au] Autor: Cumming M; Osinski A; O'Hearn L; Waksmonski P; Herman M; Gordon D; Griffiths E; Knox K; McHale E; Quillen K; Rios J; Pisciotto P; Uhl L; DeMaria A; Andrzejewski C [Ad] Endereço: Bureau of Infectious Disease and Laboratory Sciences, Division of Epidemiology and Immunization, Massachusetts Department of Public Health, Jamaica Plain, Massachusetts. [Ti] Título: Hemovigilance in Massachusetts and the adoption of statewide hospital blood bank reporting using the National Healthcare Safety Network. [So] Source: Transfusion;57(2):478-483, 2017 02. [Is] ISSN: 1537-2995 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: A collaboration that grew over time between local hemovigilance stakeholders and the Massachusetts Department of Public Health (MDPH) resulted in the change from a paper-based method of reporting adverse reactions and monthly transfusion activity for regulatory compliance purposes to statewide adoption of electronic reporting via the National Healthcare Safety Network (NHSN). The NHSN is a web-based surveillance system that offers the capacity to capture transfusion-related adverse events, incidents, and monthly transfusion statistics from participating facilities. Massachusetts' hospital blood banks share the data they enter into NHSN with the MDPH to satisfy reporting requirements. Users of the NHSN Hemovigilance Module adhere to specified data entry guidelines, resulting in data that are comparable and standardized. Keys to successful statewide adoption of this reporting method include the fostering of strong partnerships with local hemovigilance champions and experts, engagement of regulatory and epidemiology divisions at the state health department, the leveraging of existing relationships with hospital NHSN administrators, and the existence of a regulatory deadline for implementation. Although limitations exist, successful implementation of statewide use of the NHSN Hemovigilance Module for hospital blood bank reporting is possible. The result is standardized, actionable data at both the hospital and state level that can facilitate interfacility comparisons, benchmarking, and opportunities for practice improvement. [Mh] Termos MeSH primário: Bancos de Sangue Segurança do Sangue Transfusão de Sangue/normas Gestão de Riscos [Mh] Termos MeSH secundário: Bancos de Sangue/métodos Bancos de Sangue/normas Segurança do Sangue/métodos Segurança do Sangue/normas Feminino Seres Humanos Masculino Massachusetts Gestão de Riscos/métodos Gestão de Riscos/normas [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 180302 [Lr] Data última revisão: 180302 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161025 [St] Status: MEDLINE [do] DOI: 10.1111/trf.13872

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[PMID]: 29390259 [Au] Autor: Wang S; Shi N; You L; Dai M; Zhao Y [Ad] Endereço: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. [Ti] Título: Minimally invasive surgical approach versus open procedure for pancreaticoduodenectomy: A systematic review and meta-analysis. [So] Source: Medicine (Baltimore);96(50):e8619, 2017 Dec. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Minimally invasive pancreaticoduodenectomy (MIPD) remains one of the most challenging abdominal procedures. Safety and feasibility remain controversial when comparing MIPD with open pancreaticoduodenectomy (OPD). The aim of this systematic review and meta-analysis was to evaluate the feasibility and safety of MIPD versus OPD. METHODS: A systematic review of the literature was performed to identify studies comparing MIPD and OPD. Postoperative complications, intraoperative outcomes and oncologic data, and postoperative recovery were compared. RESULTS: There were 27 studies that matched the selection criteria. Totally 1306 cases of MIPD and 5603 cases of OPD were included. MIPD was associated with a reduction in postoperative hemorrhage (odds ratio [OR] 1.60; 95% confidence interval [CI] 1.03-2.49; P = .04) and wound infection (OR 0.44, 95% CI 0.30-0.66, P < .0001). MIPD was also associated with less estimated blood loss (mean difference [MD] -300.14 mL, 95% CI -400.11 to -200.17 mL, P < .00001), a lower transfusion rate (OR 0.46, 95% CI 0.35-0.61; P < .00001) and a shorter length of hospital stay (MD -2.95 d, 95% CI -3.91 to -2.00 d, P < .00001) than OPD. Meanwhile, the MIPD group had a higher R0 resection rate (OR 1.45, 95% CI 1.18-1.78, P = .0003) and more lymph nodes harvested (MD 1.34, 95% CI 0.14-2.53, P = .03). However, the minimally invasive approach proved to have much longer operative time (MD 71.00 minutes; 95% CI 27.01-115.00 minutes; P = .002) than OPD. Finally, there were no significant differences between the 2 procedures in postoperative pancreatic fistula (P = .30), delayed gastric emptying (P = .07), bile leakage (P = .98), mortality (P = .88), tumor size (P = .15), vascular resection (P = .68), or reoperation rate (P = .11). CONCLUSIONS: Our results suggest that MIPD is currently safe, feasible, and worthwhile. Future large-volume, well-designed randomized controlled trials (RCT) with extensive follow-up are awaited to further clarify this role. [Mh] Termos MeSH primário: Laparoscopia Pancreaticoduodenectomia/métodos [Mh] Termos MeSH secundário: Perda Sanguínea Cirúrgica/estatística & dados numéricos Transfusão de Sangue/estatística & dados numéricos Seres Humanos Tempo de Internação/estatística & dados numéricos Pancreaticoduodenectomia/efeitos adversos Complicações Pós-Operatórias Procedimentos Cirúrgicos Operatórios [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180301 [Lr] Data última revisão: 180301 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180203 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008619

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[PMID]: 29320978 [Au] Autor: Lim CS; Dhutia A; Riga C; Dharmadasa A; Gibbs RGJ; Hamady MS [Ad] Endereço: 1 Regional Vascular Unit, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom. [Ti] Título: Two-Vessel Branched Stent Graft for Severely Angulated Aortic Arch Aneurysm in a Jehovah's Witness. [So] Source: Vasc Endovascular Surg;52(2):154-158, 2018 Feb. [Is] ISSN: 1938-9116 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Aneurysmal disease involving the origins of supra aortic vessels often requires complex open and/or endovascular repair that is not only associated with significant risk of mortality and morbidity but also often with perioperative blood loss requiring transfusion. We report a successful repair of a large thoracic aortic aneurysm (TAA) involving the aortic arch with a custom-made Bolton Relay 2-vessel branched thoracic aortic endograft in a 42-year-old Jehovah's Witness who would otherwise be very unlikely to survive an open repair. Branched thoracic aortic endografting offers a potentially safe, minimally invasive, and effective alternative for TAA disease involving the supra-aortic arteries, especially in patients who are at high risk of open surgery. [Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia Perda Sanguínea Cirúrgica/prevenção & controle Implante de Prótese Vascular/instrumentação Prótese Vascular Procedimentos Endovasculares/instrumentação Testemunhas de Jeová Religião e Medicina Stents [Mh] Termos MeSH secundário: Adulto Angiografia Digital Aneurisma da Aorta Torácica/diagnóstico por imagem Aortografia/métodos Transfusão de Sangue Angiografia por Tomografia Computadorizada Seres Humanos Masculino Desenho de Prótese Resultado do Tratamento Recusa do Paciente ao Tratamento [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180228 [Lr] Data última revisão: 180228 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180112 [St] Status: MEDLINE [do] DOI: 10.1177/1538574417747426

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