Abstract:
BACKGROUND:Percutaneous intervention in patients with bioprosthetic mitral valve dysfunction is an alternative to conventional surgical treatment. OBJECTIVES:To report the first Brazilian experience with transseptal transcatheter bioprosthetic mitral valve-in-valve implantation (transseptal-TMVIV). METHODS:Patients with surgical bioprosthetic dysfunction submitted to transseptal-TMVIV in 12 Brazilian hospitals were included. The significance level adopted was p<0.05. RESULTS:From June/2016 to February/2019, 17 patients underwent transseptal-TMVIV. Their median age was 77 years (IQR,70-82) and median Society of Thoracic Surgeons predicted risk of mortality (STS-PROM) score was 8.7% (IQR,7.2-17.8). All patients had limiting symptoms of heart failure (FC≥III) and 5 (29.4%) had undergone more than one previous thoracotomy. Transseptal-TMVIV was successful in all patients. Echocardiographic assessment showed a significant reduction in mean mitral valve gradient (pre-intervention, 12±3.8 mmHg; post-intervention, 5.3±2.6 mmHg; p<0.001), in addition to an increase in mitral valve area (pre-intervention, 1.06±0.59 cm2; post-intervention, 2.18±0.36 cm2; p<0.001) sustained for 30 days. There was a significant and immediate reduction in the pulmonary artery systolic pressure, with an additional reduction in 30 days (pre-intervention, 68.9±16.4 mmHg; post-intervention, 57.7±16.5 mmHg; 30 days, 50.9±18.7 mmHg; p<0.001). During follow-up (median, 162 days; IQR, 102-411), significant clinical improvement (FC≤II) was observed in 87.5% of the patients. One patient (5.9%) had left ventricular outflow tract (LVOT) obstruction and died right after the procedure, and another died at 161 days of follow-up. CONCLUSION:The first Brazilian experience with transseptal-TMVIV shows the safety and effectivity of the new technique. The LVOT obstruction is a potentially fatal complication, reinforcing the importance of patients' selection and of procedural planning. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0). FUNDAMENTO:A intervenção percutânea em pacientes com disfunção de prótese biológica mitral apresenta-se como uma alternativa ao tratamento cirúrgico convencional. OBJETIVO:Relatar a primeira experiência brasileira de implante transcateter de bioprótese valve-in-valve mitral via transeptal (TMVIV-via transeptal). MÉTODOS:Foram incluídos pacientes portadores de disfunção de bioprótese cirúrgica submetidos ao TMVIV-transeptal em 12 hospitais brasileiros. Foram considerados estatisticamente significativos valores de p<0,05. RESULTADOS:Entre junho/2016 e fevereiro/2019, 17 pacientes foram submetidos ao TMVIV-via transeptal. A mediana de idade foi 77 anos (IIQ,70-82), a mediana do escore STS-PROM foi 8,7% (IIQ,7,2-17,8). Todos os pacientes tinham sintomas limitantes de insuficiência cardíaca (CF≥III), tendo 5 (29,4%) sido submetidos a mais de uma toracotomia prévia. Obteve-se sucesso do TMVIV-via transeptal em todos os pacientes. A avaliação ecocardiográfica demonstrou redução significativa do gradiente médio (pré-intervenção, 12±3,8 mmHg; pós-intervenção, 5,3±2,6 mmHg; p<0,001), assim como aumento da área valvar mitral (pré-intervenção, 1,06±0,59 cm2; pós-intervenção, 2,18±0,36 cm2; p<0,001) sustentados em 30 dias. Houve redução significativa e imediata da pressão sistólica de artéria pulmonar, com redução adicional em 30 dias (pré-intervenção, 68,9±16,4 mmHg; pós-intervenção, 57,7±16,5 mmHg; 30 dias, 50,9±18,7 mmHg; p<0,001). Durante o seguimento, com mediana de 162 dias (IIQ, 102-411), observou-se marcada melhora clínica (CF≤II) em 87,5%. Um paciente (5,9%) apresentou obstrução de via de saída de ventrículo esquerdo (VSVE), evoluindo para óbito logo após o procedimento, e outro morreu aos 161 dias de seguimento.Conclusão: A primeira experiência brasileira de TMVIV-transeptal demonstra a segurança e a efetividade dessa nova técnica. A obstrução da VSVE é uma complicação potencialmente fatal, reforçando a importância da seleção dos pacientes e do planejamento do procedimento. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).
journal_name
Arq Bras Cardioljournal_title
Arquivos brasileiros de cardiologiaauthors
Nicz PFG,Melo PHMC,Brito PHF,Lima EN,Silva RCE,Prudente ML,Fernandes FH,Deininger MO,Lopes MACQ,Petrucci FS,Reis Filho FR,Marino MA,Bernardes RC,Melo EP,Oliveira MAP,Mangione JA,Mangione FM,Falcão CHE,Martins ECC,Ludoi
10.36660/abc.20190252subject
Has Abstractpub_date
2020-09-01 00:00:00pages
515-524issue
3eissn
0066-782Xissn
1678-4170pii
S0066-782X2020005008201journal_volume
115pub_type
杂志文章,多中心研究abstract:OBJECTIVE:To determine the utility of B-type natriuretic peptide (BNP) in the diagnosis of congestive heart failure (CHF) in patients presenting with dyspnea to an emergency department (ED). METHODS:Seventy patients presenting with dyspnea to an ED from April to July 2001 were included in the study. Mean age was 72+/-...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2002001500002
更新日期:2002-12-01 00:00:00
abstract:PURPOSE:To study the autonomic behavior of the escape rhythm in congenital complete heart block (CCHB), using heart rate variability (HRV). METHODS:A group of 10 asymptomatic patients with CCHB and narrow QRS was studied, 7 females; mean age = 14 +/- 9 years. The following time domain indexes were analyzed from a 24 h...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract:PURPOSE:To evaluate septal perfusion and contractility in patients with left bundle branch block (LBBB). METHODS:Twenty patients were submitted to myocardial scintigraphy with Tecnecium-99m isontrile after exercise and dipyridamole infusion. The septal contractility was observed during the radionuclide ventriculograph...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-11-01 00:00:00
abstract::We report a case of dobutamine stress echocardiography-induced Takotsubo syndrome in a 76-year-old hypertensive patient with clinical complaints of chest pain in an elective visit to the cardiologist. Dobutamine-stress-echocardiography was requested to rule out chest pain of coronary origin. During the test, at peak e...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2009000700014
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Sleep apneas are frequent in patients with heart failure (HF). Estimate of the pre-beta blocker age (BB) point out to 45% of central apneas in these patients. OBJECTIVE:Assess the influence of BB in central apneas and their interference in the quality of sleep and life of patients with heart failure. METHO...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:2010-02-01 00:00:00
abstract:PURPOSE:To analyse the influence of unstable coronary syndromes (UCS) in the early and late prognosis after rotational atherectomy (RA). METHODS:We treated 236 patients with RA between Aug/1992 and May/1996. Patients were divided into two groups: A) stable coronary syndromes 120 (51%) patients; B) UCS: 116 (49%) patie...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:The rate of saphenous vein graft failure one year after coronary artery bypass grafting ranges from 10% to 25%. The aim of this study was to explore whether atorvastatin can reduce accumulation of vascular smooth muscle cells to inhibit intimal hyperplasia via p38 MAPK pathway inhibition. METHODS:Forty-five...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.36660/abc.20190231
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To study the factors associated with the risk of in-hospital death in acute myocardial infarction in the Brazilian public health system in Rio de Janeiro, Brazil. METHODS:Sectional study of a sample with 391 randomly drawn medical records of the hospitalizations due to acute myocardial infarction recorded in...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2003000600003
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:The arterial hypertension varies in according to the circadian cycle, presenting physiologic fall of blood pressure (BP) during sleep (dipping). The absence of this fall or its increase associates to higher incidence of target-organ damages. OBJECTIVE:To analyze the prevalence of dipping in hypertensive ind...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2010000100013
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:To characterize the cardiac electrophysiologic effects of cocaine. METHODS:In 8 dogs (9-13 kg), electrophysiologic parameters and programmed stimulation were undertaken using transvenous catheters at baseline, and after cocaine intravenous infusion (12 mg/kg bolus followed by 0.22 mg/kg/min for 25 minutes). ...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2003000900002
更新日期:2003-07-01 00:00:00
abstract::PURPOSE--To present initial experience on radiofrequency (RF) ablation of atrial flutter (AFL) guided by anatomic and electrophysiologic parameters. METHODS--Eight patients (six males), mean-age of 42 +/- 17.5 years with chronic type I AFL (mean cycle length of 251 +/- 14.3 msec, range 240 to 280 msec) were undergone ...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract:PURPOSE:To compare the efficacy of carvedilol, a new antihypertensive drug that combines vasodilatory and beta-blocker properties, with nifedipine. METHODS:In a multicenter double-blind trial, 106 mild to moderate essential hypertensive patients were treated with either carvedilol (n = 51), or nifedipine (n = 55) as m...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:To assess the effects of the relief of the mitral stenosis by percutaneous ballon valvotomy in the function of the left atrial appendage. METHODS:Twelve patients with symptomatic mitral stenosis, in sinus rhythm, were studied. They were submitted to the transesophageal echocardiogram before and after effecti...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2005000600005
更新日期:2005-06-01 00:00:00
abstract::This report describes a case of a 62 year-old man admitted for recurrent myocardial infarction and normal coronary arteries, caused by coronary embolism from aortic papillary fibroelastoma. Other conditions causing acute coronary syndrome and normal coronary arteries are discussed. A careful evaluation by transthoraci...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2012000100018
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Left ventricular hypertrophy (LVH) is a marker of increased cardiovascular risk and is frequently associated with both arterial hypertension (AH) and aortic stenosis (AoS). Also, these two maladies may co-exit in a same patient. However, in these cases, it is not clear the impact of each one in LVH. OBJECTI...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2011005000081
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:The Stroop test requires the individual to respond to specific elements of a stimulus, whereas inhibiting more automated processes. OBJECTIVE:To compare the cardiovascular reactivity induced by the computerized version of the Stroop word-color test TESTINPACS with the traditional version based on the readin...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2010005000006
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Echocardiography is a useful method for screening and assessing response to cardiac resynchronization therapy (CRT). 3D echocardiography has already established its role in the evaluation of ventricular volumes and ejection fraction (LVEF) with excellent correlation of results when compared with MRI. OBJECT...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2011005000073
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:To evaluate the influence of age on response to pravastatin treatment in patients treated by community physicians. METHODS:According to age, 873 patients were divided in three groups: group A with ages ranging from 45 to 59 years (n = 55), group B with ages from 60 to 64 years (n = 182) and group C with ages f...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-08-01 00:00:00
abstract::We presented two cases of falsely elevated CK-MB due to the presence of a type 2 macro CK, showed by isoenzymes electrophoresis. The association of this CK-MB falsely elevated with some digestive diseases are frequent. Quantification of CK isoenzymes by electrophoresis could be indicated in those cases in which the cl...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract:PURPOSE:To study if dopamine in dopaminergic doses (1.5 and 4.0 micrograms/kg/min) had some effect on the pulmonary vasoconstriction mechanism, and if in those doses the drug had some action on systemic and pulmonary hemodynamic variables, as well as in the pulmonary gas exchange. METHODS:Seventeen normal mongrel dogs...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00
abstract:PURPOSE:To relate our experience with thrombolytic therapy in 8 patients with cardiac metal prosthesis complicated with thrombosis. METHODS:Eight patients with clinical and echocardiographic diagnosis of cardiac valvar prosthesis thrombosis were treated. RESULTS:The treatment efficacy was evaluated by clinical and ec...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of coronary artery disease (CAD) risk factors (RF) and myocardial ischemia in a sample of asymptomatic diabetic patients treated on an outpatient basis. METHODS:From 80 type 2 diabetic patients initially recruited at an university outpatient endocrinology clinic, with no symptoms ...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2007001700005
更新日期:2007-11-01 00:00:00
abstract::We report on a 30-year-old female patient, with biological mitral valve prosthesis due to symptomatic mitral stenosis and a history of acute myocardial infarction and generalized tonic-clonic seizure episodes, visual hallucinations, cerebral thromboembolic events and, at present, chorea and acute carditis. The patient...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2012000200016
更新日期:2012-02-01 00:00:00
abstract::This is the report of a rare case of endomyocardial fibrosis associated with massive calcification of the left ventricle in a male patient with dyspnea on great exertion, which began 5 years earlier and rapidly evolved. Due to lack of information and the absence of clinical signs that could characterize impairment of ...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x1999001200004
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:We determined the effects of losartan and PD 123319 (antagonists of the AT1 and AT2 angiotensin receptors, respectively), and [Sar1, Ala8] ANG II (a relatively peptide antagonist of angiotensin receptors) injected into the paraventricular nucleus (PVN) on water and 3% NaCl intake, and the diuretic, natriureti...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2003000400004
更新日期:2003-04-01 00:00:00
abstract:PURPOSE:To show the author's experience with percutaneous transluminal coronary angioplasty (PTCA) in patients with prior coronary bypass surgery. METHODS:Between January 1989 and January 1991, 629 PTCA in 572 patients were performed. Forty-eight had previous revascularization surgery with interval range of 4 days to ...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract::OBJECTIVE - Angiotensin-converting enzyme inhibitors (ACEIs) have gained importance in preventing or attenuating the process of ventricular remodeling after myocardial infarction. The significance of infarct size in regard to the response to ACEIs, however, is controversial. This study aimed to analyze the effects of ...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x1999001000004
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:By reducing the specificity associated with loss of information, the influence of attenuation of the breasts is very important in myocardial perfusion studies. However, although several studies have been conducted over the past years, little has been developed to determine accurately the influence of the cha...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2010005000162
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Patients with thalassemia major present chronic hemolysis and require regular blood transfusions which may cause iron overload cardiomyopathy and chronic heart failure. Hemochromatosis is characterized by excessive iron accumulation in tissues, and heart involvement is the main cause of death in patients wit...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.1590/s0066-782x2013005000001
更新日期:2013-01-01 00:00:00
abstract::Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effecti...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
doi:10.5935/abc.20140144
更新日期:2014-11-01 00:00:00