Adaptation And Use of the Papworth Haemostasis Checklist - Clinical Outcomes Analysis at Hospital Estadual Mário Covas.

Introduction: Postoperative bleeding is one of the main causes of complications in cardiovascular surgery, which highlights the importance of ensuring adequate intraoperative hemostasis, providing a better patient outcome. This study aimed to improve the prevention of postoperative bleeding in the Cardiovascular Surgery Department of the Hospital Estadual Mário Covas (Santo André, Brazil) using an adapted version of the Papworth Haemostasis Checklist to assess the impact of this standardization on bleeding rate, postoperative complications, reoperation, and mortality.

Methods: This is a non-randomized controlled clinical trial, whose non-probabilistic sample consisted of patients undergoing cardiac surgery in the abovementioned service within a two-year interval.

Long-term cardiac changes in patients with systemic lupus erythematosus.

Background: The aim of this study was evaluate the late-onset repercussions of heart alterations of patients with systemic lupus erythematosus (SLE) after a 13-year follow up.

Methods: A historical prospective study was carried out involving the analysis of data from the charts of patients with a confirmed diagnosis of lupus in follow up since 1998. The 13-year evolution was systematically reviewed and tabulated to facilitate the interpretation of the data.

A randomized trial of the topical effect of antifibrinolytic epsilon aminocaproic Acid on coronary artery bypass surgery without cardiopulmonary bypass.

We assessed the effect of the topical application of epsilon-aminocaproic antifibrinolytic acid (EACA) on the pericardium of patients submitted to coronary artery bypass graft (CABG) without the use of cardiopulmonary bypass (CPB). This is a prospective, randomized, and double-blind study. We evaluated 26 patients with chronic coronary heart disease indicated for CABG without CPB (EACA and placebo groups).

[Transhiatal esophagectomiy using partial sternotomy].

Transhiatal Esophagectomy offers the advantage of not requiring thoracotomy or thoracoscopy. Nevertheless, it has the disadvantage of having to be performed, at least in part, with blind, blunt dissection, with high frequency of pleural lesions, increased bleeding, among other complications. The association of median diaphragm transection with partial sternotomy allows the isolation of the esophagus completely under direct vision.

Bovine pericardium retail preserved in glutaraldehyde and used as a vascular patch.

Background: In this study we evaluated the performance of bovine pericardium preserved in glutaraldehyde used as a vascular patch.

Methods: Fourteen young pigs, six females and eight males, weighting 10.3 - 18.

Adiponectin expression in epicardial adipose tissue after percutaneous coronary intervention with bare-metal stent.

Background: The classical view of adipose tissue as a passive reservoir for energy storage is no longer valid. In the past decade, adipose tissue has been shown to have endocrine functions and the most abundant peptide secreted by adipocytes is adiponectin. Pericardial adipose tissue (PAT) is distributed around coronary arteries and endovascular injury, caused by the presence of intracoronary bare-metal stent (BMS), could promote inflammatory changes in the periadvential fat, contributing to vascular restenosis.

Comparison of uniatrial and biatrial radiofrequency ablation procedures in atrial fibrillation: initial results.

Background: Atrial fibrillation (AF) is the most commonly sustained cardiac rhythm disturbance. Surgical ablation techniques were developed involving the left atrium only and modifications of the maze procedure in ablating both atria.

Objective: The aim of this study was to compare, in patients with permanent AF, the efficacy of uniatrial versus biatrial radiofrequency ablation procedure in the treatment of chronic atrial fibrillation in patients with associated cardiac disease.

An experience of vascular access for hemodialysis in Brazil.

Background: The analysis of hemodialysis services is relevant for the quality of life of patient. In this study we investigated the profile of vascular access used for hemodialysis patients in our Unit.

Methods: We evaluated 219 patients of both genders aged over 18 years old who have undergone implant or manufacture of vascular hemodialysis access.

Saphenofemoral arteriovenous fistula as hemodialysis access.

Background: An upper limb arteriovenous (AV) fistula is the access of choice for haemodialysis (HD). There have been few reports of saphenofemoral AV fistulas (SFAVF) over the last 10-20 years because of previous suggestions of poor patencies and needling difficulties. Here, we describe our clinical experience with SFAVF.

Surgical biatrial ablation of atrial fibrillation: initial results.

Objective: To evaluate the results of intraoperative radiofrequency ablation with biatrial procedure in the treatment of chronic atrial fibrillation in patients with associated cardiac disease.

Methods: Between February 2008 and May 2009, 15 consecutive patients were underwent mitral valve procedure plus modified radiofrequency biatrial ablation of chronic atrial fibrillation. The mean age was 47.

[Transdiaphragmatic intercostal hernia after spontaneous rib fractures secondary to coughing fit].

One case of transdiafragmatic intercostal hernia after intense coughing fit followed by rib fractures in patient with history of pneumonia is presented. He had a severe coughing fit, developed a right toracoabdominal hematoma and then a tumor that was gradually enlarging. Image exams confirmed the diagnosis.

Cardiac baroreflex is already blunted in eight weeks old spontaneously hypertensive rats.

Background: The literature did not evidence yet with which age spontaneously hypertensive rats (SHR) start to present baroreflex reduction. We endeavored to evaluate the baroreflex function in eight-week-old SHR.

Methods: Male Wistar Kyoto (WKY) normotensive rats and SHR aged eight weeks were studied.

Right coronary bypass grafting with coronary-coronary venous bypass graft.

Objective: The following report describes the experience of the Cardiovascular Surgery Team of the ABC Medical School with coronary-coronary bypass grafting.

Methods: Four patients undergone off-pump coronary artery bypass grafting, with coronary-coronary bypass of the right coronary artery, by using great saphenous vein graft.

Results: The follow-up period was 3 to 5 years without any intra- or postoperative recurrence.

Topical use of antifibrinolytic agent to reduce postoperative bleeding after coronary artery bypass surgery.

Objective: Antifibrinolytic agents reduce bleeding after cardiac surgery, but there are adverse effects after their systemic use. These effects are avoided by topical application of antifibrinolytic agents in pericardial cavity. We compared the effects of topically applied epsilon-aminocaproic acid (EACA) and placebo on postoperative bleeding and transfusion requirements after coronary artery bypass surgery.

Operative treatment after iatrogenic left main dissection.

Coronary dissection has a significant morbidity and mortality. The ideal management of acute coronary occlusion is the prompt restoration of the vessel patency to limit the extent and duration of ischemia. In the setting of dissection during percutaneous procedure, the usual approach has been emergency aortocoronary bypass surgery.

Effect of ventral cardiac denervation in the incidence of atrial fibrillation after coronary artery bypass graft surgery.

Objective: To evaluate the effect of ventral cardiac denervation in the incidence of atrial fibrillation after coronary artery bypass surgery.

Methods: Between September and November, 50 patients without history or previous diagnosis of atrial arrhythmia from the same institution presenting coronary heart disease with indication for coronary artery graft bypass surgery were enrolled in a prospective and randomized study. The exclusion criteria were: patients older than 75 years of age, previous history of atrial arrhythmia and associated heart surgeries.

[Surgical ablation of atrial fibrillation using radiofrequency].

Objective: To evaluate the effectiveness of intraoperative atrial fibrillation ablation using radiofrequency during mitral valve procedure. This report describes the early and midterms results.

Methods: Between September 2003 and September 2005, 15 patients with mitral disease were operated.

Simultaneous repair of congenital heart defect and pectus excavatum.

The author describes the simultaneous treatment of pectus excavatum and congenital intracardiac defect (atrial septal defect) represented by the interatrial foramen secundum. An 8-year-old boy, with clinical and echocardiography diagnosis of atrial septal defect associated with pectus excavatum was referred to a simultaneous surgical treatment of both abnormalities. The simultaneous surgical treatment of both pectus excavatum and congenital intracardiac defects make it difficult to access the heart.