Publications by authors named "Fabio-Biscegli Jatene"

Article Synopsis
  • - Fungal endocarditis is an uncommon but severe complication that can occur after transcatheter aortic valve implantation (TAVI).
  • - A case study is presented involving a 75-year-old patient who developed this condition due to the fungus Candida albicans.
  • - The patient's situation was further complicated by the formation of an aortic pseudoaneurysm.
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In newly emerging economy countries, the shortage of pediatric donor hearts and poor healthcare infrastructure poses a significant challenge. Although mechanical circulatory support (MCS) has been proven effective in enhancing heart transplant waiting list outcomes, economic barriers hinder its widespread adoption. A single-center retrospective study reviewed children under 10 kg on the heart transplant (HTx) list from 2012 to 2023.

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We describe a 15 year old patient with failing second-stage single-ventricle palliation and left pulmonary artery thrombosis successfully supported with HeartMate 3 ventricular assist device and a Fontan completion as destination therapy.

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Article Synopsis
  • Subaortic stenosis (SubAS) can remain undiagnosed until pregnancy, where the hemodynamic changes may reveal severe symptoms, necessitating urgent treatment.
  • A case study presents a 34-year-old pregnant woman who underwent surgery after being admitted for severe SubAS, successfully delivering a healthy baby at 39 weeks post-surgery.
  • Managing heart conditions like SubAS during pregnancy poses risks, but with careful planning and teamwork among healthcare providers, successful outcomes can be achieved.
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The first step in innovation is to identify a problem of real relevance and systematically address it to deliver a sophisticated and viable solution. Disruptive innovation is a process where technology, products, or services are transformed or replaced by a better innovative solution. This superiority must be perceived by users as being more accessible, simple, or convenient.

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Background: The analysis of indicators such as hospital readmission rates is crucial for improving the quality of services and management of hospital processes.

Objectives: To identify the variables correlated with hospital readmission up to 30 days following coronary artery bypass grafting (CABG).

Methods: Cross-sectional cohort study by REPLICCAR II database (N=3,392) from June 2017 to June 2019.

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Background: Analyses of extensive registries indicate adverse outcomes for women undergoing coronary artery bypass grafting (CABG) surgery, while randomized studies often lack representativeness.

Objective: To compare adjusted hospital outcomes between men and women undergoing CABG.

Methods: From July 2017 to June 2019, 3991 patients underwent primary isolated CABG, both electively and urgently, in 5 hospitals in the state of São Paulo, Brazil.

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Background: Pulmonary valve regurgitation is a significant long-term complication in patients with tetralogy of Fallot (TOF).

Objective: This study aims to investigate the effects of pulmonary valve implantation (PVI) on the anatomy and function of the right ventricle (RV) and the long-term evolution of the implanted prosthesis in the pulmonary position.

Methods: A single-center retrospective cohort analysis was performed in 56 consecutive patients with TOF who underwent PVI.

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Background: Identifying risk factors in cardiovascular surgery assists in predictability, resulting in optimization of outcomes and cost reduction.

Objective: This study aimed to identify preoperative and intraoperative risk predictors for prolonged hospitalization after coronary artery bypass grafting (CABG) surgery in the state of São Paulo, Brazil.

Methods: A cross-sectional analysis using data from the REPLICCAR II database, a prospective, consecutive, multicenter registry that included CABG surgeries performed between August 2017 and July 2019.

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Background: The neutrophil-lymphocyte ratio (NLR) is an easily accessible and inexpensive biomarker that has been shown to predict morbidity and mortality in congenital cardiac surgery. However, its regulatory mechanism remains unclear. This study aims to compare and correlate the tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, IL-6, and IL-10 messenger RNAs (mRNAs) with the NLR in patients with tetralogy of Fallot (ToF) and ventricular septal defect (VSD).

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Objective: This study aims to develop a predictive model using artificial intelligence to estimate the ICU length of stay (LOS) for Congenital Heart Defects (CHD) patients after surgery, improving care planning and resource management.

Design: We analyze clinical data from 2240 CHD surgery patients to create and validate the predictive model. Twenty AI models are developed and evaluated for accuracy and reliability.

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Article Synopsis
  • Postoperative atrial fibrillation (AF) is the most common complication after coronary artery bypass surgery and can lead to serious outcomes like stroke and increased hospital costs.
  • A study was conducted at the University of São Paulo to compare the cost-effectiveness of anticoagulants rivaroxaban versus warfarin plus enoxaparin in patients experiencing postoperative AF.
  • Results showed rivaroxaban was significantly more cost-effective and associated with lower overall costs and less bleeding risk compared to warfarin.
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The coronavirus disease (COVID-19) pandemic leveraged telemedicine worldwide mainly due to the need for social distancing, patient safety, and infection prevention. The Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) was a key reference site in the treatment of COVID-19 severe cases in the country. To continue patient's health care, it became necessary to increase the number of teleconsultations and standardize it institutionally.

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Article Synopsis
  • Tuberculosis, typically affecting the lungs, can also lead to rare complications such as purulent pericarditis, as illustrated by a case involving a 67-year-old man.
  • The patient experienced severe pericardial effusion and cardiac tamponade, leading to surgeries that included drainage of 500 mL of purulent fluid and a subsequent median sternotomy for more extensive treatment.
  • The study concludes that aggressive surgical interventions like partial pericardiectomy and debridement can be effective in managing refractory cases of tuberculous pericarditis, improving patient outcomes.
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The aims of this study were to perform pre-surgery miRNA profiling of patients who develop Vasoplegic syndrome (VS) after coronary artery bypass grafting (CABG) and identify those miRNAs that could be used as VS prognostic tools and biomarkers. The levels of 754 microRNAs (miRNAs) were measured in whole blood samples from a cohort of patients collected right before the coronary artery bypass grafting (CABG) surgery. We compared the miRNA levels of those who developed VS (VASO group) with those who did not (NONVASO group) after surgery.

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This case report shows how to perform simultaneously an open surgical correction of an aortic root aneurysm and aortic stenosis by interposition of an aortic composite graft and the transdiaphragmatic extra-anatomical correction of an aortic coarctation.

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Background: The current challenge of cardiac surgery (CS) is to improve outcomes in adverse scenarios. The aim of this study was to assess the impact of a quality improvement program (QIP) on hospital mortality in the largest CS center in Latin America.

Methods: Patients were divided into two groups: before (Jan 2013-Dec 2015, n = 3534) and after establishment of the QIP (Jan 2017-Dec 2019, n = 3544).

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Clinical prediction models for deep sternal wound infections (DSWI) after coronary artery bypass graft (CABG) surgery exist, although they have a poor impact in external validation studies. We developed and validated a new predictive model for 30-day DSWI after CABG (REPINF) and compared it with the Society of Thoracic Surgeons model (STS). The REPINF model was created through a multicenter cohort of adults undergoing CABG surgery (REPLICCAR II Study) database, using least absolute shrinkage and selection operator (LASSO) logistic regression, internally and externally validated comparing discrimination, calibration in-the-large (CL), net reclassification improvement (NRI) and integrated discrimination improvement (IDI), trained between the new model and the STS PredDeep, a validated model for DSWI after cardiac surgery.

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Article Synopsis
  • Dextrocardia is a rare heart condition where the heart is positioned on the right side, often accompanied by various situs arrangements, making surgeries complex.
  • A case presented involved a patient with dextrocardia and situs inversus totalis requiring a redo aortic valve replacement, where the main surgeon was positioned on the patient's left side for better access.
  • A detailed surgical plan and the use of CT scans were crucial for the successful operation, highlighting the importance of teamwork in handling such challenging cases.
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