Prosthesis-Patient Mismatch after Surgical Aortic Valve Replacement: Neither Uncommon nor Harmless.

Prosthesis-patient mismatch (PPM) after surgical aortic valve replacement (SAVR) is an issue that has been overlooked (not to say neglected). Cardiac surgeons must bear in mind that this is a real problem that we must tackle. The purpose of this paper is to be a wake-up call to the surgical community by giving a brief overview of what PPM is, its incidence and impact on the outcomes.

Closure of Patent Foramen Ovale versus Medical Therapy after Cryptogenic Stroke: Meta-Analysis of Five Randomized Controlled Trials with 3440 Patients.

Objective: We aimed to determine whether patent foramen ovale closure reduces the risk of stroke, also assessing some safety outcomes.

Introduction: The clinical benefit of closing a patent foramen ovale after a cryptogenic stroke has been an open question for several decades, so that it is necessary to review the current state of published medical data in this regard.

Methods: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LI-LACS, Google Scholar and reference lists of relevant articles were searched for randomized controlled trials that reported any of the following outcomes: stroke, death, major bleeding or atrial fibrillation.

CABG Surgery Remains the best Option for Patients with Left Main Coronary Disease in Comparison with PCI-DES: Meta-Analysis of Randomized Controlled Trials.

Objective: To compare the safety and efficacy of coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients with unprotected left main coronary artery (ULMCA) disease.

Methods: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported outcomes at 1-year follow-up after PCI with DES and CABG for the treatment of ULMCA stenosis. Five studies fulfilled our eligibility criteria and they included a total of 4.

Stopping versus continuing acetylsalicylic acid before coronary artery bypass surgery: A systematic review and meta-analysis of 14 randomized controlled trials with 4499 patients.

This study aimed to evaluate the efficacy and safety of continuing versus stopping aspirin [acetylsalicylic acid (ASA)] preoperatively in patients undergoing coronary artery bypass graft surgery. MEDLINE, EMBASE, CENTRAL/Cochrane Controlled Trials Register (CCTR), ClinicalTrials.gov, Scientific Electronic Library Online (SciELO), Literatura Latino Americana em Ciências da Saúde (LILACS), Google Scholar and reference lists of relevant articles were searched for randomized controlled trials that reported efficacy outcomes of myocardial infarction and mortality, and safety outcomes of blood loss, packed red blood cell transfusion and surgical re-exploration were compared between groups.

Pulmonary valve replacement after operative repair of tetralogy of Fallot: meta-analysis and meta-regression of 3,118 patients from 48 studies.

Because the real benefit of pulmonary valve replacement (PVR) in patients with repaired tetralogy of Fallot who develop pulmonary insufficiency remains unclear, it is necessary to analyze the evidence published around the world. We performed a systematic review of studies that reported data about the effect of PVR in patients with repaired tetralogy of Fallot that developed pulmonary insufficiency, until December 2012. The variables chosen to represent the benefit were both right ventricular (RV) and left ventricular measures, QRS duration, and functional class.

EuroSCORE and mortality in coronary artery bypass graft surgery at Pernambuco Cardiologic Emergency Medical Services [Pronto Socorro Cardiológico de Pernambuco].

Objective: The aim of this study is to evaluate the applicability of EuroSCORE in patients undergoing coronary artery bypass graft (CABG) surgery at the Division of Cardiovascular Surgery of Pernambuco Cardiologic Emergency Medical Services--PROCAPE.

Methods: A retrospective study involving 500 patients operated between May 2007 and April 2010. The registers contained all the information used to calculate the EuroSCORE.

Clinical and surgical profile of patients operated for postinfarction interventricular septal rupture.

Objectives: To study clinical features, complications and in-hospital outcomes of patients operated for postinfarction ventricular septal rupture.

Methods: A retrospective study involving 21 patients between January/1996 and June/2009. All operations were performed at the Division of Cardiovascular Surgery of Complexo Hospitalar HUOC/PROCAPE.

Treatment of atrial fibrillation using ultrasonic cardiac ablation, during valvular heart surgery.

Objective: This study aims to evaluate the surgical treatment of atrial fibrillation with ultrasound ablation concomitant to mitral surgery in PROCAPE's patients with permanent atrial fibrillation.

Methods: From March 2008 through January 2009 a prospective study was performed at the Pernambuco Cardiology Emergency Facility on 44 consecutive patients with a permanent atrial fibrillation and concomitant cardiac valvular surgery indication, from March 2008 through January 2009 at Pernambuco Cardiology Emergency Facility Twenty two patients underwent epicardial ultrasonic ablation on the right atrium and had ultrasonic ablation performed in the left atrium endocardial concomitant with the valve procedure. The other 22 patients, the concurrent controls were submitted to valve procedure without ultrasonic ablation.

Postoperative mediastinitis in cardiovascular surgery postoperation. Analysis of 1038 consecutive surgeries.

Objective: To report the incidence of mediastinitis in cardiovascular surgery postoperation.

Methods: The records of all 1038 patients who underwent cardiovascular surgical procedures between May/2007 and June/2009 were reviewed. All operations were performed in Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE.