Mechanical Circulatory Assist Devices: Which Is the Best Device as Bridge to Heart Transplantation?

Introduction: Heart transplantation is the recommended treatment method for patients with advanced heart failure that is refractory to clinical treatment. Due to the progressive severity of these patients and the impossibility of performing the transplant in a short term, there are mechanical circulatory assist devices that can offer necessary hemodynamic support and clinical stability in the period preceding the heart transplant surgery. The present study aims to address and describe the main devices used as bridges for heart transplantation, as well as to analyze their advantages and disadvantages.

Protective effects of 17β-oestradiol on coagulation and systemic inflammation after total occlusion of the descending aorta in male rats.

Objectives: The surgical treatment for diseases of the descending aorta is related to a high mortality rate because of the activation of a systemic inflammatory process due to ischaemia and reperfusion (I/R) injury. Activation of coagulation can contribute to the inflammatory process, resulting in microcirculatory damage and multiple organ failure. Our goal was to evaluate the role of prophylactic intravenous 17β-oestradiol (E2) in coagulation, the inflammatory response and hepatic injury after occlusion of the descendent proximal aorta in male rats.

Mortality Rates of Surgical Techniques for Correcting Atrioventricular Disjunction.

We compared the mortality rates of two surgical techniques for correction of atrioventricular disjunction in 10 out of 720 patients who underwent mitral valve replacement from 2005 to 2012. In group I, the mitral annulus was fixed with bovine pericardial strips; in group II, a 'patch' of bovine pericardium was sutured and extended from the base of the lateral and medial papillary muscles, covered the posterior wall of the left ventricle, went through the posterior mitral annulus, and ended in the posterior wall of the left atrium adjacent to the mitral ring. The group II technique showed a lower mortality.

Sex differences in the coagulation process and microvascular perfusion induced by brain death in rats.

Brain death (BD) leads to a systemic inflammation associated with the activation of coagulation, which could be related to decreased microcirculatory perfusion. Evidence shows that females exhibit higher platelet aggregability than males. Thus, we investigated sex differences in platelets, coagulation and microcirculatory compromise after BD.

Improvement in cardioplegic perfusion technique in single aortic clamping - initial results.

Introduction: The most common method used for myocardial protection is administering cardioplegic solution in the coronary circulation. Nevertheless, protection may be achieved by intermittent perfusion of the coronary system with patient's own blood. The intermittent perfusion may be performed by multiple sequences of clamping and opening of the aortic clamp or due single clamping and accessory cannulation of the aortic root as in the improved technique proposed in this study, reperfusion without the need for multiple clamping of the aorta.

Incidence of stroke and acute renal failure in patients of postoperative atrial fibrillation after myocardial revascularization.

Introduction: Postoperative atrial fibrillation is the most common arrhythmia in cardiac surgery, its incidence range between 20% and 40%.

Objective: Quantify the occurrence of stroke and acute renal insufficiency after myocardial revascularization surgery in patients who had atrial fibrillation postoperatively.

Methods: Cohort longitudinal bidirectional study, performed at Portuguese Beneficent Hospital (SP), with medical chart survey of patients undergoing myocardial revascularization surgery between June 2009 to July 2010.