Coronary artery bypass using only computed tomography as pre-operative angiogram.

Coronary artery bypass graft (CABG) is a well established procedure with current precise indications. The advent and spread of this technique was possible after the introduction of the coronary angiogram. Although many evaluation methods have been developed in the past years, to date, none have been able to replace the invasive coronary angiogram as a pre-operative exam.

Bentall and De Bono surgery for correction of valve and ascending aortic disease: long-term results.

Objective: A retrospective study was performed in a series of consecutive patients who underwent a Bentall and De Bono procedure.

Methods: Data were removed of medical records and follow-up data were obtained from clinical records and direct contact with patients. A total of 39 patients were studied between January 1996 and December 2005.

Patent ductus arteriosus treatment in the premature newborn: clinical and surgical analisys.

Background: The surgical treatment of patency ductus arteriosus is indicated when the clinical intervention fails. However, this treatment may have some complications.

Objective: To analyze clinical and surgical aspects involved on the treatment of patency ductus arteriosus in premature newborn.

Myocardial revascularization and ventricular restoration through pacopexy.

Objective: To analyze left ventricle performance after myocardial revascularization associated to ventricular geometrics restoration by "pacopexy" in schemic myocardiopathy patients with significant ventricular dysfunction in whom ventricular restoration was obtained through special technique.

Methods: Myocardial revascularization associated to ventricular geometrics restoration through special technique, with no use of prosthesis or other synthetic materials.

Results: Patients functional class was shown to have improved 93.

[Surgical treatment of aortic valve disease with stentless bovine pericardium prosthesis: immediate results].

Objective: To present the immediate results and assess the clinical and hemodynamic performance of stentless bovine pericardial bioprostheses in aortic position.

Methods: Twenty patients were operated who were indicated for surgery for valve replacement with biological prosthesis. Eleven patients were male; sixteen had aortic stenosis; four, insufficiency; the mean age was 66.

End-stage cardiomyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration.

Background: Secondary mitral insufficiency is a strong risk factor for death in end-stage cardiomyopathy. The possible correction of mitral regurgitation has now been accepted as an alternative to cardiac transplantation in a special subset of patients. We propose a new surgical approach that consists of implantation of a mitral prosthesis that is smaller than the annulus, and preservation and traction of the papillary muscles to reduce sphericity of the left ventricle.

[Cardiac transplantation and neoplasms: experiences at Escola Paulista de Medicina of the Federal University of São Paulo].

Objective: To study the occurrence and types of neoplasms developed by patients who underwent an orthotopic cardiac transplantation under the Program of Cardiac Transplantation of Escola Paulista de Medicina, Federal University of São Paulo.

Methods: This is an observational study of 106 patients who underwent orthotopic cardiac transplantation from November 1986 to September 2002 and survived at least thirty days following the procedure. The triple immunosuppressive regimen given included cyclosporin A, azathioprine and a corticosteroid agent.

Off-pump myocardial revascularization: critical analysis of 23 years' experience in 3,866 patients.

Background: Surgical myocardial revascularization without cardiopulmonary bypass (CPB) is not new, with the first consecutive series of patients appearing in the early eighties. There has been increased interest in this alternative approach, especially in patients with comorbidities. There is controversy regarding advantages, risks, and usefulness of this method of myocardial revascularization.

Inflammatory reaction after sirolimus-eluting stent implant.

Sirolimus-eluting stents (SES) are supposed to attenuate cell proliferation and reduce restenosis rate. Histologic finding from coronary artery after SES implant showed fibrosis and inflammatory infiltrate, revealing a chronic inflammatory reaction. Extension of coronary inflammatory reaction after stenting needs clarification.

[Sildenafil improves right ventricular function in a cardiac transplant recipient].

We report the case of a male patient who underwent orthotopic cardiac transplantation. A marginal donor was used, because the recipient's clinical condition was critical. He experienced cardiogenic shock due to right ventricular dysfunction secondary to pulmonary hypertension associated with vasoplegia.

Coronary artery and myocardial inflammatory reaction induced by intracoronary stent.

Background: Intracoronary stents have been extensively used in percutaneous coronary revascularization. However, despite the breakthroughs and developments associated with this new technology, novel complications and findings have emerged compelling the cardiac surgeon to cope with this new scenario. The presence of an intracoronary foreign body (stent) might induce an inflammatory reaction to the coronary artery and surrounding cardiac muscle.

Vasoplegic syndrome after off-pump coronary artery bypass surgery.

Objective: The vasoplegic syndrome (VS) has been implicated in life-threatening complications after open heart surgery, where the whole-body inflammatory reaction is attributed to the cardiopulmonary bypass (CPB). Off-pump coronary artery bypass grafting (OPCAB) has been recently achieving growing enthusiasm mainly due avoiding the side effects of CPB. However herein the occurrence of VS in OPCAB is reported.