Additional improvement in regional myocardial ischemia after intracardiac injection of bone marrow cells during CABG surgery.

Background: Post-procedure residual ischemia is associated with worse prognosis in patients with coronary artery diasease (CAD).

Objective: We evaluated whether autologous bone marrow-derived cells (BMC) contribute to additional reduction in regional stress-induced myocardial ischemia (SIMI) in patients undergoing incomplete coronary artery bypass graft surgery (CABG).

Methods: In a double-blind, randomized, placebo-controlled trial, we enrolled 143 patients (82% men, 58 ± 11 years) with stable CAD and not candidates for complete CABG.

Early increase in myocardial perfusion after stem cell therapy in patients undergoing incomplete coronary artery bypass surgery.

Incomplete revascularization is associated with worse long-term outcomes. Autologous bone marrow cells (BMC) have recently been tested in patients with severe coronary artery disease. We tested the hypothesis that intramyocardial injection of autologous BMC increases myocardial perfusion in patients undergoing incomplete coronary artery bypass grafting (CABG).

Synergism between keratinocyte growth factor and carboxymethyl chitosan reduces pericardial adhesions.

Background: Mesothelial injury is the pivot in the development of adhesions. An increase in the proliferation of mesothelial cells was verified by in vitro studies with the use of keratinocyte growth factor (KGF). This study investigated the influence of KGF associated with thermo-sterilized carboxymethyl chitosan (NOCCts) in the reduction of pericardial adhesions.

Endomyocardial fibrosis: pathological and molecular findings of surgically resected ventricular endomyocardium.

Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy of unknown etiology prevalent in tropical regions affecting the inflow tract and apex of one or both ventricles, which show fibrous thickening of the endocardium and adjacent myocardium. Surgical treatment is recommended for patients in functional classes III or IV (New York Heart Association). The gross and histological features of the heart have been comprehensively studied in autopsies, but studies in surgical samples are still lacking.

Mitral valve replacement with chordae tendineae preservation, traction and fixation in end-stage dilated cardiomyopathy.

Objective: This study aimed at evaluating results of mitral valve replacement using a new technique of complete chordae tendineae adjustment for left ventricular remodeling.

Methods: Twenty end-stage idiopathic dilated cardiomyopathy patients with severe functional mitral valve regurgitation underwent mitral valve replacement. Seventeen (85%) were in functional class IV.

Left ventricular free-wall rupture after acute myocardial infarction imaged by cardiovascular magnetic resonance.

This manuscript describes a rare situation where after acute myocardial infarction a patient underwent cardiovascular magnetic resonance (CMR), which identified a previously undiagnosed rupture of the free wall of the LV, leading to successful surgical management.

Aortic valve rupture due to blunt chest trauma.

We report a patient admitted to our hospital with aortic valve rupture due to blunt chest trauma. The aortic rupture was accurately identified by the transesophageal echocardiogram, allowing a better surgical approach.

Coronary artery bypass grafting in acute myocardial infarction. Analysis of preoperative predictors of mortality.

Objective: To assess preoperative predictors of mortality in patients undergoing coronary artery bypass grafting (CABG) within the first 30 days of acute myocardial infarction (AMI).

Methods: Between March 1998 and July 2002, 753 AMI patients were consecutively and prospectively entered into a database, 135 (17.9%) of whom underwent isolated CABG and were enrolled in this study.

Quality of life in patients with symptomatic multivessel coronary artery disease: a comparative post hoc analyses of medical, angioplasty or surgical strategies-MASS II trial.

Objective: We evaluated the impact of Coronary Artery Bypass Graft Surgery (CABG), Percutaneous Coronary Intervention (PCI) or Medical Therapy (MT) on self-perceived quality of life among patients with stable Coronary Artery Disease (CAD).

Background: The Medicine, Angioplasty and Surgery Study (MASS-II) implemented initial policies of CABG, PCI or continued medical treatment in patients who allow assessment of mid-term health consequences.

Methods: A total of 542 patients were randomly assigned to CABG (175), to PCI (180) and to MT (187).

Cell biology, MRI and geometry: insight into a microscopic/macroscopic marriage.

Objective: The concept of cell therapy as an adjunctive therapy to myocardial surgical revascularization for patients with severe coronary artery disease is illustrated by two case reports of ischemic cardiac disease that were unsuitable for revascularization by coronary grafting. The potential interaction of cell therapy, magnetic resonance imaging (MRI) of viability, and left ventricle (LV) restoration is described.

Methods: Each patient had an ejection fraction below 30%, a relatively conical heart, and MRI gadolinium scan showing predominantly viable muscle.

Ontario score and cardiac risk during waiting for elective coronary bypass grafting.

Background: Waiting lists for coronary bypass grafting are of major concern in several countries and prioritisation systems to the surgery have been proposed. The aim of this study was to verify the adequacy of Ontario score in predicting cardiac events during the waiting for elective coronary bypass grafting.

Methods: A composite end-point (sudden or cardiac death, myocardial infarction, unstable angina or hospital admission) and sudden, cardiac death were analysed in 460 patients referred to the surgery.

Risk factor analysis of hospital mortality in patients with endocarditis with ring abscess.

Background: Endocarditis associated with ring abscess is a pathology with high morbidity and mortality.

Aim Of The Study: The purpose of this study was to analyze hospital mortality risk factors in patients with ring abscess due to endocarditis.

Methods: From January 1982 to December 2000, 104 patients underwent surgical intervention at the Heart Institute of the University of São Paulo Medical School for valve endocarditis with ring abscess.

Coronary revascularization with the left internal thoracic artery and radial artery: comparison of short-term clinical evolution between elective and emergency surgery.

Background: Left internal thoracic artery-to left anterior descending artery grafting has become a fundamental part of coronary artery bypass grafting. This grafting has led to increased use of other arterial conduits, of which the radial artery is most popular. Whether radial grafting can be used in the emergency patient is not known.

Ascending aortic aneurysm after pediatric heart transplantation: case report of an unusual complication.

A 28-month-old boy, weighing 11 kg, with severe dilated cardiomyopathy, was transplanted on December 1995. Hypertension and supraventricular tachycardia were detected in the immediate post-operative period, with favorable outcome. After 5 months of clinically asymptomatic follow-up, a dilation in the ascending aorta was observed on routine echocardiogram.

Surgical ventricular restoration: the RESTORE Group experience.

Congestive heart failure may be caused by late left ventricular (LV) dilation following anterior infarction. Early reperfusion prevents transmural necrosis, and makes the infarcted segment akinetic rather than dyskinetic. Surgical ventricular restoration (SVR) reduces LV volume and creates a more elliptical chamber by excluding scar in either akinetic or dyskinetic segments.

The body mass index and level of resection: predictive factors for compensatory sweating after sympathectomy.

Objective: Compensatory sweating (CS) is the most common adverse event and the main cause of dissatisfaction among patients undergoing a VATS sympathectomy for the treatment of primary hyperhidrosis. It has been described that obese individuals experience more sweating than thinner ones. The aim of this study is to identify the Body Mass Index (BMI) and the level of resection as predictive factors for CS and its relation to levels of patient satisfaction following the procedure.

Late evolution of mitral commissurotomy in patients with low echocardiographic score.

Objective: The purpose of this study was to analyze the late results with open mitral commissurotomy in patients with low echocardiographic scores and to identify variables influencing these late results.

Methods: We studied 50 patients who underwent open mitral commissurotomy due to rheumatic mitral stenosis at the Heart Institute University of São Paulo Medical School. Enrolled patients had a Wilkins echocardiographic score View Article and Find Full Text PDF

[Vascular prosthesis infection in thoracic aorta surgery: review of the experience and a case report illustrating treatment with an unconventional technique].

We report the case of a 37-year-old-female patient who had undergone a Bentall procedure at our service and returned with intense chest pain and acute aortic dissection type III, which was diagnosed and clinically treated. One year after this episode, this dissection expanded, and the patient underwent surgery with interposition of a Dacron graft in the descending aorta. In the immediate postoperative period, the patient experienced left bronchopneumonia and was discharged afebrile and in good condition.

Left ventricular lipoma.

We report the case of a 21-year-old female referred to our institution complaining of dizziness when standing up, which improved in the dorsal decubitus position and at rest, after a few minutes. The symptom, which had lasted for years, was not accompanied by vertigo, syncope, or neurological changes, but was gradually getting worse. Transthoracic echocardiogram showed a hyperechoic mass in the middle-apical region of the left ventricular posterior wall and normal pericardium.