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.

Surgical myocardial revascularization of patients with ischemic cardiomyopathy and severe left ventricular disfunction.

Objective: To determine long-term survival, identify preoperative factors predictive of a favorable outcome, and assess functional improvement after coronary artery bypass grafting in patients with advanced left ventricular dysfunction.

Methods: Between 1995 and 2001, 244 patients who underwent coronary artery bypass grafting and had a preoperative left ventricular ejection fraction less than or equal to 35% were included. left ventricular ejection fraction was determined by uniplanar or biplanar ventriculography during left heart catheterization.

Long-term follow-up of patients undergone coronary artery bypass grafting with exclusive use of arterial grafts.

Objective: To evaluate the long-term results of the coronary artery bypass grafting with exclusive use of arterial grafts for patients with triple vessel disease.

Methods: We evaluated 136 patients who underwent isolated coronary artery bypass grafting between January 1995 and December 1997. 353 grafts were used for revascularization of 449 arteries (mean: 3.

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.

[Cell therapy plus transmyocardial laser revascularization: a proposed alternative procedure for refractory angina].

Objective: We tested the hypothesis that TMLR combined with intramyocardial injection of BMC is safe, and may help increase the functional capacity of patient with refractory angina.

Methods: Nine patients (eight men), 65+/-5 years old, with refractory angina for multivessel disease and previous myocardial revascularization procedures (CABG/PCI), not candidates for another procedure due to the extension of the disease were enrolled. TMLR (11+/-3 laser drills) was performed via a limited thoracotomy using a CO2 Heart Laser System.

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.

[Technical aspects of coronary sinus catheterization based on the atrial component of the intracavitary electrogram and radiological anatomy during the implantation procedure of a biventricular pacemaker].

Objective: To present a technical proposal based on the experience of 130 implantations using a simplified technique for coronary sinus catheterization, based on the atrial component of the intracavitary electrogram and radiological anatomy.

Methods: From October, 2001 to October, 2004, 130 biventricular pacemaker implantations were performed, using radiological anatomy and observation of the intracavitary electrogram, focusing on the atrial component.

Results: The implantation of the system using left ventricular pacing via coronary sinus was not possible in 8 patients.

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.

[Cardiac papillary fibroelastoma. Experience of an institution].

Primary intracardiac tumors are rare, with prevalence between 0.0017% and 0.19% from non-selected autopsy studies.

[Comparative study between the therapeutic effects of surgical myocardial revascularization and coronary angioplasty in equivalent ischemic situations: analysis through myocardial scintigraphy with 99mTc-Sestamibi].

Objective: To assess the myocardial ischemic load to previous and after myocardial revascularization.

Methods: Ninety-six randomized patients, carriers of multivessel coronary artery disease, stable angina, preserved left ventricular function, and exercise-induced myocardial ischemia treated with revascularization (SMR) or coronary angioplasty (TCA). Myocardial scintigraphy with 99mTc-Sestamibi was performed prior to and 6 months after myocardial revascularization.

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.

[Correction of thoracic and thoracoabdominal aortic aneurysms. Central cannulation technique].

Objective: To demonstrate the viability of the use of extracorporeal circulation established between the left atrium and ascending aorta to induce deep hypothermia for correcting thoracic and thoracoabdominal aortic aneurysms.

Methods: From January 1994 to July 2001, 38 patients (mean age, 54.6 +/- 12.

[Comparative study of the results of coronary artery bypass grafting and angioplasty for myocardial revascularization in patients with equivalent multivessel disease].

Objective: To investigate the relative efficacy of different therapeutic strategies in patients with symptomatic multivessel coronary artery disease with preserved ventricular function. The primary objectives were defined as a combination of death of cardiac origin, acute myocardial infarction (AMI), and refractory angina that required revascularization, and the secondary objectives were defined as anginal state and exercise-induced ischemia.

Methods: Of the 20,769 patients assessed on cine coronary angiography at InCor, 210 were chosen for this study and were randomized either for coronary artery bypass grafting (CABG, n = 105) or transluminal coronary angioplasty (TCA, n = 105).

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.