Challenges of Congenital Heart Surgery in Brazil: It is Time to Designate Pediatric Congenital Heart Surgery Subspecialty.

Congenital heart disease (CHD) affects eight to ten out of every 1,000 births, resulting in approximately 23,057 new cases in Brazil in 2022. About one in four children with CHD requires surgery or other procedures in the first year of life, and it is expected that approximately 81% of these children with CHD will survive until at least 35 years of age. Professionals choosing to specialize in CHD surgery face numerous challenges, not only related to mastering surgical techniques and the complexity of the diseases but also to the lack of recognition by medical societies as a separate subspecialty.

Esophageal Perforation by Fish Bone Ingestion Causing Purulent Pericarditis.

A previously healthy 38-year-old woman presented with new-onset sudden chest pain radiating to the back, associated with cough, dyspnea, nausea, vomiting, and gastric fullness after eating a bony fish. A diagnosis of gastroesophageal reflux disease was made. After a week of progressive worsening of her symptoms, she was referred to the specialist hospital.

Left Atrial Appendage Autograft for Anomalous Origin of Left Coronary Artery From Pulmonary Artery.

A novel interposition technique is presented in which a pediatric patient underwent reimplantation of the anomalous origin of the left coronary artery from the pulmonary artery into the aorta by creation of an extension using an autograft of the left atrial appendage. The advantage of this technique is that the autograft remains patent and lies anatomically without tension over the pulmonary artery as demonstrated in the follow-up computed tomography angiogram.

Assessment of pain and quality of life in patients undergoing cardiac surgery: a cohort study.

Objective: This study aimed to evaluate postoperative pain and quality of life in patients undergoing median sternotomy.

Methods: A cohort study was carried out on a sample of 30 patients who underwent elective cardiac surgery by longitudinal median sternotomy. Patients were interviewed at Intensive Care Unit discharge and hospital discharge, when the Visual Numeric Scale and the Brief Pain Inventory were applied, and 2 weeks after hospital discharge, when the World Health Organization Quality of Life-Bref questionnaire was administered.

Surviving the Struggle of COVID-19: Practical Recommendations for Pediatric/Adult Cardiology and Cardiac Surgical Programs in Resource-Limited Settings: a Review.

Introduction: The primary aim of this systematic review is to provide perioperative strategies to help restore or preserve cardiovascular services under threat from financial and personnel constraints imposed by the coronavirus disease 2019 (COVID-19) pandemic.

Methods: The Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBASE, Cochrane Central Register of Controlled Trials/CCTR, and Google Scholar were systematically searched using the search terms "(cardiac OR cardiology OR cardiothoracic OR surgery) AND (COVID-19 or coronavirus OR SARS-CoV-2 OR 2019-nCoV OR 2019 novel coronavirus OR pandemic)". Additionally, the webpages of relevant medical societies, including the World Federation Society of Anesthesiologists, the Cardiothoracic Surgery Network, and the Society of Thoracic Surgeons, were screened for relevant information.

Early Mobilization Prescription in Patients Undergoing Cardiac Surgery: Systematic Review.

Introduction: Early mobilization of patients in the postoperative period of cardiac surgery who are hospitalized in the intensive care unit (ICU) is a practice that has a positive impact.

Methods: This is a systematic review of studies published until September 2020 in the Medical Literature Analysis and Retrieval System Online (or MEDLINE®), Embase, Physiotherapy Evidence Database (or PEDro), Scientific Electronic Library Online (or SciELO), and Latin American and Caribbean Health Sciences Literature (or LILACS) databases. Randomized clinical trials describing mobilization protocols performed early in ICU patients after cardiac surgery were included.

Applicability of the Disruptions in Surgery Index in the Cardiovascular Management Scenarios - A Marker for Developing Functionally Efficient Teams.

Introduction: To support the development of practices and guidelines that might help to reduce adverse events related to human factors, we aimed to study the response and perception by members of a cardiovascular surgery team of various error-driven or adverse features that might arise in the operating room (OR).

Methods: A previously validated Disruptions in Surgery Index (DiSI) questionnaire was completed by individuals working together in a cardiovascular surgical unit. Results were submitted to reliability analysis by calculating the Cronbach's alpha coefficient.

Emotional quality-of-life and patient-reported limitation in sports participation in children with uncorrected congenital and acquired heart disease in healthcare-restricted settings in low- and middle-income countries.

Background: Little is known about emotional quality-of-life in paediatric heart disease in low- and middle-income countries where the prevalence of uncorrected lesions is high. Research on emotional quality-of-life and its predictors in these settings is key to planning interventions.

Methods: Ten-year retrospective cross-sectional study of children aged 6-17 years with uncorrected congenital or acquired heart disease in 12 low- and middle-income countries was conducted.

Acute Response to Aerobic Exercise on Autonomic Cardiac Control of Patients in Phase III of a Cardiovascular Rehabilitation Program Following Coronary Artery Bypass Grafting.

Objective: The aim of the present study was to investigate the acute response to aerobic exercise on autonomic cardiac control of patients undergoing coronary artery bypass grafting (CABG).

Methods: The study sample consisted of eight patients (age: 58.6±7.

Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry.

Introduction: Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015.

Pre-validation Study of the Brazilian Version of the Disruptions in Surgery Index (DiSI) as a Safety Tool in Cardiothoracic Surgery.

Introduction: Most risk stratification scores used in surgery do not include external and non-technical factors as predictors of morbidity and mortality.

Objective: The present study aimed to translate and adapt transculturally the Brazilian version of the Disruptions in Surgery Index (DiSI) questionnaire, which was developed to capture the self-perception of each member of the surgical team regarding the disruptions that may contribute to error and obstruction of safe surgical flow.

Methods: A universalist approach was adopted to evaluate the conceptual equivalence of items and semantics, which included the following stages: (1) translation of the questionnaire into Portuguese; (2) back translation into English; (3) panel of experts to draft the preliminary version; and (4) pre-test for evaluation of verbal comprehension by the target population of 43 professionals working in cardiothoracic surgery.

Modified Hybrid Procedure in Hypoplastic Left Heart Syndrome: Initial Experience of a Center in Northeastern Brazil.

Introduction:: Although it only corresponds to 2.5% of congenital heart defects, hypoplastic left heart syndrome (HLHS) is responsible for more than 25% of cardiac deaths in the first week of life. Palliative surgery performed after the second week of life is considered an important risk factor in the treatment of HLHS.

The Brazilian Registry of Adult Patient Undergoing Cardiovascular Surgery, the BYPASS Project: Results of the First 1,722 Patients.

Objective: To report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients.

Methods: Data collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1). The study population consists of patients over 18 years of age, and the types of operations recorded were: coronary artery bypass graft (CABG), mitral valve, aortic valve (either conventional or transcatheter), surgical correction of atrial fibrillation, cardiac transplantation, mechanical circulatory support and congenital heart diseases in adults.

Climacteric Symptoms and Sexual Dysfunction: Association between the Blatt-Kupperman Index and the Female Sexual Function Index.

 To investigate the association between the intensity of climacteric symptoms and sexual dysfunction in women aged 40 to 65 years.  Observational, analytic, cross-sectional study conducted with 63 women aged 40 to 65 treated at the gynecology outpatient clinic of a public hospital in northeastern Brazil. A questionnaire was used to collect identification data, clinical information, gynecological-obstetric data, lifestyle traits and information on chronic diseases.

Effects of Resistance Exercise Applied Early After Coronary Artery Bypass Grafting: a Randomized Controlled Trial.

Objective: To evaluate the effects of resistance exercise applied early after coronary artery bypass grafting.

Methods: It is a randomized controlled trial with 34 patients undergoing coronary artery bypass grafting between August 2013 and May 2014. Patients were randomized into two groups by simple draw: a control group (n=17), who received conventional physical therapy and an intervention group (n=17), who received, additionally, resistance exercise.

Sex Differences in Mortality After CABG Surgery.

Introduction: Numerous studies have shown that women undergoing coronary artery bypass graft surgery present higher mortality rate during hospitalization, and often complications when compared to men.

Objective: To compare the mortality of men and women undergoing coronary artery bypass graft surgery and identify factors related to differences occasionally found.

Methods: Retrospective cohort study conducted with 215 consecutive patients who underwent coronary bypass surgery.

Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass grafting.

Objective: To compare the effects of different levels of positive end-expiratory pressure on respiratory mechanics and oxygenation indexes in the immediate postoperative period of coronary artery bypass grafting.

Methods: Randomized clinical trial in which 136 patients underwent coronary artery bypass grafting between January 2011 and March 2012 were divided into three groups and admitted to mechanical ventilation with different positive end-expiratory pressure levels: Group A, 5 cmH2O (n=44), Group B, 8 cmH2O (n=47) and Group C, 10 cmH2O (n=45). Data about respiratory mechanics were obtained from mechanical ventilator monitor and oxygenation indexes from arterial blood gas samples, collected twenty minutes after intensive care unit admission.

Acute kidney injury after coronary artery bypass grafting: assessment using RIFLE and AKIN criteria.

Objective: To compare the RIFLE (Risk, Injury, Failure, Loss and End-stage Renal Failure) and AKIN (Acute Kidney Injury Network) criteria for diagnosis of acute kidney injury after coronary artery bypass grafting.

Methods: Retrospective cohort. 169 patients who underwent coronary artery bypass grafting from January 2007 through December 2008 were analyzed.

Assesment of CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery.

Introduction: Neurological dysfunction is a feared postoperative morbidity of cardiac surgery, an important cause of death and increased spending in hospitals. Its prediction, however, is still uncertain.

Objective: To assess the applicability of a preoperative score as a predictor of neurological dysfunction after coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB).

[Echocardiographic associations with renal function in hypertensive individuals treated at primary care level].

Introduction: Microalbuminuria (MA) and glomerular filtration rate (GFR) can be associated with cardiac complications hypertension (AH), which may lead to changes in the structure, function and left ventricular geometry.

Objectives: To correlate changes of the GFR and MA with the parameters of the left ventricle (LV) assessed by echocardiography.

Methods: A cross-sectional study was carried out from February through July 2010 with 220 hypertensive patients treated at two Primary Care Outpatient Clinics in São Luis.