Non-vitamin K versus vitamin K antagonist oral anticoagulants in surgical mitral valve repair or bioprosthetic valve replacement in the first three months after surgery.

Introduction And Objectives: Oral anticoagulation (OAC) with non-vitamin K antagonist oral anticoagulants (NOACs) after surgical mitral valve repair (MVR) or bioprosthetic valve replacement (BVR) in mitral position remains a controversial topic among the cardiovascular community, in particular in the early postoperative period. This study aimed to evaluate the efficacy and safety of NOACs in the first three months after MVR or mitral BVR compared to vitamin K antagonists (VKAs).

Methods: This was a single-center retrospective study with prospectively collected peri-intervention outcomes between 2020 and 2021.

What is the role of septal myectomy in aortic stenosis?

Asymmetric basal septal hypertrophy is present in 10% of patients with hemodynamic significant aortic valve stenosis. From the surgeon's standpoint, it represents a dilemma as it may be implicated in suboptimal short and long-term results after aortic valve replacement (AVR), but also heighten unwarranted complications at the time of surgical correction. To provide insight about the usefulness and safety of concomitant septal myectomy in this setting, we performed a literature review searching Medline from its inception to November 2020 using the Pubmed interface.

Hemangioma of the mitral valve: Following the murmur.

Cardiac hemangiomas are an exceedingly rare condition, with about 100 cases described in the literature, of which only 13 were valvular. We report the case of a 66-year-old woman, with no prior cardiovascular disease, who presented with an abdominal infection caused by Enterococcus faecalis, complicated by recrudescent fever and new-onset systolic mitral murmur. The transesophageal echocardiogram revealed a large vegetation on the posterior leaflet of the mitral valve, with a high embolic risk, leading to a diagnosis of acute endocarditis.

Extracorporeal Membrane Oxygenation: The First 10 Years Experience of a Portuguese Pediatric Intensive Care Unit.

Introduction: In Portugal, extracorporeal membrane oxygenation (ECMO) is used in pediatric patients since 2010. The aim of this study was to describe the clinical characteristics of patients, indications, complications and mortality associated with the use of ECMO during the first 10-years of experience in the Pediatric Intensive Care Unit located in Centro Hospitalar Universitário Lisboa Norte.

Material And Methods: Retrospective observational cohort study of all patients supported with ECMO in a Pediatric Intensive Care Unit, from the 1st of May 2010 up to 31st December 2019.

[ECMO in Neonates with Congenital Diaphragmatic Hernia: The Experience of a Portuguese ECMO Referral Center].

Introduction: The use of extracorporeal membrane oxygenation (ECMO) is considered by many authors as one of the most important technological advances in the care of newborns with congenital diaphragmatic hernia. The main objective of this study was to report the experience of a Portuguese ECMO center in the treatment of congenital diaphragmatic hernia.

Material And Methods: Descriptive retrospective study of newborns with congenital diaphragmatic hernia requiring ECMO support in a Pediatric Intensive Care Unit from January 2012 to December 2019.

Practical guide for the use of PCSK9 inhibitors in Portugal.

Reducing low-density lipoprotein cholesterol (LDL-C) levels is one of the most important strategies for reducing the risk of cardiovascular events. However, in clinical practice, a high proportion of patients do not achieve recommended LDL-C levels through lifestyle and lipid-lowering therapy with statins and ezetimibe. PCSK9 inhibitors (PCSK9i) are a new therapeutic option that significantly (50-60%) reduces LDL-C levels, which in clinical trials translates into an additional reduction in risk for cardiovascular events, and has a good safety profile.

Long-term assessment of the Ross procedure in adults: Clinical and echocardiographic follow-up at 20 years.

Introduction: The Ross procedure is an alternative to standard aortic valve (AV) replacement in young and middle-aged patients. However, durability and incidence of reoperation remain a concern for most cardiac surgeons. Our aim was to assess very long-term clinical and echocardiographic outcomes of the Ross procedure.

Comparison of multiparametric risk scores for predicting early mortality after transcatheter aortic valve implantation.

Introduction: Surgical risk scores are widely used to identify patients at high surgical risk who may benefit from transcatheter aortic valve implantation (TAVI). A multiparametric TAVI mortality risk score based on a French registry (FRANCE-2) has recently been developed. The aim of our study was to compare the 30-day mortality prediction performance of the FRANCE-2, EuroSCORE II and STS scores.

Sequential transcatheter aortic valve implantation due to valve dislodgement - a Portico valve implanted over a CoreValve bioprosthesis.

Transcatheter aortic valve implantation (TAVI) has become an important treatment in high surgical risk patients with severe aortic stenosis (AS), whose complications need to be managed promptly. The authors report the case of an 86-year-old woman presenting with severe symptomatic AS, rejected for surgery due to advanced age and comorbidities. The patient underwent a first TAVI, with implantation of a Medtronic CoreValve, which became dislodged and migrated to the ascending aorta.

[Congenital Heart Disease in Children with Down Syndrome: What Has Changed in the Last Three Decades?].

Introduction: The prevalence of Down syndrome has increased in the last 30 years; 55% of these children have congenital heart disease.

Material And Methods: A retrospective longitudinal cohort study; clinical data from 1982 to 2013 databases with the diagnosis of Down syndrome or trisomy 21 in a reference hospital in pediatric cardiology and cardiac surgery.

Objective: to assess the progress in the last three decades of cardiological care given to children with Down syndrome and congenital heart disease.

Left ventricular pseudoaneurysm - a challenging diagnosis.

Left ventricular pseudoaneurysm is a rare complication of acute myocardial infarction, associated with high mortality. However, it can present in a non-specific manner, complicating and delaying the diagnosis. The authors present the case of a 65-year-old patient, hypertensive, with no other known relevant medical history, who presented with chest pain, cough and left pleural effusion, initially attributed to a pulmonary process.

Aortic valve replacement for severe aortic stenosis in octogenarians: patient outcomes and comparison of operative risk scores.

Introduction And Aim: Isolated aortic valve replacement (AVR) in octogenarians is associated with increased operative risk, due to higher prevalence of associated risk factors and other comorbidities, making outcome prediction essential. We sought to analyze operative mortality and morbidity and to compare the predictive accuracy of the logistic European System for Cardiac Operative Risk Evaluation score (EuroSCORE) I, EuroSCORE II and Society of Thoracic Surgeons (STS) score in this population.

Methods: We retrospectively enrolled 106 consecutive octogenarians with symptomatic severe aortic stenosis undergoing isolated AVR in a large-volume single center between January 2003 and December 2010 and calculated surgical risk scores.

Subcutaneous implantable cardioverter-defibrillator: Initial experience.

Background: Implantable cardioverter-defibrillators (ICDs) are important tools in the prevention of sudden death, but implantation requires transvenous access, which is associated with complications. Subcutaneous implantable cardioverter-defibrillators (S-ICDs) may prevent some of these complications.

Aim: To evaluate the therapeutics and complications associated with S-ICD systems.

[A rare case of two mechanisms of prosthetic valve dysfunction in the same patient].

Prosthetic valve dysfunction is a significant clinical event. Determining its etiological mechanism and severity can be difficult. The authors present the case of a 50-year-old man, with two mechanical valve prostheses in aortic and mitral positions, hospitalized for decompensated heart failure.

[Complications of endomyocardial biopsy after heart transplantation: a lesser evil].

Endomyocardial biopsy is still the principal method for diagnosing cardiac allograft rejection. However, this procedure can be associated, albeit rarely, with potentially serious complications. We describe the case of a patient with extensive anterior myocardial infarction without revascularization, who developed cardiogenic shock and required heart transplantation.

[Total anomalous pulmonary venous connection: a 17-years experience of a single pediatric cardiology center].

Objective: We reviewed our patients who underwent surgical repair for total anomalous pulmonary venous connection at our hospital.

Material And Methods: All patients with total anomalous pulmonary venous connection who underwent correction from February 1995 to October 2012 were included in this retrospective analysis. Clinical data was collected on presentation,morphology, associated cardiac lesions, echocardiography and cardiac cathetherization results, surgical repair and postoperative course.

Coronary artery bypass grafting in octogenarians: long-term results.

Introduction: As surgical revascularization is becoming more frequent in octogenarians, we reviewed our data to analyze the impact of coronary artery bypass grafting on short- and long-term morbidity and mortality.

Methods: We performed a retrospective study of 101 consecutive patients aged 80 years or older, who underwent coronary artery bypass in a single cardiac center between January 2002 and December 2007. The patients were divided into two groups: off-pump (64.