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Search Results: 1 - 10 of 23229 matches for " Frederico Pires Vasconcelos;Lima "
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Tratamento da fibrila??o atrial com abla??o por ultrassom, durante corre??o cirúrgica de doen?a valvar cardíaca
Lins, Rosaly Moraes Marques;Lima, Ricardo de Carvalho;Silva, Frederico Pires Vasconcelos;Menezes, Alexandre Motta de;Salerno, Pedro Rafael;Thé, Emmanuel Caou;Sepúlveda, Diana;Albuquerque, Eugênio;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000300008
Abstract: objective: this study aims to evaluate the surgical treatment of atrial fibrillation with ultrasound ablation concomitant to mitral surgery in procape's patients with permanent atrial fibrillation. methods: from march 2008 through january 2009 a prospective study was performed at the pernambuco cardiology emergency facility on 44 consecutive patients with a permanent atrial fibrillation and concomitant cardiac valvular surgery indication, from march 2008 through january 2009 at pernambuco cardiology emergency facility twenty two patients underwent epicardial ultrasonic ablation on the right atrium and had ultrasonic ablation performed in the left atrium endocardial concomitant with the valve procedure. the other 22 patients, the concurrent controls were submitted to valve procedure without ultrasonic ablation. patients with serious diseases such as coronary and others were excluded of the research. results: it was observed 90% restoration to sinus rhythm immediately after surgery in patients submitted to treatment of atrial fibrillation with ultrasound ablation simultaneous a mitral surgery. the evolution in late post operation showed that the maintenance of sinus rhythm drops although it was still 27% higher in the group which received ablation compared with the control group. 86.40% of the patients who received ablation had improved in functional class; they also have fewer complications than patients in the control group. conclusion: the results showed that the patients who received treatment for atrial fibrillation simultaneously with valvar surgery had advantages related to the control group.
Aspectos técnicos na esqueletiza??o da artéria torácica interna com bisturi ultra-s?nico
Menezes, Alexandre Motta de;Vasconcelos, Frederico Pires de;Lima, Ricardo de Carvalho;Costa, Mário Gesteira;Escobar, Mozart Augusto Soares de;
Revista Brasileira de Cirurgia Cardiovascular , 2007, DOI: 10.1590/S0102-76382007000200009
Abstract: objective: to describe the technique and evaluate the immediate results of using an ultrasonic scalpel in the skeletonization of the internal thoracic artery for coronary artery bypass grafting surgery. methods: from january 2000 to october 2006, 188 patients were submitted to coronary artery bypass grafting with the internal thoracic artery skeletonized using an ultrasonic scalpel. seventy-one patients (37.8%) were women. the patients' ages varied from 28 to 81 years old. the entire internal thoracic artery was exposed opening the endothoracic fascia using scissors as close as possible to the arterial adventitia. an ultrasonic scalpel was used to transect and coagulate all the intercostal branches, thereby minimizing the use of metallic clips. results: the skeletonized internal thoracic arteries presented with excellent flow, obviating the need for intraluminal manipulation for vasodilatation. in the immediate postoperative period, two patients were found to have temporary left-sided diaphragmatic paralysis. there were no sternal wound infections in this series. the dissection can be performed in approximately 33 minutes however with more experience this time may be reduced. conclusion: this technique facilitates and shortens the internal thoracic artery skeletonization procedure and does not cause arterial spasms. cauterization of the collateral branches with an ultrasonic scalpel is efficient and the use of metallic clips is almost unnecessary. it is a procedure that is easy to reproduce and may be recommended as the first-choice technique for the dissection of the internal thoracic artery.
Mediastinite no pós-operatório de cirurgia cardiovascular: análise de 1038 cirurgias consecutivas
, Michel Pompeu Barros de Oliveira;Silva, Débora Oliveira;Lima, érika Nibbering de Souza;Lima, Ricardo de Carvalho;Silva, Frederico Pires Vasconcelos;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Cavalcanti, Paulo Ernando Ferraz;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000100008
Abstract: objective: to report the incidence of mediastinitis in cardiovascular surgery postoperation. methods: the records of all 1038 patients who underwent cardiovascular surgical procedures between may/2007 and june/2009 were reviewed. all operations were performed in division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. results: the complication occurred within, on average, 13 days after operation, in total of 25 (2.4%), eight (32%) deaths occurred. several risk factors mediastinitis were identified: 56% diabetes, 56% smokers, 20% obeses, 16% with chronic obstructive pulmonary disease and 8% of chronic renal failure. mediastinitis were reported in 21 (84%) cases of patients submitted to coronary artery bypass grafting, being associated to major risk of infection development (ic 3.448.30, p=0.0001). high rates of complications were observed: respiratory insufficiency (44%), stroke (16%), cardiogenic shock (12%), acute renal failure (28%), pulmonary infection (36%), multiple organs failure (16%) and esternal deiscence (48%). bacterial cultures of exudates were positive in 84% of patients; staphylococcus aureus was the most responsible pathogen (28.8%). conclusion: mediastinitis stays a serious surgical complication and difficult management in cardiovascular surgery postoperation. the disease stays with low incidence, but still with high lethality. coronary bypass was associated to major risk of infection development.
EuroSCORE e mortalidade em cirurgia de revasculariza??o miocárdica no Pronto Socorro Cardiológico de Pernambuco
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Silva, Frederico Pires Vasconcelos;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000400010
Abstract: objective: the aim of this study is to evaluate the applicability of euroscore in patients undergoing coronary artery bypass graft (cabg) surgery at the division of cardiovascular surgery of pernambuco cardiologic emergency medical services - procape. methods: a retrospective study involving 500 patients operated between may 2007 and april 2010. the registers contained all the information used to calculate the euroscore. the outcome of interest was death. univariate analysis and multivariate analysis by backward logistic regression were applied to assess the association between each variable in the euroscore and deaths. the following parameters were calculated: sensitivity, specificity, positive predictive value, and negative predictive value. the power of concordance between the predicted mortality by the euroscore and the observed mortality was measured using the kappa coefficient. the accuracy of the model was evaluated by the roc (receiver operating characteristic) curve. results: the incidence of death was 13%. in multivariate analysis, nine variables remained independent predictors of death: chronic obstructive pulmonary disease, creatinine >2,3mg/dl, active endocarditis, preoperative critical state, unstable angina, ejection fraction 30% to 50%, acute myocardial infarction < 90 days, emergency surgery and additional surgery. the score had a sensitivity of 88.4%, specificity of 79.3%, positive predictive value of 40.7%, negative predictive value of 97.7% and 80.6% concordance. the accuracy measured by the area under the roc curve was 0.892 (95% ci 0.862-0.922). conclusions: the euroscore proved to be a simple and objective index, revealing a satisfactory discriminator of postoperative evolution in patients undergoing cabg surgery at our institution.
GuaragnaSCORE satisfactorily predicts outcomes in heart valve surgery in a Brazilian hospital
, Michel Pompeu Barros de Oliveira;Sá, Marcus Villander Barros de Oliveira;Albuquerque, Ana Carla Lopes de;Silva, Belisa Barreto Gomes da;Siqueira, José Williams Muniz de;Brito, Phabllo Rodrigo Santos de;Vasconcelos, Frederico Pires;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2012, DOI: 10.5935/1678-9741.20120003
Abstract: objective: the aim of this study is to evaluate the applicability of guaragnascore for predicting mortality in patients undergoing heart valve surgery in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape, recife, pe, brazil. methods: retrospective study involving 491 consecutive patients operated between may/2007 and december/2010. the registers contained all the information used to calculate the score. the outcome of interest was death. association of model factors with death (univariate analysis and multivariate logistic regression analysis), association of risk score classes with death and accuracy of the model by the area under the roc (receiver operating characteristic) curve were calculated. results: the incidence of death was 15.1%. the nine variables of the score were predictive of perioperative death in both univariate and multivariate analysis. we observed that the higher the risk class of the patient (low, medium, high, very high, extremely high), the greater is the incidence of postoperative af (0%; 7.2%; 25.5%; 38.5%; 52.4%), showing that the model seems to be a good predictor of risk of postoperative death, in a statistically significant association (p <0.001). the score presented a good accuracy, since the discrimination power of the model in this study according to the roc curve was 78.1%. conclusions: the brazilian score proved to be a simple and objective index, revealing a satisfactory predictor of perioperative mortality in patients undergoing heart valve surgery at our institution.
Perfil clínico-cirúrgico de pacientes operados por ruptura do septo interventricular pós-infarto do miocárdio
, Michel Pompeu Barros de Oliveira;Sá, Marcus Villander Barros de Oliveira;Barbosa, Caio Henrique;Silva, Niedjon Peixoto de Carvalho;Escobar, Rodrigo Renda de;Rueda, Fábio Gon?alves de;Silva, Frederico Pires Vasconcelos;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000300010
Abstract: objectives: to study clinical features, complications and in-hospital outcomes of patients operated for postinfarction ventricular septal rupture. methods: a retrospective study involving 21 patients between january/1996 and june/2009. all operations were performed at the division of cardiovascular surgery of complexo hospitalar huoc/procape. results: mean age of patients was 62.81 years (± 8.21), 61.9% (n = 13) were male. rupture occurred on average 4.8 days after infarction. cardiogenic shock was observed in 57.1% (n = 12), being risk factor for death (100% with shock vs. 22.2% without shock; p<0.001). survivors had a higher mean ejection fraction compared to deaths (66.29% ± 4.61% versus 42.71% ± 4.79%, p <0.001). all were classified as high risk by the euroscore, and the survivors had lower average score compared to deaths (6.57 ± 0.53 versus 10.93 ± 2.23; p <0.001). the majority (76.2%, n = 16) of the patients needed to use vasoactive drugs and 57.1% (n = 12) considered hemodynamically unstable. need for vasoactive drugs was a risk factor for death (81.3% with vasoactive drugs versus 20% without vasoactive drugs, p = 0.025). hemodynamic instability was also a risk factor for death (100% in the unstable group versus 22.2% in the stable group; p <0.001). the rate of in-hospital mortality was 66.7% (n = 14). conclusions: the need for vasoactive drugs, hemodynamic instability and cardiogenic shock were associated with higher rates of mortality. patients who had adverse outcomes had less ventricular function and higher score in the euroscore. mortality remains high
Mitral-aortic annular enlargement: modification of Manouguian's technique
Costa Mario Gesteira,Vasconcelos e Silva Frederico P.,Menezes Alexandre Mota de,Lima Ricardo de Carvalho
Revista Brasileira de Cirurgia Cardiovascular , 2002,
Abstract: We hereby present a technical modification for mitral-aortic annular enlargement. The mitral valve is replaced through the retro-septal approach, avoiding patches for left atrial roof closure. We report a mitral-aortic valve replacement in a patient whose original annuli would preclude adequate prostheses. The simultaneous annular enlargement may be necessary for avoiding patient-prosthesis mismatch and for reconstructing destroyed mitral and aortic annuli. The technique may minimize the risk of bleeding and of paravalvular leakage, using an approach well known to cardiac surgeons.
ORIGEM E DISTRIBUI O DA ARTéRIA CELíACA DE AVESTRUZES (Struthio camelus)
Bruno Gomes Vasconcelos,Frederico Ozanam Carneiro e Silva,Renata Lima de Miranda,Cheston Cesar Honorato Pereira
Ciência Animal Brasileira , 2012,
Abstract: The exploration of ostriches aims at trading meat, feathers, leather and grease. The digestive system is intimately related to productivity, and the celiac artery is amongst the major vessels responsible for its nutrition. The artery′s origin and distribution was studied here. In 30 specimens, the left ischiatic artery was cannulated for the injection of a blood vessels marker solution and then fixed in formalin solution 10% via deep intramuscular, subcutaneous and intracavitary applications. We concluded that this artery originated from the descending aorta, its first branch is ventral and it headed for the right side sending branches to: esophagus, proventriculus, ventriculus, spleen, liver, gallbladder, pancreas, duodenum, ileum, left and right cecum.
Modifica??es topográficas da jun??o uretrovesical e da uretra proximal após cirurgia combinada de Marshall-Marchetti-Krantz e Burch
Alencar, Arinaldo Vasconcelos de;Brandt, Frederico Teixeira;Costa, Hélio de Lima Ferreira Fernandes;Albuquerque, Carla Daisy;Costa, Rosangela Falc?o da;Alencar, Saulo Barbosa Vasconcelos de;
Revista Brasileira de Ginecologia e Obstetrícia , 2009, DOI: 10.1590/S0100-72032009000800004
Abstract: purpose: to study the changes in the urethrovesical junction (uvj) and in the proximal urethra (pu) caused by the marshall-marchetti-krantz-burch (mmk-b) combined surgery through perineal ultrasonography. methods: an interventional, longitudinal and prospective study has been conducted. thirty-two women with stress urinary incontinence were submitted to perineal ultrasonography before and 30 days after surgery to evaluate the pubo-urethral distance (pud), the proximal urethra length, the uvj horizontal distance (uvjhd) and the uvj vertical distance (uvjvd), the patient being at rest, and in effort during the valsava manoeuvre. results have been expressed in mean and standard deviation. the student's t-test has been used to compare pre and postoperative results whenever the variables fulfilled the normality test criterion; otherwise, the wilcoxon's paired test has been used. results: as compared with the preoperative measures, the marshall-marchetti-krantz-burch surgery has reduced the pud at rest (14 mm x 4.3 mm) and during effort (20.8 mm x 6.4 mm); has reduced the uvjhd at rest (14 mm x 4.3 mm) and during effort (20.8 mm x 6.4 mm); has increased the pu length at rest (16.7 mm x 19.7 mm) and during effort (1.6 mm x 15.4 mm); and has increased uvjvd during effort (-5.4 mm x 14.8 mm), but has not changed it at rest (16.2 mm x 18.7 mm, p = 0.085). conclusions: the marshall-marchetti-krantz-burch surgery has significantly reduced the urethrovesical junction vertical and horizontal mobility without raising the urethrovesical junction.
Nova técnica cirúrgica de preparo da veia safena para revasculariza??o do miocárdio sem manipula??o direta - no-touch
Rueda, Fabio de;Souza, Domingos;Lima, Ricardo de Carvalho;Menezes, Alexandre;Johansson, Benny;Dashwood, Michael;Thé, Emmanuel;Gesteira, Mário;Escobar, Mozart;Vasconcelos, Frederico;
Arquivos Brasileiros de Cardiologia , 2008, DOI: 10.1590/S0066-782X2008000600002
Abstract: background: optimization of the saphenous vein for myocardial revascularization. objective: to present the no-touch technique of the saphenous vein preparation. this technique consists of harvesting the vein with a pedicle of surrounding tissue, which protects the vein from spasms, obviating the need for distension. methods: a prospective, randomized study with 156 patients who underwent artery bypass grafting was performed comparing three saphenous vein harvesting techniques: conventional, intermediate, and no-touch. a morphological study of the endothelium was carried out using scanning microscopy. an angiographic assessment of the vein graft patency was performed at a mean follow-up time of 18 months. also, an immunohistochemical assessment was carried out to identify the endothelial enzyme nitric oxide synthase (enos) in the vein wall results: the preservation of the endothelial cell integrity was greater in the no-touch technique than in the other procedures. at angiographic follow-up, the patency for the no-touch group was 95.4%, 88.9% for the grafts of the conventional technique group, and 86.2% for the grafts performed in the intermediate technique group. the immunohistochemical assessment revealed enos in all three layers of the vein wall in the no-touch group and reduction of this enzyme in the conventional group. conclusion: the endothelial integrity and enos activity were better preserved when using the no-touch technique for vein graft harvesting. the mechanical protection provided by the cushion of surrounding tissue in the no-touch group, the vasorelaxation and thromboresistant activities of nitric oxide may be responsible for the reduction of vasospasms and improved patency rate.
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