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Search Results: 1 - 10 of 38732 matches for " Paulo Roberto;Lucchese "
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Estudo clínico de um sistema cardioversor-desfibrilador implantável que apresenta limiares de desfibrila??o baixos usando eletrodos de estrutura fractal
LUCCHESE, Fernando A.;BROFMAN, Paulo Roberto S.;PACHóN, José Carlos;SCHALDACH, Marc;
Revista Brasileira de Cirurgia Cardiovascular , 1999, DOI: 10.1590/S0102-76381999000100011
Abstract: due to continuously improved technologies, the present generation of implantable cardioverter-defibrillators (icd) guarantees a high degree of safety and efficacy for detecting and terminating ventricular tachyarrhythmias. this paper summarizes the clinical results obtained with 1058 single-chamber icd (phylax 6, phylax xm, biotronik) employing single-lead and active housing technology (sps and kainox rv (single coil), sl-icd and kainox sl (double coil, biotronik). in all but 3 patients (> 99%), reliable low-energy defibrillation was achieved using transvenous leads only. this has led to the trend to replace dft testing by a short function test during implantation in order to minimize the risks associated with repeated induction of fibrillation and extended anesthesia.
Estudo clínico de um sistema cardioversor-desfibrilador implantável que apresenta limiares de desfibrila o baixos usando eletrodos de estrutura fractal
LUCCHESE Fernando A.,BROFMAN Paulo Roberto S.,PACHóN José Carlos,SCHALDACH Marc
Revista Brasileira de Cirurgia Cardiovascular , 1999,
Abstract: Em fun o do contínuo desenvolvimento tecnológico, a gera o atual de cardioversores-desfibriladores implantáveis (CDI) garante um alto grau de seguran a e eficiência na detec o e revers o de taquiarritmias ventriculares. O presente trabalho sumariza os resultados clínicos obtidos com 1058 CDI de camara única (Phylax 6, Phylax XM, Biotronik) utilizando eletrodo único e tecnologia de carca a ativa, SPS e Kainox RV (com uma mola intracavitária de choque), SL-ICD e Kainox SL (com duas molas intracavitárias de choque, Biotronik). Na quase totalidade dos pacientes, com exce o de 3 (> 99%), foram obtidos limiares de desfibrila o com baixa energia usando apenas um eletrodo transvenoso. Isto tem permitido substituir o teste de limiar de desfibrila o usual por um teste simples durante o implante, afim de minimizar os riscos associados com repetidas indu es de fibrila o e conseqüente extens o do período de anestesia.
Avalia??o de resultados tardios com bioprótese de aorta heteróloga porcina
Kalil, Renato A. K;Sant'Anna, Jo?o Ricardo;Schoer, Júlio E;Prates, Paulo Roberto;Lucchese, Fernando A;Pereira, Edemar M;Costa, Altamiro R;Nesralla, Ivo A;
Revista Brasileira de Cirurgia Cardiovascular , 1989, DOI: 10.1590/S0102-76381989000100009
Abstract: the clinical results of an aortic heterograft model (biocor) was evaluated in a series of 150 patients, operated upon from 1982 to 1988 and followed-up for until 7 years post-operatively. sixty-two were female and 88 male. age ranged from 15 to 81 (m = 51.6) years. there were 9 in functional class ii, 120 in iii and 21 in iv. in the isolated mitral position there were 46 implants, aortic isolated 50, multiple 30 and 24 associated with myocardial revascularization (5 mitral and 19 aortic). hospital mortality was 12% (18 cases). twenty seven patients were lost for late follow-up. late mortality was 2.6% (4 cases), caused by rena! failure, meningoencefalitis, congestive heart failure and pulmonary embolism. there were 5 (3.3%), due to infectious endocarditis, paravalvular leaks, primary tissue failure (2 cases at ages 15 and 25). three others patients presented clinical signs of mild regurgitation and were not reoperated. the actuarial survival curves showed a probability of survival and probability of no surgical events, respectively, for the whole group: 82.9 ± 3.7 years and 70.1 ± 6.7 years, for the aortic group: 88.0 ± 5.6% and 60.4 ± 17.4%, for the mitral group: 87.3 ± 5.6% and 70.9 ± 11.1%. at the last clinical evaluation, there were 82 patients in functional class i, 17 in ii and 2 in iii. bioprosthesis attributed failures occurred in 21.4% of the patients operated upon, younger than 30 years, 1.1% between 31 and 60 years, and 2% in the older than 61 years. male sex was related to 4.5% of failures and female, 1.6%. there was no difference between the mitral, aortic, or multiple groups. the bioprosthesis evaluated, for a follow-up of 7 years, presented good results. causes of failure were usually related to age, infection or leaking, at a low incidence in the study period. longer observation, however, is still advisable for definitive conclusions.
Postoperative necrotizing fasciitis of the thorax in cardiac surgery
Frota Filho, José Dario;Drews, Carlos;Le?es, Paulo;Blacher, Celso;Tostes, Francisco;Delatorre, Nilton;Vieira, Mariana;Lúcio, Eraldo;Pereira, Wagner;Sales, Marcela;Lobo, Roberto;Stuermer, Ralf;Tanaka, Nicasio;Portugal, Luis;Lucchese, Fernando;
Arquivos Brasileiros de Cardiologia , 2001, DOI: 10.1590/S0066-782X2001000300008
Abstract: necrotizing fasciitis is a rare soft tissue infection and a life-threatening emergency, often fatal. its incidence and management are described plentifully in the medical literature regarding the most common anatomical sites involved like the abdomen, lower and upper limbs, and perineum. however, available data and case reports of chest wall necrotizing fasciitis after thoracic procedures are scarce, mainly after major cardiac operations. we report and discuss a case of necrotizing fasciitis of the chest wall occurring in the immediate postoperative period of a cardiac procedure, and include a brief review of the concepts, pathophysiology, and treatment reported in the medical literature. we emphasize the need for early diagnosis and urgent and effective surgical debridement. of importance is the fact that we have not found any references in the literature to cases similar or equal to the one we describe here, which occurred in the postoperative period of a cardiac procedure.
Reopera??es após cirurgia de Bentall-De Bono para ectasia anulo-aórtica
Kalil, Renato A. K;Garcia-Macedo, Ricardo;Prates, Paulo Roberto;Lucchese, Fernando A;Sant'Anna, Jo?o Ricardo;Lara, Raul F. A;Costa, Altamiro R;Daudt, Nestor S;Pereira, Edemar M;Nesralla, Ivo A;
Revista Brasileira de Cirurgia Cardiovascular , 1988, DOI: 10.1590/S0102-76381988000200003
Abstract: a major surgical problem is imposed when late complications occur in patients submitted previously to aortic root replacement by the bentall-de bono technique. during an 11 years period, from january 1976 to december 1986, 37 patients had aortic root replacement with valved conduits and 5 presented late complications (13.5%) requiring a new operation. the lesions were: biological valve degeneration, infective endocarditis and suture leaks leading to pseudo aneurysm, peritubular leakage and hemolysis. there was 1 systemic embolization with an infected vegetation. the 5 patients were re-operated, with 1 surgical death (20%), in a case presenting fungal endocarditis (aspergillus), due to uncontroled bleeding. the remaining 4 had an uneventful hospital course. there was 1 late death during a surgical exploratory thoracic procedure. the remaining 3 patients enjoy a normal active life. one of these still has a small peritubular leakage causing mild aortic regurgitation and hemolysis. the surgical procedure consisted of dacron tube replacement preserving the implanted valve prostheses in the 2 cases with infective endocarditis. two ruptures biological valves were replaced by methalic disc valves. in this situation, the dacron tubes were preserved and the valves approached through a longitudinal incision in the tube. the suture leaks were corrected with direct isolated mattress sutures. late re-operations may be required after aortic root replacement with composite valve-tube grafts. they can be performed at an acceptable surgical risk. the technique should be as conservative as possible and directed to the causing lesions, preserving the remaining structures. a methalic prosthesis should be the first choice for the primary procedure, in order to avoid late tissue degeneration.
Estudo das artérias coronárias no cora??o transplantado
Nesralla, Ivo A;Sant'Anna, Jo?o Ricardo;Prates, Paulo Roberto;Lucchese, Fernando A;Kalil, Renato A. K;Pereira, Edemar M;Costa, Altamiro R;Rossi, Martinez;Moraes, Cláudio;Santos, Marisa F;Souza, Blau F;
Revista Brasileira de Cirurgia Cardiovascular , 1991, DOI: 10.1590/S0102-76381991000300004
Abstract: late post-operative serial coronariographic evaluation was performed in a series of 6 patients submitted to cardiac transplantation. they were part of a series of 16 patients operated on from june 1984 to december 1990. their age were from 10 days to 54 years, 14 male and 2 female. the followup time was from 2 to 6 years. the cineangiograms were performed yearly for coronary pattern evolutive evaluation. the mean donor age was 18 ± 3 years. in 4 patientes it was possible to compare late results with the preoperative donor cinecoronaryangiogram. the comparative morphometric analysis, at serial examination did not reveal any proximal or distal coronary lesion in any patient. left ventricular function was considered normal, but varied degrees of myocardial hypertrophy were present in all patients. in conclusion: 1) coronary artery disease, although frequent in transplanted hearts, was not present in this series; 2) early donor age could have been an important factor, as well as the immunossupressive regime emploied; 3) cinecoronary ventriculoangiogram is important for follow-up of transplanted patients, and could eventually orient for retransplantation.
Tratamento cirúrgico para ectasia anulo-aórtica
García-Macedo, Ricardo;Kalil, Renato A. K;Prates, Paulo Roberto;Lucchese, Fernando A;Sant'Ana, Jo?o Ricardo;Pereira, Edemar M;Costa, Altamiro Reis;Lara, Raul Feck A;Nesralla, Ivo A;
Revista Brasileira de Cirurgia Cardiovascular , 1986, DOI: 10.1590/S0102-76381986000100007
Abstract: this is a report of 27 patients presenting annulo-aortic ectasia submitted to surgical correction with a composite valve-tube graft (bentall-de bono technique), between 1976 and 1985. twenty three (85.2%) had cystic medial necrosis, 3 (11,1%) were chronic aortic disections and 1 (3.7%) was luetic aortitis. age ranged from 29 to 64 years (m = 48). three were female and 24 male patients. the valves used were homologous dura maier in 7 cases, heterologous aorta in 9 and mechanical prosthesis in 11. functional class (nyha) was i-ii in 7 and iii-iv in 9 patients. there was 1 (3.7%) hospital death, due to bleeding and renal failure. significant early complications were represented by arrhythmias in 13 cases (48%) and bleeding in 3 (11%). in the late follow-up therev.were 9 deaths, due to: sudden death (2 patients, 7.4%), bleeding in reoperation (1 patient, 3.7%), hospital infection (1 patient, 3.7%), infectious endocarditis (1 patient, 3.7%) and accidental causes (2 patients, 7.4%). five patients (18.5%) needed reoperation in the late follow-up: 2 due to bioprosthetic failure, 2 for replacement of an infected dacron tube and 1 for repair of pseudo-aneurysm and periprosthetic leak. the actuarial survival curve showed a probability of 83.7% up to the 3rd. year, 61 % for the 5th. year and 42.7% from the 6th. to the 9th. year of follow-up. the 17 patients surviving are in functional class i-ii (nyha). the composite valve-dacron tube graft (bentall-de bono) technique for correction of annulo-aortic ectasia is associated with a low hospital mortality. the improvement in functional class is significant. there have been a small number of complications and the long term survival is very satisfactory.
Avalia??o de marcapasso unicameral de ajuste automático de freqüência de pulso mediado por movimenta??o corporal
Brofman, Paulo R;Loures, Danton R. da Rocha;Rossi, Paulo R. F;Ardito, Roberto V;Greco, Osvaldo T;Braile, Domingo M;Sant'Anna, Jo?o R;Lucchese, Fernando A;Kalil, Renato A. K;Eloy, Ricardo;Barros, Rubens T;Andrade, José Carlos S;Pesarini, Aldo;Gauch, Paulo R. A;
Revista Brasileira de Cirurgia Cardiovascular , 1987, DOI: 10.1590/S0102-76381987000300004
Abstract: to evaluate the physiologic benefits of the rate response estimulation, 48 patients were submited to a 24 hours holter recording and paired tolerance treadmill test (aai vvi and aai-r/vvi-r modes, selected in random order) one month after implantation of an activity sensing pacemaker activitrax 8400. mean age of the patients was 46 years and indications for pacing included atrial arrhythmias (16 patients) or a-v conduction disturbances (32 patients, including 25 with complete a-v block). the underlying disease was chagas cardiomiopathy, in 32 patients. initial pacemaker setting was: basic rate: 60 or 70 ppm; maximum activity rate: 125 ppm; activity threshold: medium, rate response: 5. the 24 hours holter recording documented appropriate changes in heart during daily activities. oversensing, which resulted in pacing interval fluctuations, was diagnosed in two patients and required pacemaker reprograming. treadmill test showed a significant increase in heart rate during exercise: mean control value: 66.9 ppm; 4 min.: 84.6 ppm; 6 min.: 90.5 ppm (p < 0.05). in the paired test, the aai/vvi-activity mode enabled the patients to increase heart rate (12.5%) and exercise time (20.2%; p < 0.05). none of the patients presented exercise induced ventricular arrhythmias in mode aai/vvi-activity; on the other hand, 12 patients showed ventricular arrhythmia during exercise in mode aai/vvi. clinical improvement and more active life was referred by all patients in this short follow-up period. the activitrax 8400 was effective in improving patients exercise capacity.
Ventriculectomia parcial esquerda: ponte para transplante?
FROTA FILHO, José Dario;LUCCHESE, Fernando A.;BLACHER, Celso;LE?ES, Paulo E.;HALPERIN, Cídio;LúCIO, Eraldo A.;PEREIRA, Wagner;SALES, Marcela;LUNKENHEIMER, Paul Peter;REDMANN, Klaus;VARGAS, Luis E.;STUERMER, Ralf;LOBO, Roberto;MOREIRA, Fabio;BUENO, Angela P.;JUNG, Luiz A.;
Revista Brasileira de Cirurgia Cardiovascular , 2000, DOI: 10.1590/S0102-76382000000400006
Abstract: objective: to assess the suitability of partial left ventriculectomy (plv) as a bridge to transplantation. background: cohort study, prospective. material and methods: fifty-three patients were submitted to plv in a time frame of 5 years. seven out of 53 patients, ages ranging from 37 to 64 years old, 5 males and 2 females, all with idiopathic dilated cardiomyopathy, were transplanted afterwards. ejection fraction, nyha functional classes, maximum oxygen consumption, left ventricular end-diastolic diameter and quality of life scores were analysed preoperatively and then at three and six months and immediately before transplantation. results: the numerical values mentioned below are referred to the data obtained pre-ventriculectomy, at 3 and 6 postoperative months and immediately before transplantation. nyha functional classes: 3.71 ± 0.49, 2.57 ± 1.13 (p=0.011), 3.0 ± 1.29 and 3.86 ± 0.38. ejection fraction: 25.17 ± 6.15, 35.5 ± 8.41 (p=0.013), 32.33 ± 7.12 and 26.17 ± 3.76. left ventricular end-diastolic diameter: 79.16 ± 10.85, 67.66 ± 9.2, 65.83 ± 9.57 e 64.25±8.99. maximum vo2 was 8.12 ± 3.47 pre-vpe and increased to 13.2 ± 7.75 at six months (p=0.068). quality of life scores: 4.29 ± 1.25, 3.0 ± 1.41 (p=0.050), 3.29 ± 1.8 e 4.57 ± 1.13. 7/53 patients (13.20%) were subsequently transplanted. survival time, from plv up to tx ranged from 7 to 33 months (18.71±11.78). follow-up was 100%. conclusion: improvement in quality of life, nyha functional classes and maximum vo2 consumption, as well as increase in ejection fraction and sustained decrease in left ventricular end-diastolic diameter, in short-term, can benefit patients previously excluded from tx and bring them back to the awaiting list. however, high immediate mortality rates in overall casuistry can limit its routine indication as a biological bridge to transplantation.
Influence of CDW Recycled Aggregate on Drying Shrinkage of Mortar  [PDF]
Paulo Roberto Lopes Lima, Monica Batista Leite
Open Journal of Civil Engineering (OJCE) , 2012, DOI: 10.4236/ojce.2012.22009
Abstract: The use of fine recycled aggregates as raw material in the production of mortars appears as a good alternative to minimize waste disposal, so as to reduce natural resources consumption and to find and supply suitable substitutes for natural aggregates. However, the use of this alternative material in a safe way must be carried out by a wide investigation of its long term behavior. In this way, this paper will examine the mechanical strength, physical properties and drying shrinkage of mortar, which use recycled fine aggregates that have originated from construction and demolition waste (CDW) containing mortar (55%), ceramic (26%) and concrete (16%). Two natural mortars, made with natural sand, were produced with cement/sand ratios of 1:4 and 1:8 (by weight) and a fixed consistency index of 260 +10 mm. Recycled mortar was produced with 50% of substitution rate, in volume, of natural aggregate by recycled one. Results show that recycled mortars present higher total porosity, absorption rate and drying shrinkage than reference mortar.
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