1
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Sass�Carvalho E, Francilene S. Souza M, Cristina O. Abud K, R. P. Castro C, G. Penha J, Maria Thomaz A, A. Guimar鉫s V, Augusto Lopes A. Prediction of Pulmonary Arterial Pressure Level after Repair of Congenital Cardiac Communications and Discharge from the Hospital: Role of Down Syndrome and Early Postoperative Hemodynamics. CONGENIT HEART DIS 2022. [DOI: 10.32604/chd.2022.019382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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2
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Dinardi LFL, Devido M, Pereira TV, Romano GL, Zorzanelli L, Thomaz AM, Tanaka AC, Siqueira AVDS, Ikari NM, Azeka E. CONGENITAL HEART DISEASE IN ADULTS - A NEW PROFILE INSPIRES A NEW PARADIGM. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)04115-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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3
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Kormann-Moreira MC, Martins AVV, Lemouche SO, Santana MD, Tanaka ACS, Zorzanelli L, Thomaz AM, Ikari NM, Avila WS. GOING AGAINST THE ODDS - A CASE OF SUCCESS IN A PREGNANT PATIENT WITH COMPLEX CONGENITAL HEART DISEASE. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)04096-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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4
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Bernoche C, Timerman S, Polastri TF, Giannetti NS, Siqueira AWDS, Piscopo A, Soeiro ADM, Reis AGADC, Tanaka ACS, Thomaz AM, Quilici AP, Catarino AH, Ribeiro ACDL, Barreto ACP, Azevedo Filho AFBD, Pazin Filho A, Timerman A, Scarpa BR, Timerman B, Tavares CDAM, Martins CSL, Serrano Junior CV, Malaque CMS, Pisani CF, Batista DV, Leandro DLF, Szpilman D, Gonçalves DM, Paiva EFD, Osawa EA, Lima EG, Adam EL, Peixoto E, Evaristo EF, Azeka E, Silva FBD, Wen FH, Ferreira FG, Lima FG, Fernandes FL, Ganem F, Galas FRBG, Tarasoutchi F, Souza GEC, Feitosa Filho GS, Foronda G, Guimarães HP, Abud ICK, Leite ISL, Linhares Filho JPP, Moraes Junior JBDMX, Falcão JLADA, Ramires JAF, Cavalini JF, Saraiva JFK, Abrão KC, Pinto LF, Bianchi LLT, Lopes LNGD, Piegas LS, Kopel L, Godoy LC, Tobase L, Hajjar LA, Dallan LAP, Caneo LF, Cardoso LF, Canesin MF, Park M, Rabelo MMN, Malachias MVB, Gonçalves MAB, Almeida MFBD, Souza MFS, Favarato MHS, Carrion MJM, Gonzalez MM, Bortolotto MRDFL, Macatrão-Costa MF, Shimoda MS, Oliveira-Junior MTD, Ikari NM, Dutra OP, Berwanger O, Pinheiro PAPC, Reis PFFD, Cellia PHM, Santos Filho RDD, Gianotto-Oliveira R, Kalil Filho R, Guinsburg R, Managini S, Lage SHG, Yeu SP, Franchi SM, Shimoda-Sakano T, Accorsi TD, Leal TDCA, Guimarães V, Sallai VS, Ávila WS, Sako YK. Atualização da Diretriz de Ressuscitação Cardiopulmonar e Cuidados Cardiovasculares
de Emergência da Sociedade Brasileira de Cardiologia - 2019. Arq Bras Cardiol 2019; 113:449-663. [PMID: 31621787 DOI: 10.5935/abc.20190203] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Claudia Bernoche
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil.,Hospital Nove de Julho, São Paulo, SP - Brasil
| | - Sergio Timerman
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Thatiane Facholi Polastri
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Adailson Wagner da Silva Siqueira
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Agnaldo Piscopo
- Conselho Regional de Medicina de São Paulo (CREMESP), São Paulo, SP - Brasil
| | - Alexandre de Matos Soeiro
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil.,Hospital BP Mirante, São Paulo, SP - Brasil
| | | | - Ana Cristina Sayuri Tanaka
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Ana Maria Thomaz
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Andrei Hilário Catarino
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Anna Christina de Lima Ribeiro
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Antonio Carlos Pereira Barreto
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Antonio Pazin Filho
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), São Paulo, SP - Brasil
| | - Ari Timerman
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil
| | - Bruna Romanelli Scarpa
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Bruno Timerman
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Cantidio Soares Lemos Martins
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Carlos Vicente Serrano Junior
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Cristiano Faria Pisani
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Daniel Valente Batista
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Daniela Luana Fernandes Leandro
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - David Szpilman
- Hospital Municipal Miguel Couto, Secretaria Municipal de Saúde, Rio de Janeiro, RJ - Brasil
| | - Diego Manoel Gonçalves
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Edison Ferreira de Paiva
- Serviço de Clínica Geral do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Eduardo Atsushi Osawa
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Eduardo Gomes Lima
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil.,Hospital Nove de Julho, São Paulo, SP - Brasil
| | | | | | | | - Estela Azeka
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Fan Hui Wen
- Instituto Butantan, Secretaria de Estado da Saúde de São Paulo e do Ministério da Saúde, São Paulo, SP - Brasil
| | - Fatima Gil Ferreira
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Felipe Gallego Lima
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Felipe Lourenço Fernandes
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Fernando Ganem
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Flavio Tarasoutchi
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Germano Emilio Conceição Souza
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Gustavo Foronda
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil.,Hospital Israelita Albert Einstein, São Paulo, SP - Brasil.,Hospital Sepaco, São Paulo, SP - Brasil
| | - Helio Penna Guimarães
- Hospital do Coração (HCor), São Paulo, SP - Brasil.,Universidade Federal de São Paulo (UNIFESP), São Paulo, SP - Brasil
| | | | - Ivanhoé Stuart Lima Leite
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Jaime Paula Pessoa Linhares Filho
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | - Jose Antônio Franchini Ramires
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - José Fernando Cavalini
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Karen Cristine Abrão
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Lecio Figueira Pinto
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Leonardo Luís Torres Bianchi
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | - Liliane Kopel
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Lucas Colombo Godoy
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Lucia Tobase
- Secretaria Municipal da Saúde da Prefeitura Municipal de São Paulo, São Paulo, SP - Brasil
| | - Ludhmila Abrahão Hajjar
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Luís Augusto Palma Dallan
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Luiz Fernando Caneo
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | - Marcelo Park
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | - Maria Aparecida Batistão Gonçalves
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Maria Francilene Silva Souza
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Maria Helena Sampaio Favarato
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil.,Hospital Sírio Libanês, São Paulo, SP - Brasil
| | | | - Maria Margarita Gonzalez
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Milena Frota Macatrão-Costa
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Mônica Satsuki Shimoda
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Mucio Tavares de Oliveira-Junior
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Nana Miura Ikari
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Otávio Berwanger
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Patrícia Feitosa Frota Dos Reis
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Pedro Henrique Moraes Cellia
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Raul Dias Dos Santos Filho
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Roberto Kalil Filho
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Ruth Guinsburg
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP - Brasil
| | - Sandrigo Managini
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Silvia Helena Gelas Lage
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - So Pei Yeu
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Tania Shimoda-Sakano
- Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | - Tatiana de Carvalho Andreucci Leal
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Vanessa Guimarães
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Vanessa Santos Sallai
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Walkiria Samuel Ávila
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Yara Kimiko Sako
- Sociedade Brasileira de Cardiologia (SBC), Rio de Janeiro, RJ - Brasil
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Thomaz AM, Kajita LJ, Aiello VD, Zorzanelli L, Galas FRB, Machado CG, Barbero-Marcial M, Jatene MB, Rabinovitch M, Lopes AA. EXPRESS: Parameters associated with outcome in pediatric patients with congenital heart disease and pulmonary hypertension subjected to combined vasodilator and surgical treatments. Pulm Circ 2019; 9:2045894019837885. [PMID: 30806154 PMCID: PMC6688149 DOI: 10.1177/2045894019837885] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 02/20/2019] [Indexed: 01/22/2023] Open
Abstract
Management of pediatric pulmonary hypertension associated with congenital heart disease (PHT-CHD) is challenging. Some patients have persistently elevated pulmonary artery pressure (PAP) after cardiac surgery, an undesired condition that is difficult to predict. We investigated the value of clinical, hemodynamic, and histopathological data in predicting the outcome in a prospective cohort. Patients with PHT-CHD received sildenafil orally pre- and postoperatively for six months and then were subjected to a catheter study. Thirty-three patients were enrolled (age range = 4.6–37.0 months). Pulmonary vascular resistance (PVR) was 4.9 (range = 3.9–7.2) Wood units × m2 (median with IQR). Twenty-two patients had a ≥ 20% decrease in PVR and pulmonary-to-systemic vascular resistance ratio (PVR/SVR) in response to inhaled nitric oxide (NO). The response was directly related to the degree of medial hypertrophy of pulmonary arterioles (P < 0.05) (morphometric analysis, intraoperative lung biopsy). Subsequently, five of the non-responders had a ≥ 30% increase in pulmonary blood flow in response to sildenafil (3.0 [2.0–4.0] mg/kg/day). Six months after surgery, PAP and PVR were significantly lower (P < 0.001 vs. baseline), even in seven patients with Heath-Edwards grade III/IV pulmonary vascular lesions (P = 0.018), but still abnormal in 12 individuals (>25 mmHg and >3.0 U × m2, respectively). A preoperative PVR/SVR of ≥24% during NO inhalation and a wall thickness of arteries accompanying respiratory bronchioli of ≥4.7 (Z score) were identified, respectively, as risk and protection factors for abnormal postoperative hemodynamics (hazard ratio [95% CI] = 1.09 [1.01–1.18], P = 0.036; and 0.69 [0.49–0.98], P = 0.040, respectively). Thus, in PHT-CHD patients receiving oral sildenafil pre- and post-surgical repair of cardiac lesions, mid-term postoperative outcome is predictable to some extent.
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Affiliation(s)
- Ana Maria Thomaz
- Heart Institute, University of São Paulo
School of Medicine, São Paulo, Brazil
| | - Luiz J. Kajita
- Heart Institute, University of São Paulo
School of Medicine, São Paulo, Brazil
| | - Vera D. Aiello
- Heart Institute, University of São Paulo
School of Medicine, São Paulo, Brazil
| | - Leína Zorzanelli
- Heart Institute, University of São Paulo
School of Medicine, São Paulo, Brazil
| | | | - Cleide G. Machado
- Hospital das Clínicas, University of São
Paulo School of Medicine, São Paulo, Brazil
| | | | - Marcelo B. Jatene
- Heart Institute, University of São Paulo
School of Medicine, São Paulo, Brazil
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6
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Affiliation(s)
- Antonio Augusto Lopes
- Instituto do Coração (InCor) - Faculdade de Medicina - Universidade de São Paulo, São Paulo, SP - Brazil
| | - Ana Maria Thomaz
- Instituto do Coração (InCor) - Faculdade de Medicina - Universidade de São Paulo, São Paulo, SP - Brazil
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7
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Azeka E, Jatene MB, Jatene IB, Horowitz ESK, Branco KC, Souza Neto JD, Miura N, Mattos S, Afiune JY, Tanaka AC, Santos CCL, Guimarães ICB, Manso PH, Pellizari RCRS, Santos MVC, Thomaz AM, Cristofani LM, Ribeiro ACL, Kulikowski LD, Sampaio MC, Pereira AC, Soares A, Soares Junior J, Oh GHY, Moreira V, Mota CCC, Afiune CMC, Pedra C, Pedra S, Pedrosa A, Guimarães V, Caneo LF, Ferreiro CF, Cavalheiro Filho C, Stefanello B, Negrão CE, Turquetto ALR, Mesquita SMF, Maeda WF, Zorzanelli L, Panajotopolos N, Siqueira AWS, Galas FRB, Hajjar LA, Benvenuti LA, Vincenzi P, Odone V, Lopes MH, Strabelli TMV, Franchi SM, Takeuti AD, Duarte MF, Leon RGP, Hermida RPM, Sorpreso ICE, Soares Junior JM, Melo NR, Baracat EC, Bortolotto MRFL, Scanavacca M, Shimoda MS, Foronda G, Romano BW, Silva DB, Omura MM, Barbeiro CPM, Vinhole ARG, Palomo JSH, Gonçalves MAB, Reis ICF, Oliveira LG, Ribeiro CC, Isosaki M, Vieira LP, Feltrim MIZ, Manoel LA, Abud KCO, Paschotto DR, Neves ILI, Senaha LE, Garcia ACCN, Cipriano SL, Santos VC, Ferraz AS, Moreira AELC, De Paulo ARSA, Duque AMPC, Trindade E, Bacal F, Auler Junior JOC, Almeida DR. [I Guidelines of heart failure and heart transplantation in the fetus, in children and adults with congenital cardiopathy, The Brazilian Society of Cardiology]. Arq Bras Cardiol 2015; 103:1-126. [PMID: 25591041 DOI: 10.5935/abc.2014s005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lopes AA, Barst RJ, Haworth SG, Rabinovitch M, Al Dabbagh M, Del Cerro MJ, Ivy D, Kashour T, Kumar K, Harikrishnan S, D'Alto M, Thomaz AM, Zorzanelli L, Aiello VD, Mocumbi AO, Santana MVT, Galal AN, Banjar H, Tamimi O, Heath A, Flores PC, Diaz G, Sandoval J, Kothari S, Moledina S, Gonçalves RC, Barreto AC, Binotto MA, Maia M, Al Habshan F, Adatia I. Repair of congenital heart disease with associated pulmonary hypertension in children: what are the minimal investigative procedures? Consensus statement from the Congenital Heart Disease and Pediatric Task Forces, Pulmonary Vascular Research Institute (PVRI). Pulm Circ 2014; 4:330-41. [PMID: 25006452 DOI: 10.1086/675995] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 01/16/2014] [Indexed: 11/04/2022] Open
Abstract
Standardization of the diagnostic routine for children with congenital heart disease associated with pulmonary arterial hypertension (PAH-CHD) is crucial, in particular since inappropriate assignment to repair of the cardiac lesions (e.g., surgical repair in patients with elevated pulmonary vascular resistance) may be detrimental and associated with poor outcomes. Thus, members of the Congenital Heart Disease and Pediatric Task Forces of the Pulmonary Vascular Research Institute decided to conduct a survey aimed at collecting expert opinion from different institutions in several countries, covering many aspects of the management of PAH-CHD, from clinical recognition to noninvasive and invasive diagnostic procedures and immediate postoperative support. In privileged communities, the vast majority of children with congenital cardiac shunts are now treated early in life, on the basis of noninvasive diagnostic evaluation, and have an uneventful postoperative course, with no residual PAH. However, a small percentage of patients (older at presentation, with extracardiac syndromes or absence of clinical features of increased pulmonary blood flow, thus suggesting elevated pulmonary vascular resistance) remain at a higher risk of complications and unfavorable outcomes. These patients need a more sophisticated diagnostic approach, including invasive procedures. The authors emphasize that decision making regarding operability is based not only on cardiac catheterization data but also on the complete diagnostic picture, which includes the clinical history, physical examination, and all aspects of noninvasive evaluation.
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Affiliation(s)
- Antonio Augusto Lopes
- Heart Institute, University of São Paulo, São Paulo, Brazil ; Leader of the Congenital Heart Disease Task Force, PVRI
| | - Robyn J Barst
- Columbia University College of Physicians and Surgeons, New York, New York, USA ; In memoriam
| | | | - Marlene Rabinovitch
- Stanford University School of Medicine, Stanford, California, USA ; Leader of the Congenital Heart Disease Task Force, PVRI
| | | | - Maria Jesus Del Cerro
- La Paz Children's Hospital, Madrid, Spain ; Leader of the Pediatric Task Force, PVRI
| | - Dunbar Ivy
- Children's Hospital Colorado, Aurora, Colorado, USA
| | | | | | - S Harikrishnan
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | | | | | - Vera D Aiello
- Heart Institute, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Hanaa Banjar
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Omar Tamimi
- King Abdulaziz Cardiac Center, Riyadh, Saudi Arabia
| | | | | | - Gabriel Diaz
- Universidad Nacional de Colombia, Bogota, Colombia
| | | | - Shyam Kothari
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | - Margarida Maia
- Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Ian Adatia
- Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada ; Leader of the Pediatric Task Force, PVRI
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9
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Aiello VD, Thomaz AM, Pozzan G, Lopes AA. Capillary hemangiomatosis like-lesions in lung biopsies from children with congenital heart defects. Pediatr Pulmonol 2014; 49:E82-5. [PMID: 24019248 DOI: 10.1002/ppul.22889] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 07/06/2013] [Indexed: 11/11/2022]
Abstract
The morphological findings in the lung vessels of children with pulmonary arterial hypertension associated with uncorrected congenital cardiac shunts may be qualitatively and quantitatively assessed by lung biopsy in selected cases. Among 297 lung biopsies collected over a period of 11 years two cases were detected presenting the typical findings of pulmonary capillary hemangiomatosis, a rare disorder usually associated with pulmonary veno-occlusive disease. We report the clinical and histological findings and discuss about the impact of this unexpected and not-previously described associated lesion on the prognosis and on the therapeutic strategy in patients with pulmonary hypertension associated with congenital heart disease.
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Affiliation(s)
- Vera Demarchi Aiello
- Laboratory of Pathology, Heart Institute (InCor), São Paulo University Medical School, São Paulo, Brazil
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Soares RPS, Bydlowski SP, Nascimento NM, Thomaz AM, Bastos ENM, Lopes AA. Plasmatic ADAMTS-13 metalloprotease and von Willebrand factor in children with cyanotic congenital heart disease. Braz J Med Biol Res 2013; 46:375-81. [PMID: 23558858 PMCID: PMC3854409 DOI: 10.1590/1414-431x20122603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 11/23/2012] [Indexed: 11/29/2022] Open
Abstract
Changes in plasma von Willebrand factor concentration (VWF:Ag) and ADAMTS-13 activity
(the metalloprotease that cleaves VWF physiologically) have been reported in several
cardiovascular disorders with prognostic implications. We therefore determined the
level of these proteins in the plasma of children with cyanotic congenital heart
disease (CCHD) undergoing surgical treatment. Forty-eight children were enrolled (age
0.83 to 7.58 years). Measurements were performed at baseline and 48 h after surgery.
ELISA, collagen-binding assays and Western blotting were used to estimate antigenic
and biological activities, and proteolysis of VWF multimers. Preoperatively, VWF:Ag
and ADAMTS-13 activity were decreased (65 and 71% of normal levels considered as 113
(105-129) U/dL and 91 ± 24% respectively, P < 0.003) and correlated (r = 0.39, P =
0.0064). High molecular weight VWF multimers were not related, suggesting an
interaction of VWF with cell membranes, followed by proteolytic cleavage. A low
preoperative ADAMTS-13 activity, a longer activated partial thromboplastin time and
the need for cardiopulmonary bypass correlated with postoperative bleeding (P <
0.05). Postoperatively, ADAMTS-13 activity increased but less extensively than VWF:Ag
(respectively, 2.23 and 2.83 times baseline, P < 0.0001), resulting in an
increased VWF:Ag/ADAMTS-13 activity ratio (1.20 to 1.54, respectively, pre- and
postoperative median values, P = 0.0029). ADAMTS-13 consumption was further confirmed
by decreased ADAMTS-13 antigenic concentration (0.91 ± 0.30 to 0.70 ± 0.25 µg/mL, P
< 0.0001) and persistent proteolysis of VWF multimers. We conclude that, in
pediatric CCHD, changes in circulating ADAMTS-13 suggest enzyme consumption,
associated with abnormal structure and function of VWF.
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Affiliation(s)
- R P S Soares
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, SP, Brasil
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Kanashiro TM, Vilas Boas LS, Thomaz AM, Tozetto-Mendoza TR, Setsuko M, Machado CM. Identification of respiratory virus in infants with congenital heart disease by comparison of different methods. Rev Inst Med Trop Sao Paulo 2012; 53:241-6. [PMID: 22012448 DOI: 10.1590/s0036-46652011000500001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 08/22/2011] [Indexed: 11/22/2022] Open
Abstract
Respiratory virus infections are the main cause of infant hospitalization and are potentially severe in children with congenital heart disease (CHD). Rapid and sensitive diagnosis is very important to early introduction of antiviral treatment and implementation of precautions to control transmission, reducing the risk of nosocomial infections. In the present study we compare different techniques in the diagnosis of respiratory viruses in CHD infants. Thirty-nine samples of nasopharyngeal aspirate were obtained from CHD infants with symptoms of respiratory infection. The Multiplex PCR (Seeplex® RV 12 ACE Detection) driven to the detection of 12 respiratory viruses was compared with the direct immunofluorescence assay (DFA) and PCR, both targeting seven respiratory viruses. The positivity found by DFA, Multiplex and PCR was 33.3%, 51.3% and 48.7%, respectively. Kappa index comparing DFA and Multiplex, DFA and PCR and PCR and Multiplex PCR was 0.542, 0.483 and 0.539, respectively. The concordance between techniques was considered moderate. Both Multiplex PCR (p = 0.001) and PCR (p = 0.002) detected significantly more respiratory virus than DFA. As the performance of the tests may vary, the combination of two or more techniques may increase diagnostic sensitivity favoring the diagnosis of co-infections, early introduction of antiviral therapy and implementation of appropriate measures.
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Affiliation(s)
- Tatiana Mitiko Kanashiro
- Laboratório de Virologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brazil
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Lopes AA, Dos Anjos Miranda R, Gonçalves RC, Thomaz AM. A computer-based matrix for rapid calculation of pulmonary hemodynamic parameters in congenital heart disease. Ann Thorac Med 2011; 4:124-7. [PMID: 19641642 PMCID: PMC2714565 DOI: 10.4103/1817-1737.53348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Accepted: 04/10/2009] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND: In patients with congenital heart disease undergoing cardiac catheterization for hemodynamic purposes, parameter estimation by the indirect Fick method using a single predicted value of oxygen consumption has been a matter of criticism. OBJECTIVE: We developed a computer-based routine for rapid estimation of replicate hemodynamic parameters using multiple predicted values of oxygen consumption. MATERIALS AND METHODS: Using Microsoft® Excel facilities, we constructed a matrix containing 5 models (equations) for prediction of oxygen consumption, and all additional formulas needed to obtain replicate estimates of hemodynamic parameters. RESULTS: By entering data from 65 patients with ventricular septal defects, aged 1 month to 8 years, it was possible to obtain multiple predictions for oxygen consumption, with clear between-age groups (P <.001) and between-methods (P <.001) differences. Using these predictions in the individual patient, it was possible to obtain the upper and lower limits of a likely range for any given parameter, which made estimation more realistic. CONCLUSION: The organized matrix allows for rapid obtainment of replicate parameter estimates, without error due to exhaustive calculations.
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Affiliation(s)
- Antonio Augusto Lopes
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil.
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Guimarães VA, Atik E, Castelli JB, Ikari NM, Thomaz AM, Lopes AAB. [Association of plastic bronchitis to protein-losing enteropathy after fontan operation]. Arq Bras Cardiol 2010; 94:e109-12. [PMID: 20498923 DOI: 10.1590/s0066-782x2010000400024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2008] [Accepted: 09/01/2009] [Indexed: 11/22/2022] Open
Abstract
We report an unusual case of association of plastic bronchitis (PB) to protein-losing enteropathy (PLE) in a girl of 4 years and 9 months of age with double inlet single left ventricle and ventriculoarterial concordance. submitted to total cavopulmonary surgery. with an intracardiac lateral tunnel at the age of three. The elimination of the 10 cm fibrin bronchial mold (PB) and the alpha-1-antitrypsin elevation of 52 mg/g in feces had both become outstanding. Using sildenafil. the thoracic duct ligature and the cardiac transplant were programmed in case of continuity of the process.
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Affiliation(s)
- Vanessa Alves Guimarães
- Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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