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Almeida GG, Cardoso LF, Paiva CRC, Jardim JPV. TRANSPLANTE DE MEDULA ÓSSEA NO BRASIL: DISTRIBUIÇÃO E PERFIL DE DOADORES CADASTRADOS ENTRE 2015 E 2022. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.555] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Cardoso LF, Gupta J, Shuman S, Cole H, Kpebo D, Falb KL. What Factors Contribute to Intimate Partner Violence Against Women in Urban, Conflict-Affected Settings? Qualitative Findings from Abidjan, Côte d'Ivoire. J Urban Health 2016; 93:364-78. [PMID: 27000124 PMCID: PMC4835354 DOI: 10.1007/s11524-016-0029-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [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] [Indexed: 11/30/2022]
Abstract
Rapid urbanization is a key driver of the unique set of health risks facing urban populations. One of the most critical health hazards facing urban women is intimate partner violence (IPV). In post-conflict urban areas, women may face an even greater risk of IPV. Yet, few studies have examined the IPV experiences of urban-dwelling, conflict-affected women, including those who have been internally displaced. This study qualitatively examined the social and structural characteristics of the urban environment that contributed to the IPV experiences of women residing in post-conflict Abidjan, Côte d'Ivoire. Ten focus groups were conducted with men and women, both internally displaced (IDPs) and non-displaced. Lack of support networks, changing gender roles, and tensions between traditional gender norms and those of the "modern" city were reported as key contributors to IPV. Urban poverty and with it unemployment, food insecurity, and housing instability also played a role. Finally, IDPs faced heightened vulnerability to IPV as a result of displacement and discrimination. The relationship between economic strains and IPV are similar to other conflict-affected settings, but Abidjan's urban environment presented other unique characteristics contributing to IPV. Understanding these factors is crucial to designing appropriate services for women and for implementing IPV reduction interventions in urban areas. Strengthening formal and informal mechanisms for help-seeking, utilizing multi-modal interventions that address economic stress and challenge inequitable gender norms, as well as tailoring programs specifically for IDPs, are some considerations for IPV program planning focused on conflict-affected women in urban areas.
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Affiliation(s)
- L F Cardoso
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA.
| | - J Gupta
- George Mason University, Department of Global and Community Health, College of Health and Human Services, Fairfax, VA, USA
| | - S Shuman
- La Salle University, Philadelphia, PA, USA
| | - H Cole
- International Rescue Committee, London, UK
| | - D Kpebo
- International Rescue Committee, Abidjan, Côte d'Ivoire
| | - K L Falb
- International Rescue Committee, New York, USA
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Cardoso LF, de Paula FJA, Maciel LMZ. Resistance to thyroid hormone due to mutations in the THRB gene impairs bone mass and affects calcium and phosphorus homeostasis. Bone 2014; 67:222-7. [PMID: 25063548 DOI: 10.1016/j.bone.2014.07.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 07/07/2014] [Accepted: 07/15/2014] [Indexed: 11/25/2022]
Abstract
CONTEXT Resistance to thyroid hormone (RTH) is an inherited syndrome of reduced tissue responsiveness to thyroid hormone, which is usually due to mutations in the thyroid hormone receptor β gene (THRB). Few studies have been conducted to investigate bone and mineral metabolism in RTH. OBJECTIVE The objective of the study was to evaluate the clinical and biochemical parameters related to bone and mineral metabolism in RTH due to mutations in the THRB gene (RTHβ). DESIGN AND PARTICIPANTS We conducted a cross-sectional study on 14 patients with RTHβ (RTHG), eight adults and six children, and 24 control subjects (CG). OUTCOMES Serum measures included total calcium (TCa), inorganic phosphate (iP), alkaline phosphatase (AP), parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), osteocalcin (OC), carboxyterminal telopeptide (CTX), and fibroblast growth factor 23 (FGF-23). We estimated the renal threshold phosphate concentration (TmPO4/GFR) and assessed bone mass using dual X-ray absorptiometry. RESULTS Adults and children with RTH showed higher serum levels of TCa than controls (P=.029 and, P=.018 respectively). However, only children with RTH exhibited lower serum levels of iP than controls (P=.048). FGF-23 was higher in RTHβ children (P=.04). RTHβ adults had lower whole-body (P=.01) and lumbar spine (P=.01) bone mineral density than control subjects. The same pattern was observed when the results were expressed as Z-scores between groups, with a lower value in RTHG than in CG for the lumbar spine of adults (P=.03). No difference was observed between groups in PTH, 25OHD, AP, OC, and CTX. CONCLUSION Biochemical abnormalities are seen in children with RTH (Low iP, high FGF23), while high calcium (with normal UCa) is seen in RTH subjects of all ages, and later on, in adult life, low BMD is seen. Considering that the TRα1 isoform is the predominant TR in the skeleton, we hypothesize that probably these patients may exhibit enhanced calcium flux from bone to circulation. Our data represent a challenge for new studies to unveil the control of calcium and phosphorus homeostasis and fracture risk in these patients.
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Affiliation(s)
- L F Cardoso
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - F J A de Paula
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - L M Z Maciel
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
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Gonzalez MM, Timerman S, Gianotto-Oliveira R, Polastri TF, Canesin MF, Schimidt A, Siqueira AW, Pispico A, Longo A, Pieri A, Reis A, Tanaka ACS, Santos AM, Quilici AP, Ribeiro ACL, Barreto ACP, Pazin-Filho A, Timerman A, Machado CA, Franchin Neto C, Miranda CH, Medeiros CR, Malaque CMS, Bernoche C, Gonçalves DM, Sant'Ana DG, Osawa EA, Peixoto E, Arfelli E, Evaristo EF, Azeka E, Gomes EP, Wen FH, Ferreira FG, Lima FG, Mattos FR, Galas FG, Marques FRB, Tarasoutchi F, Mancuso FJN, Freitas GR, Feitosa-Filho GS, Barbosa GC, Giovanini GR, Miotto HC, Guimarães HP, Andrade JP, Oliveira-Filho J, Fernandes JG, Moraes Junior JBMX, Carvalho JJF, Ramires JAF, Cavalini JF, Teles JMM, Lopes JL, Lopes LNGD, Piegas LS, Hajjar LA, Brunório L, Dallan LAP, Cardoso LF, Rabelo MMN, Almeida MFB, Souza MFS, Favarato MH, Pavão MLRC, Shimoda MS, Oliveira Junior MT, Miura N, Filgueiras Filho NM, Pontes-Neto OM, Pinheiro PAPC, Farsky OS, Lopes RD, Silva RCG, Kalil Filho R, Gonçalves RM, Gagliardi RJ, Guinsburg R, Lisak S, Araújo S, Martins SCO, Lage SG, Franchi SM, Shimoda T, Accorsi TD, Barral TCN, Machado TAO, Scudeler TL, Lima VC, Guimarães VA, Sallai VS, Xavier WS, Nazima W, Sako YK. [First guidelines of the Brazilian Society of Cardiology on Cardiopulmonary Resuscitation and Cardiovascular Emergency Care]. Arq Bras Cardiol 2014; 101:1-221. [PMID: 24030145 DOI: 10.5935/abc.2013s006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [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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Fernandes JL, Sampaio RO, Brandão CM, Cardoso LF, Tarasoutchi F, Pomerantzeff P, Auler JO, Grinberg M. Improvement of cardiac hemodynamics with inhaled nitric oxide after surgery in patients with mitral stenosis and severe pulmonary hypertension. Crit Care 2005. [PMCID: PMC4097462 DOI: 10.1186/cc3555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Timerman S, Bento A, Cardoso L, Moretti M, Sanadi N, Ramires J. Crit Care 2003; 7:P065. [DOI: 10.1186/cc1954] [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] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kawabata V, Cardoso L, Timerman S, Cesar L, Ramires J. Crit Care 2003; 7:P066. [DOI: 10.1186/cc1955] [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] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Timerman S, Cardoso L, Ramires J, Halperin H. Crit Care 2003; 7:P064. [DOI: 10.1186/cc1953] [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] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Paiva E, Perondi M, Factore L, Kern K, Berg R, Timerman S, Cardoso L, Ramires J. Crit Care 2002; 6:P161. [DOI: 10.1186/cc1620] [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] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Dias AR, Dias RR, Gaiotto F, Lima J, Cerqueira FM, Grinberg M, Sampaio R, de Lara Lavitola P, Elias N, Tarasoutchi F, Cardoso LF, Stolf NA. Mini-sternotomy for the treatment of aortic valve lesions. Arq Bras Cardiol 2001; 77:221-8. [PMID: 11562684 DOI: 10.1590/s0066-782x2001000900002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare inverted-L mini-sternotomy performed above the sternal furcula with conventional sternotomy in patients with aortic valve diseases who undergo surgical treatment. METHODS We operated upon 30 patients who had aortic valve lesions that had clinical and hemodynamic findings. All patients underwent inverted-L sternotomy, which extended from above the manubrium of the sternum to the 3rd right intercostal space, without opening the pleural cavity. Their ages ranged from 32 to 76 years, and 18 were males and 12 were females. We used negative pressure in a venous 1/4-inch cannula, and the patients were maintained in Trendelemburg's position. Twenty-seven patients received bioprostheses with diameters ranging from 23 to 29mm. Three patients underwent only removal of the calcifications of the aortic valve leaflets and aortic commissurotomy. RESULTS The mean duration of anoxic cardiac arrest was 63.11min. Access was considered good in all patients. One death was due to pulmonary and renal problems not related to the incision. All patients had a better recovery in the intensive care unit, got out of bed sooner, coughed more easily, and performed prophylactic physiotherapeutic maneuvers for respiratory problems more easily and with less pain in the incision. Early ambulation was more easily carried out by all patients. CONCLUSION Mini-sternotomy proved to be better than the conventional sternotomy because it provided more comfort for the patients in the early postoperative period, with less pain and greater desire for early ambulation and all its inherent advantages.
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Affiliation(s)
- A R Dias
- Instituto do Coração, Hospital das Clínicas, FM, USP, Sao Paulo, Brazil
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Pomerantzeff PM, Brandão CM, Faber CM, Grinberg M, Cardoso LF, Tarasoutchi F, Stolf NA, Verginelli G, Jatene AD. Mitral valve repair in rheumatic patients. Heart Surg Forum 2001; 3:273-6. [PMID: 11178286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND There is controversy regarding the role of reparative techniques for rheumatic-mitral valve disease. We have analyzed the late results of mitral valve repair in a group of patients with rheumatic mitral valve insufficiency. METHODS From March 1980 to December 1997, 201 patients with rheumatic fever underwent mitral valve repair at the Heart Institute, Hospital das Clínicas, Medical School, University of São Paulo. The mean age of patients was 26.9 +/- 15.4 years, with 59.7% of the patients being female. Other diagnoses were present in 67.7% of patients; the most common was tricuspid regurgitation (31.3%). Mitral valve repair techniques included: 1) Carpentier ring annuloplasty in 75 patients (37.3%); 2) posterior annuloplasty with bovine patch in 68 patients (33.8%); 3) posterior segmental annuloplasty in 16 patients (7.9%); 4) quadrangular resection of the posterior leaflet with ring plication in 11 patients (5.5%); 5) partial resection of the anterior leaflet in 6 patients (3%); 6) De Vega's annuloplasty in 6 patients (3%); 7) Kay's annuloplasty in 5 patients (2.5%); 8) Reed's annuloplasty in 4 patients (2%); and 9) miscellaneous techniques in 10 patients (4.9%). Combined techniques were used in 94 patients (46.8%), the most frequent of which was chordal shortening (48 patients, 23.9%). Other non-mitral cardiac procedures were performed in 113 patients (56.2%). Actuarial survival and event-free curves (Kaplan-Meier method) were compared by linear regression analysis. RESULTS The in-hospital mortality rate was 2.0% (four patients). The causes of death were multiorgan failure in two patients and low cardiac output in the other two patients. In the late postoperative period, 83.9% of the patients were in New York Heart Association (NYHA) functional class 1. The actuarial survival was 93.9% +/- 1.9% at a mean of 125 months. Twenty-three patients were reoperated in the postoperative period at a mean interval of 35.7 months. Survival free from reoperation was 43.3% +/- 13.7% at 125 months. When analyzing the patients according to age, actuarial survival was 91.3% +/- 3.8% in the group of patients younger than 16 years (Group 1), compared with 95.6% +/- 2.7% in the group older than 16 years (Group 2), with a statistically significant difference of p < 0.0001. Survival free from reoperation was 50.8% +/- 16.9% in Group 1 and 47.0% +/- 14.9% in Group 2 (p < 0.0001). CONCLUSIONS Late results obtained with mitral valve repair for rheumatic mitral valve insufficiency were satisfactory and exceeded those reported for mitral valve replacement in the same population.
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Affiliation(s)
- P M Pomerantzeff
- Heart Institute, Hospital das Clínicas, Medical School, University of São Paulo, Brazil
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Pomerantzeff PM, Brandao CM, Cauduro P, Puig LB, Grinberg M, Tarasoutchi F, Cardoso LF, Lerner A, Stolf NA, Verginelli G, Jatene AD. Fisics-Incor bovine pericardial bioprostheses: 15 year results. Heart Surg Forum 2001; 1:130-5. [PMID: 11276451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND From March 1982 to December 1995, 2,607 Fisics-Incor bovine pericardial bioprostheses were implanted in 2,259 patients. Mean age was 47.2 +/- 17.5 years, and 55% were male. Rheumatic fever was present in 1,301 (45.7%) patients. METHODS One thousand and seventy-three aortic valve replacements, 1,085 mitral replacements, 27 tricuspid replacements, 195 mitral-aortic replacements, and 16 other combined valve replacements were carried out. Combined procedures were performed in 788 (32.9%) patients, the most frequent being tricuspid valve repair (9.2%) and coronary artery bypass grafting (7.7%). RESULTS Hospital mortality was 8.6% (194 patients), 8.6% for the mitral group, 4.7% for the aortic group, and 12.8% for double-valve replacements. The linear rates for calcification, thromboembolism, rupture, leak and endocarditis were, respectively, 1.1%, 0.2%, 0.9%, 0.1% and 0.5% patient-year. The actuarial survival curve was 56.7 +/- 5.4% in 15 years. Survival free from endocarditis was 91.92%, survival free from thromboembolism was 95 +/- 1.7%, survival free from rupture was 43.7 +/- 9.8%, survival free from leak was 98.9 +/- 4.5%, and survival free from calcification was 48.8 +/- 7.9% in 15 years. In the late postoperative period, 1,614 (80.6%) patients were in New York Heart Association functional Class I. CONCLUSIONS We conclude that the results with the Fisics-Incor bovine pericardial prostheses were satisfactory in our group of patients.
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Affiliation(s)
- P M Pomerantzeff
- Heart Institute, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil
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Park M, Sangeam M, Volpe M, Leite P, Viecilli P, Feltrim M, Nozawa E, Lorenzi-filho G, Timerman S, Cardoso L, Ramires J. Crit Care 2001; 5:P5. [DOI: 10.1186/cc1338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Tarasoutchi F, Grinberg M, Filho JP, Izaki M, Cardoso LF, Pomerantezeff P, Nuschbacher A, da Luz PL. Symptoms, left ventricular function, and timing of valve replacement surgery in patients with aortic regurgitation. Am Heart J 1999; 138:477-85. [PMID: 10467198 DOI: 10.1016/s0002-8703(99)70150-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Because cardiac decompensation is subtle, the best time to perform aortic valve replacement surgery may be difficult to determine. We investigated the relation of symptoms to left ventricular (LV) function and the timing of valve replacement in patients with aortic regurgitation (AR) of largely rheumatic origin. METHODS Sixty-eight initially asymptomatic patients (mean age 29 years) with severe chronic AR were monitored for 36 months. Assessments included baseline and yearly echocardiograms and radioisotope ventriculography (resting and exercise) and clinical examinations every 6 months. RESULTS Forty-seven patients (69%) remained asymptomatic and 21 (31%) had symptoms develop after 24 to 36 months. Compared with symptomatic patients, asymptomatic patients had significantly (P <.05) lower baseline LV end-diastolic diameter, end-systolic diameter, end-systolic stress, and volume/mass ratio but greater shortening fraction and ejection fraction (EF) at rest. These variables remained stable without statistically significant change until surgical correction in symptomatic patients. Percent variation of EF from rest to exercise increased in patients who remained asymptomatic (EF 2.8% +/- 10.6%) but decreased in those who became symptomatic (EF -4.2% +/- 13%; P <.05). Twenty symptomatic patients (New York Heart Association class III/IV, angina and/or syncope) had valve replacement surgery, after which all were in New York Heart Association class I/II and had significant decreases of LV end-diastolic and end-systolic diameters and an increase on percent variation of EF from rest to exercise (P <.0001). CONCLUSIONS Development of symptoms did not correlate with change in any ventricular function indexes. Surgery on appearance of symptoms restored LV function to near normal.
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Affiliation(s)
- F Tarasoutchi
- Heart Institute, School of Medicine, University of São Paulo, SP, Brazil
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Abstract
Binding properties of the subtypes of adenosine A2 receptors in membrane preparations and the effects of adenosine receptor ligands on cAMP accumulation in slices from the optic tectum of neonatal chicks have been investigated. [3H]2-[4-(2-p-carboxyethyl)phenylamino]-5'-N-ethylcarboxaminoadenosin e (CGS 21680), a selective ligand for adenosine A2a receptors, did not bind to optic tectal membranes, as observed with rat striatal membranes. CGS 21680 also did not induce cyclic AMP accumulation in optic tectum slices. However, 5'-N-ethylcarboxamidoadenosine (NECA), 2-chloro-adenosine or adenosine induced a 2.5- to 3-fold increase on cyclic AMP accumulation in this preparation. [3H]NECA binds to fresh non-washed-membranes obtained from optic tectum of chicks, displaying one population of binding sites, which can be displaced by NECA, 8-phenyltheophylline, 2-chloro-adenosine, but is not affected by CGS 21680. The estimated K(D) value was 400.90 +/- 80.50 nM and the Bmax was estimated to be 2.51 +/- 0.54 pmol/mg protein. Guanine nucleotides, which modulate G-proteins activity intracellularly, are also involved in the inhibition of glutamate responses by acting extracellularly. Moreover, we have previously reported that guanine nucleotides potentiate, while glutamate inhibits, adenosine-induced cyclic AMP accumulation in slices from optic tectum of chicks. However, the guanine nucleotides, GMP or GppNHp and the metabotropic glutamate receptors agonist, 1S,3R-ACPD did not alter the [3H]NECA binding observed in fresh non-washed-membranes. Therefore, the adenosine A2 receptor found in the optic tectum must be the adenosine A2b receptor which is available only in fresh membrane preparations, and its not modulated by guanine nucleotides or glutamate analogs.
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Affiliation(s)
- C I Tasca
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, Brasil.
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Abstract
Glutamate and adenosine both modulate adenylyl cyclase activity through interaction of their specific receptors with stimulatory or inhibitory G-proteins. Guanine nucleotides (GN), which modulate G-protein activity intracellularly, are also involved in the inhibition of glutamate responses, acting from the outside of the cells. We had previously reported that glutamate inhibits adenosine-induced cyclic AMP (cAMP) accumulation in slices obtained from the optic tectum of chicks. In the present study we investigated the interaction of GN with these two neurotransmitters and found that GN inhibit the inhibitory effect of glutamate on adenosine-induced cAMP accumulation and potentiate adenosine-induced cAMP accumulation. These effects were observed with 5'-guanylylimidodiphosphate (GppNHp) or GMP, but not with guanosine (the nucleoside). Besides, these interactions of GN occur via a metabotropic glutamate receptor (mGluR) sensitive to (1 S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid (1 S,3R-ACPD) but not to L-2-amino-4-phosphonobutyrate (L-AP4). These effects were partially modulated by a mGluR antagonist, (RS)-alpha-methyl-4-carboxyphenylglycine ((RS)M-CPG), and by an adenosine receptor antagonist, 8-phenyltheophylline. GN only potentiated the adenosine response when adenosine was acting through its receptor positively linked to adenylyl cyclase. Therefore, the data show that guanine nucleotides not only inhibit glutamate-induced responses, but also stimulate adenosine-induced responses, a fact that may contribute to the understanding of the physiological functions of guanine nucleotides.
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Affiliation(s)
- C I Tasca
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
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Cardoso LF, Rati MA, Pomerantzeff PM, Medeiros CC, Tarasoutchi F, Rossi EG, Avila WS, Grinberg M. [Comparison between percutaneous balloon valvuloplasty and open commissurotomy for mitral stenosis]. Arq Bras Cardiol 1998; 70:415-21. [PMID: 9713084 DOI: 10.1590/s0066-782x1998000600007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To compare immediate and late (12 months) follow-up of clinical and Doppler echocardiographic results between percutaneous mitral balloon valvuloplasty and open commissurotomy in a prospective and randomized trial. METHODS Eighty eight symptomatic patients with severe mitral stenosis and favorable anatomy were randomized in a prospective trial comparing the two procedures. All patients were submitted to clinical and Doppler echocardiographic evaluation before the procedures and immediate and twelve months thereafter. RESULTS Mean mitral gradient (mmHg) decreased from 12.2 +/- 5.8 to 5.80 +/- 2.7 (p < 0.001) in commissurotomy group (CG) and from 11.7 +/- 6.1 to 5.0 +/- 2.4 (p < 0.001) in the balloon valvuloplasty group (VG). Mitral valve are (cm2) increased from 0.98 +/- 0.21 to 2.52 +/- 0.46 in CG and from 1.05 +/- 0.25 to 2.18 +/- 0.40 in VG (p < 0.001). In both groups there was a slight decrease in mitral valve area at 12 month follow-up. There was no death in either group. One patient in the VG had moderate mitral regurgitation and underwent surgery. At the 12 month follow-up, all patients in CG and 97.7% of patients in VG were in New York Heart Association functional class I or II. CONCLUSION Both procedures were safe and showed similar immediate improvement in mitral gradient and functional class. Mitral valve area had a greater increase immediately after commissurotomy, however, there was a significantly greater reduction in the CG after 12 months of follow-up, when compared to balloon valvuloplasty. In both groups, mitral gradient remained reduced and most patients did not change functional class during the follow-up.
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Affiliation(s)
- L F Cardoso
- Instituto do Coração, Hospital das Clínicas, FMUSP
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Tasca CI, Cardoso LF, Martini LH, Ramírez G, Souza DO. Guanine nucleotides inhibit cAMP accumulation induced by metabotropic glutamate receptor activation. Neurochem Res 1998; 23:183-8. [PMID: 9475513 DOI: 10.1023/a:1022480825290] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Metabotropic glutamate receptors (mGluRs) have been shown to modulate adenylate cyclase activity via G-proteins. In the present study we report similar results to the previously observed in the literature, showing that glutamate and the metabotropic agonists, 1S,3R-ACPD or quisqualate induced cAMP accumulation in hippocampal slices of young rats. Moreover, guanine nucleotides GTP, GDP or GMP, inhibited the glutamate-induced cAMP accumulation. By measuring LDH activity in the buffer surrounding the slices, we showed that the integrity of the slices was maintained, indicating that the effect of guanine nucleotides was extracellular. GMP, GDPbeta-S or Gpp(NH)p abolished quisqualate-induced cAMP accumulation. GDPbeta-S or Gpp(NH)p but not GMP inhibited 1S,3R-ACPD-induced cAMP accumulation. The response evoked by glutamate was also abolished by the mGluR antagonists: L-AP3 abolished glutamate-induced cAMP accumulation in a dose-dependent manner and MCPG was effective only at the 2 mM dose. DNQX was ineffective. We are reporting here, an inhibition induced by guanine nucleotides, via an extracellular site (s), similar to the observed with classical glutamate antagonists on a cellular response evoked by mGluR agonists.
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Affiliation(s)
- C I Tasca
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Trindade, Florianópolis, SC, Brasil
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Grinberg M, Cardoso LF. [Success and satisfaction. The clinical perspective of percutaneous mitral valvotomy]. Arq Bras Cardiol 1997; 68:145-6. [PMID: 9435349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Pomerantzeff PM, Tarasoutchi F, de Brito Júnior FS, Munhoz AM, Cardoso LF, Brandão CM, Grinberg M, Stolf NA, Bellotti G, Pileggi F, Jatene AD. [Results of aortic stenosis surgery in patients with severe ventricular dysfunction]. Arq Bras Cardiol 1996; 67:375-8. [PMID: 9246823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To study the short and long term clinical course of patients with severe aortic stenosis after surgical treatment of the valvular lesion. METHODS Thirty survivors among 31 consecutive patients with severe left ventricular dysfunction (LVD) due to aortic stenosis (AS) were submitted to clinical and echocardiographic follow-up during a mean of 30 months after surgical treatment of the valvular lesion. Twenty five (83.3%) patients were male with a mean age of 50 years (25 to 74). Before operation the following parameters were obtained: diastolic left ventricular diameter (DLVD), shortening fraction (SF), left ventricular ejection fraction (LVEF), aortic valve area (AVA), left ventricular-aortic pressure gradient (PG) and NYHA functional class (FC). During the follow up, after the surgical procedure, FC, DLVD, LVEF and SF could be analysed and compared with previous data. RESULTS A significant rise in SF (p = 0.001) and LVEF (p = 0.0001), as well as a decrease in DLVD (p = 0.001) were observed in the follow up. Symptoms lessened in severity in the majority of patients. Three of our patients died with progressive LVD and heart failure, after at least 36 months of follow-up. These results indicate that when operation is carried out in patients with AS and left ventricular failure, a significant improvement in left ventricular function and in symptoms takes place. Although the risk of surgical treatment is increased in this group of patients, LVD should not be considered a contraindication to the procedure. CONCLUSION The left ventricular dysfunction is not a contraindiction for the surgical treatment of the aortic stenosis.
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Cardoso LF. [Mitral valvoplasty by balloon catheter. A method in improvement]. Arq Bras Cardiol 1996; 66:275-6. [PMID: 9008910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Cardoso LF, Grinberg M, Patrício M, Neves Rati MA, Medeiros CC, Tarasoutchi F, Avila WS, Rossi EG, Bellotti G. [Comparative study between inoue single balloon and double balloon in percutaneous mitral valvuloplasty. Immediate results and after 1 year follow-up]. Arq Bras Cardiol 1996; 66:213-6. [PMID: 8935686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To compare early and 12 months results of mitral stenosis (MS) correction by percutaneous balloon valvuloplasty (PMBV) using Inoue's single-balloon or double balloon techniques. METHODS We submitted 139 consecutive patients to PMBV using Inoue single-balloon (n = 56, GI) or the double balloon technique (n = 83, GII). The two groups were similar, in: age, sex, functional class (FC), echocardiographic (ECHO) score, mitral valve area (MVA), and gradient (G) or presence of regurgitation. Clinical and ECHO data were compared before (PRE), immediately after (POI) and one year following the procedure (PO12M). RESULTS PMBV was successfully performed in 53 (95%) patients of GI and in 79 (96%) of GII. Statistical analyses showed that the groups were similar at POI but different at PO12M (p < 0.002). ECHO immediately after PMBV showed that: MVA increased from 0.99 +/- 0.23 to 2.01 +/- 0.44cm2 (p < 0.001) in GI and from 0.94 +/- 0.23 to 2.09 +/- 0.35cm2 (p < 0.001) in GII and G decreased from 11.58 +/- 5.02 to 5.16 +/- 2.23mmHg (p < 0.001) in GI and from 12.48 +/- 4.89 to 5.96 +/- 3.21mmHg (p < 0.001) in GII. After one year 36 (64%) patients in GI and 62 (74%) in GII underwent an ECHO study. A comparison between immediate and one year follow-up results showed that MVA decreased from 2.01 +/- 0.4 to 2.00 +/- 0.3cm2 (NS) in GI and from 2.09 +/- 0.3 to 1.74 +/- 0.4cm2 (p < 0.001) in GII and G decreased from 5.16 +/- 2.2 to 5.50 +/- 2.9mmHg (NS) in GI and from 5.96 +/- 3.2 to 8.61 +/- 4.8mmHg (p < 0.001) in GII. There was therefore a sustained improvement of MVA and G after one year in GI and a significant decrease in MVA and G in GII. The FC after one year was similar and satisfactory in both groups. CONCLUSION Both techniques are equally effective in relieving MS immediately after PMBV, but after one year, despite similar FC, Inoue-balloon technique seems to be superior to maintain MVA and G.
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Affiliation(s)
- L F Cardoso
- Instituto do Coração do Hospital da Clínicas-FMUSP, São Paulo, SP
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Tasca CI, Vendite D, Martini LH, Cardoso LF, Souza DO. Modulation of adenosine-induced cAMP accumulation via metabotropic glutamate receptors in chick optic tectum. Neurochem Res 1995; 20:1033-9. [PMID: 8570007 DOI: 10.1007/bf00995557] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Changes on cyclic adenosine monophosphate (cAMP) levels in response to adenosine and glutamate and the subtype of glutamate receptors involved in this interaction were studied in slices of optic tectum from 3-day-old chicks. cAMP accumulation mediated by adenosine (100 microM) was abolished by 8-phenyltheophylline (15 microM). Glutamate and the glutamatergic agonists kainate or trans-D, L-1-aminocyclopentane-1,3-dicarboxylic acid (trans-ACPD) did not evoke cAMP accumulation. Glutamate blocked the adenosine response in a dose-dependent manner. At 100 microM, glutamate did not inhibit the effect of adenosine. The 1 mM and 10 mM doses of glutamate inhibited adenosine-induced cAMP accumulation by 55% and 100%, respectively. When glutamatergic antagonists were used, this inhibitory effect was not affected by 200 microM 6,7-dihydroxy-2,3,dinitroquinoxaline (DNQX), an ionotropic antagonist, and was partially antagonized by 1 mM (RS)-alpha-methyl-4-carboxyphenylglycine [(RS)M-CPG], a metabotropic antagonist, while 1 mM L-2-amino-3-phosphonopropionate (L-AP3) alone, another metabotropic antagonist, presented the same inhibitory effect of glutamate. Kainate (10 mM) and trans-ACPD (100 microM and 1 mM) partially blocked the adenosine response. This study indicates the involvement of metabotropic glutamate receptors in adenylate cyclase inhibition induced by glutamate and its agonists trans-ACPD and kainate.
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Affiliation(s)
- C I Tasca
- Departamento de Bioquimica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Tarasoutchi F, Grinberg M, Parga Filho J, Cardoso LF, Izaki M, Pomerantzeff P, Lunardi W, Meneghetti C, da Luz PL, Bellotti G. [Postoperative course of left ventricular function in aortic insufficiency]. Arq Bras Cardiol 1995; 65:147-52. [PMID: 8554491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To analyze the follow-up of left ventricular function (LVF) after surgical correction of severe chronic aortic insufficiency (AI). METHODS Twenty-one out of 68 patients with AI, initially asymptomatic and that developed symptoms during the follow-up period of 24-36 months, were studied. Relationship between symptoms and LVF by echocardiogram and radioisotopic ventriculography at rest and in isotonic exercise were studied. Three clinical moments (CM) were assumed: CM-0- at the beginning of the study, when all patients were asymptomatic; CM-1- manifestation of the symptoms during 24-36 months; CM-2- corresponding to the late post-operative period of 8 months of 20 out of 21 patients (one refused the surgery). The analysis did not show any significant differences between the mean values of all echocardiographic variables (diastolic and systolic diameters, shortening fraction, final systolic stress, volume-mass ratio, contractility index) and the ejection fraction of the left ventricle (EF) obtained by the radioisotope ventriculography at rest and, including exercise, between clinical moments 0 and 1. RESULTS In the CM-2, involution was verified for functional class I/II in all cases and absence of expressive complications or immediate or late postoperative mortality. Comparison between CM-2 and 0 showed expressive regression of the diameters at rest in the postoperative period and with significant improvement in the means mainly the percentual variation of the EF and total time of effort. CONCLUSION Symptoms assembled patients with more advanced eccentric hypertrophy and did not coincide with any immediate change in findings studied at rest and at exercise. It represented a point of reference for surgical indication compatible with late postoperative involution of chronic adaptation of AI.
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Rossi EG, Grinberg M, Wajngarten M, Cardoso LF, Kalil L, Avila WS, da Luz PL, Bellotti G. [Clinico-morphological dissociation in patients with mitral valve stenosis]. Arq Bras Cardiol 1995; 64:455-8. [PMID: 8526776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To study characteristics of the natural history of mitral stenosis (MS) in patients that have no correlation between mitral valve areas (MVA) and symptoms. METHODS We studied 18 patients with MS, that presented no correlation between MVA and functional class (FC), 16 (89%) were female and two (11%) men, with age ranging from 16 to 54 (mean 33) years. Patients assigned to group A (8 cases) had FC III and MVA > or = 1.5 cm2 and group B (10 cases) FC I/II and MVA < 1.1 cm2. FC and MVA at the start (initial time-It) and after 12 months or before surgical correction (SC) or percutaneous mitral balloon valvuloplasty (PBV) (final time-Ft) were compared. All patients with predict O2 uptake (%PRED VO2) at It were evaluated. RESULTS Five (63%) patients of group A, that maintained MVA > or = 1.5 cm2, changed to FC I/II but three (38%) needed a SC or PBV (2 with lesser MVA at Ft). At group B, six (60%) patients needed SC or PBV. CONCLUSION MS patients with MVA > or = 1.5 and FC III, providing MVA do not decrease, improves their FC, becoming it more compatible with MVA %PRED VO2. The cases of group B presented the greatest probability of needing SC or PVB.
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Affiliation(s)
- E G Rossi
- Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo
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26
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Tarasoutchi F, Grinberg M, Scarabucci M, Cardoso LF, Cavalheiro Filho C, Rached RA, Pomerantzeff P, da Luz PL, Bellotti G. [Preoperative erythrocytopheresis in a patient with SC hemoglobinopathy and mitral stenosis]. Arq Bras Cardiol 1995; 64:463-4. [PMID: 8526778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Hemoglobinopathies are associated with thrombotic complications, when exposed to cardiopulmonary bypass. A 54-year old, black woman with hemoglobinopathy SC and severe mitral stenosis was submitted to eritrocytopheresis 48 hours before mitral commissurotomy surgery. The therapeutic determined appearance of the percentual hemoglobin A of 68% with reduction the hemoglobin S of 48% to 15% and the hemoglobin C of 51% to 17%. No complications occurred during postoperative period. To best of our knowledge, that is the first report about application the eritrocytopheresis in the pre operative extra corporeal circulation care in surgical treatment of patients with chronic rheumatic heart disease and hemoglobinopathy SC.
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Affiliation(s)
- F Tarasoutchi
- Instituto do Coração do Hospital das Clínicas - FMUSP, São Paulo
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27
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Tarasoutchi F, Grinberg M, Parga Filho J, Cardoso LF, Izaki M, Lavítola P, Cardoso RH, da Luz PL, Bellotti G. [The relationship between left ventricular function and the precipitation of symptoms in severe chronic aortic insufficiency]. Arq Bras Cardiol 1995; 64:301-9. [PMID: 7495386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To study the relationship between symptoms and left ventricular function in 68 patients with severe chronic aortic regurgitation using echocardiogram and radionuclide left ventriculography at rest. METHODS Three stages of natural history are assumed: the 1st, at the beginning of the study, when all patients were asymptomatic (clinical stage 0); the 2nd, at the end of 36 month persistence of asymptomatic (clinical stage 1), consisting of 45 patients (group AA); the 3rd, on occasion of manifestation of the symptoms during this period of time (clinical stage 2), consisting of 21 patients (group AS-PRE), with two fatalities not related to valvopathy. RESULTS The comparison between the groups resulted in similarities in the mean ages, mean time of knowledge of the disease, predominance of males and rheumatic etiology. The profile analysis showed that the significant initial differences between the average of all echocardiographic variables (diastolic diameter, systolic diameter, shortening fraction, final systolic stress, volume-mass ratio, contractility index) and of the ejection fraction of the left ventricle obtained by the radionuclide ventriculography at rest, remained during the study. CONCLUSION Development of symptoms grouped patients with more advanced excentric hypertrophy, did not coincide with any immediate change in the laboratory markers studied at rest and it was used as a referential for surgical therapy.
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Affiliation(s)
- F Tarasoutchi
- Instituto do Coração do Hospital das Clínicas, FMUSP
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Ayres CV, Cardoso LF, Grinberg M, Rati MA, Medeiros CC, Tarasoutchi F, Avila WS, Rossi EG, Bellotti G. [Mitral stenosis correction by double catheter-balloon valvuloplasty technique]. Arq Bras Cardiol 1995; 64:27-31. [PMID: 7669007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To evaluate long-term efficacy of double balloon percutaneous mitral valvuloplasty technique (PMV2B). METHODS Sixty-eight patients (76% female), mean-age 32 (15-69) years who had been submitted to PMV2B, that completed clinical and echodopplercardiographic one year follow-up (PO12M). Admission criteria were: exertional dyspnoea, no thromboembolism antecedent up to three months before the procedure, absence of other cardiac disease requiring correction, an admissible echodopplercardiographic score, absence of intracavitary thrombus and mitral regurgitation absent or minor. RESULTS The patients were divided in two groups: group A of 7 (11%) patients that have a cardiac event in this period, and group B of 61 patients that completed the follow-up without a cardiac event. In group A three patients have had a severe mitral regurgitation, one case was unsuccessful and other one had a re-stenosis. There were two deaths, not related to the intervention. In group B, haemodynamic results before and immediately after PMV2B (POI) showed a significant improvement, except in relation to cardiac index. There was an increase in the grade of mitral regurgitation in 17 (28%) patients and in two cases this regurgitation became moderate. The mitral valvar area (MVA) variation between PRE x POI x PO12M presented, comparing MVA between POI and PO12M, a significant reduction. Two (3%) patients with a reduction greater than 50% of the initial increase, 33 (54%) between 10 and 50% and 26 (42%) less that 10% remained in functional class I/II. CONCLUSION PMV2B is an attractive treatment to select symptomatic mitral stenosis patients, with a low incidence of complications, symptomatic effective improvement that was maintained in one year follow-up, although there was a reduction in MVA.
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Affiliation(s)
- C V Ayres
- Instituto do Coração do Hospital das Clínicas-FMUSP
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Tarasoutchi F, Grinberg M, Wu TC, Filho CC, Rached RA, Cardoso LF, Pomerantzeff PM, Estevez Filho A, da Luz PL, Bellotti G. [Chronic rheumatic cardiopathy in a patient with of hemophilia successfully treated with surgery]. Arq Bras Cardiol 1994; 63:389-91. [PMID: 7611917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
A 52 year-old man, with rheumatic cardiopathy and hemophilia was admitted to the hospital for aortic valve replacement and mitral valve commisurotomy. He had a history of allergic reaction to cryoprecipitate, and to undergo to the cardiac surgery, the ideal level of factor VIII was estimated to be 100%. To reach this level he first received 2,500UI of the factor VIII:C increasing the factor VIII:C level from 20 to 58%. During the surgery he received an additional dose of 1,500UI of factor VIII plus 3,500,000UI of aprotinin (Trasylol), which was started at the beginning of the anaesthesia and maintained during the surgical procedure, increasing the factor VIII level to 220%. The patient was discharged 11 days after the surgery without any hemorrhagic complication.
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Cardoso LF, Grinberg M, Vieira ML, Lopes NH, Tarasoutchi F, Lourenço Filho DD, Bellotti G. [Aneurysms of the left and non coronary sinus of Valsalva associated to mitral and aortic rheumatic valves and obstructive coronary disease]. Arq Bras Cardiol 1994; 63:303-5. [PMID: 7771949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
A 30 years old, male, patient with rare multiple aneurysms of sinus of Valsalva associated to mitral and aortic regurgitation and total occlusion of circumflex artery had the clinical diagnosis made accidentally. The multiple aneurysms were detected by transesophageal echodopplercardiography and hemodynamic study. The diagnosis were confirmed at surgery and the patient underwent correction of the aneurysms through the use of pericardial patches and mitral and aortic valve replacement.
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Affiliation(s)
- L F Cardoso
- Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo
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31
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Tarasoutchi F, Grinberg M, Barreto Filho JA, Vasconcelos JT, Cardoso LF, Lunardi W, Mansur A, Pomerantzeff P, da Luz PL, Bellotti G. [Acquired ventricular septal defect during infective endocarditis]. Arq Bras Cardiol 1994; 63:203-5. [PMID: 7778992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
We studied five patients with acquired ventricular septal defect during the course of an infective endocarditis. All patients were male and had a previous aortic valve disease associated with an aortic ring abscess. Clinical examination was useful for the diagnosis of 4 cases, emphasizing the following findings: systolic murmur and/or left paraesternal thrill and right-heart failure. Incidence of congestive heart failure was 60%, while 40% of all patients died during the in-hospital course. No specific etiologic agent was detected. Therefore, acquired ventricular septal defect should be suspected in patients with infective endocarditis of the aortic valve that evolve with a systolic murmur and/or paraesternal thrill and right-heart failure. Immediate surgical treatment is mandatory in these cases.
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Affiliation(s)
- F Tarasoutchi
- Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo
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Lunardi W, Grinberg M, Scaff M, Antelmi I, Mutarelli E, Kajita LJ, Esteves A, Tarasoutchi F, Cardoso LF, Rossi E. [Neurological events in infective endocarditis]. Arq Bras Cardiol 1993; 61:349-55. [PMID: 8204070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
PURPOSE The study of frequency, modalities and course of neurological complications of infective endocarditis (IE), as well as the current indication and value of supplementary examinations. METHODS Sixty-three patients with IE, 39 with native valve and 24 with valvar prosthesis, were prospectively studied; the mean age was 42 years and 45 (71.4%) were males. Two groups were formed: A) 41 patients without neurological events and B) 22 patients who presented 28 neurological events before or during hospitalization: ischemic cerebrovascular accident 20, hemorrhagic cerebrovascular accident 2, meningeal hemorrhage 2, meningitis 2, brain abscess 1 and seizure 1. All patients were submitted to neurological clinical examination; 57 computerized tomographies of the cranium, 28 arteriographies and 32 cerebrospinal fluid analysis were performed. RESULTS The incidence of neurological events corresponded to 34.92% of IE patients, with a clear predominance (85.71%) of vascular as compared to infectious manifestations. Mortality was 2.32 times higher in group B patients (22.73% x 9.76%), albeit p = 0.256, and was not related to staphylococcal etiology. The neurological events were not related to sex, age and presence of valvar prosthesis. The presence of neurological complications was greater (p = 0.047) in patients with simultaneous infections in two valves (mitral and aortic) and also (p = 0.00884) in those with IE in prosthesis implanted for less than three months. All supplementary neurological examinations in group A were normal. CONCLUSION 1) Occurrence of neurological events is a factor which influences the prognosis of IE; 2) supplementary neurological examinations did not reveal subclinical neurological complications; 3) neurological complications were significantly more frequent in patients with simultaneous mitral and aortic valve IE; 4) IE in prosthesis implanted for less than 3 months has a greater probability to develop a neurological picture as compared to IE in prosthesis implanted for more than 3 months.
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Affiliation(s)
- W Lunardi
- Instituto do Coração do Hospital das Clínicas, FMUSP
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33
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Cardoso LF, Grinberg M, Ratti MA, de Magalhães LP, Antelmi I, Medeiros CC, Tarasoutchi F, Rossi EG, Avila WS, Bellotti G. [Comparison between the use of unifoil double balloon and bifoil balloon in successful mitral valvuloplasty by balloon catheter]. Arq Bras Cardiol 1993; 61:87-91. [PMID: 8297227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
PURPOSE To compare immediate and long term results balloon mitral valvuloplasty (BMV) using double balloon or bifoil balloon. METHODS One hundred and thirteen consecutive cases of BMV used aleatory double balloon (group DB--55 cases) or bifoil balloon (group BF--16 cases). Patients were similar regarding to age, sex, valvopaty etiology, functional class and echocardiographic score. Seventy one (63%) patients achieved 12 months follow-up. RESULTS In group DB there were 2 (4%) insuccess, 2 (4%) cardiac tamponade and 2 (4%) deaths, 91% patients had immediate criteria of success. Mitral valve area (MVA) increased from 0.8 to 1.69cm2 and mitral gradient (G) by echodopplercardiographic (ECHO) decreased from 17.9 to 4.8mmHg. Three (5%) patients developed severe mitral regurgitation (MR) and needed surgical intervention. At follow-up 2 (4%) developed mitral restenosis. MVA estimated by ECHO study after one year follow-up was inferior to 1.15cm2 in 15 (32%) cases, between 1.5 and 2.0cm2 in 17 (37%) and superior to 2.0cm2 in 14 (31%). In group BF there were 2 (12.5%) insuccess, 4 (25%) developed severe MR occurring 1 death immediate post-operative mitral valve replacement. Among 14 (87%) success cases, MVA increased from 0.8 to 1.89cm2 and G decreased from 18 to 6.4mmHg. Lately 2 (12.5%) needed surgical intervention because significative MR. At 12th month follow-up the ECHO study showed that in one (10%) case MVA was < 1.5cm2, and in 3 (27%) cases was between 1.5 and 2.0cm2. CONCLUSION There were similar good results in both groups, however group DB had more restenosis, cardiac tamponade and vascular complications and group BF had more severe MR.
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Affiliation(s)
- L F Cardoso
- Instituto do Coração do Hospital das Clínicas-FMUSP
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Cardoso LF, Grinberg M, Ayres CV, Rati MA, Medeiros CC, Tarasoutchi F, Sant'Anna FM, Bellotti G. [Mitral catheter-balloon valvuloplasty in surgical high risk patients]. Arq Bras Cardiol 1993; 60:301-5. [PMID: 8311744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
PURPOSE To evaluate percutaneous mitral balloon valvuloplasty (PMBV) in surgical high risk patients. METHODS Twenty (12%) patients out of 172 submitted to a PMBV were considered high surgical risk cases; 17 (85%) were women and mean age was 43 (18-69). Thirteen (65%) were in acute pulmonary edema (3 were pregnant, 2 had previous cerebrovascular event, 1 had pulmonary thromboembolism and other had chronic renal failure), and 7 (35%) were in functional class (CF) III (2 had coronary artery disease, 2 severe obesity, 1 pulmonary neoplasia, 1 cardiac cachexia and one with previous cerebrovascular event). All patients underwent PMBV through transseptal technique. Double balloon was used in 10 (50%) patients; Inoue balloon in 5 (25%), mono-foil in 3 (15%) and bi-foil in 2 (10%). RESULTS Seventeen (85%) obtained success and 2 (10%) had clinical improvement. The hemodynamic results pre versus post-PMBV showed: left atrium pressure (LAP) mmHg 28.2 +/- 10.0 x 15.2 +/- 9.2 (n = 20) (p < 0.001), mitral medium gradient (G) mmHg 21.2 +/- 10.7 x 10.7 +/- 6.7 (n = 18) (p < 0.001), mitral valve area (MVA) cm2 0.73 +/- 0.3 x 1.73 +/- 0.6 (n = 11) (p < 0.001), pulmonary artery pressure mmHg 52.0 +/- 18.2 x 40.1 +/- 14.7 (n = 18) (p < 0.001) and cardiac index L/min/m2 2.1 +/- 0.4 x 2.5 +/- 0.6 (n = 14) (p < 0.001). Comparative echocardiography results pre, post and 6 months after PMBV showed: MVA 1.06 +/- 0.39 x 1.92 +/- 0.51 x 1.65 +/- 0.5 and G 13.8 +/- 4.7 x 7.3 +/- 3.6 x 7.3 +/- 4.4. There were two immediate deaths (pulmonary thromboembolism and multiple organs failure) and other after hospital discharge. The complications were: 2 (10%) patients with neurological complications, 1 (5%) atrial septal defect and other right atrium perforation (5%). CONCLUSION PMBV offers an alternative to surgical treatment in high risk surgical patients and the results are maintained in the 6 month follow-up.
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Affiliation(s)
- L F Cardoso
- Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo
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35
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Pomerantzeff PM, Brandão CM, Amato M, Fukushima J, Horta P, Ratti M, Medeiros CC, Tarasoutichi F, Cardoso LF, Grinberg M. [Randomized study comparing mitral valve replacement with and without preservation of mitral ring chordae tendinae papillary continuity]. Arq Bras Cardiol 1993; 60:321-5. [PMID: 8311748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
PURPOSE To demonstrate the importance of the preservation of mitral annulus-chordae tendineae-papillary muscles continuity in mitral valve replacement. METHODS We studied 21 patients who were submitted to mitral valve replacement, divided in two randomized groups: group 1, 12 cases who undergone mitral valve replacement, with preservation of the posterior leaflet and correspondent chordae tendineae; and group 2-9 cases who undergone conventional mitral valve replacement, excising the mitral valve apparatus. The left ventricular function was studied both, in the pre and post operative period, by echocardiography, cardiac catheterization, and radioisotopic study. The statistical analysis was done by the Wilcoxson's test. RESULTS There were no early post operative deaths. Analyzing the results of the ejection fraction by the radioisotopic study we found a significant difference (p = 0.03) between the percentual decrease of the two groups. The results of the fractional shortening were higher in group 1 than in group 2, however not significant. The left ventricular diastolic diameters average was lower in group 1 than in group 2, so as the left atrium diameter. We found a decrease in left ventricular end-diastolic pressure in group 1, however there was an increase in group 2, by the cardiac catheterization. There was a proportional increase in group 1 both in lung artery and lung capillary pressures. There was a significant difference (p = 0.05) between the average values of right ventricular diastolic pressure. CONCLUSION There is better preservation of left ventricular function in group 1.
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Avila WS, Grinberg M, Cardoso LF, Faccioli R, Bellotti G, Pileggi F. [Course of pregnancy and puerperium in women with mitral valve stenosis]. Rev Assoc Med Bras (1992) 1992; 38:195-200. [PMID: 1340375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To study pregnancy, delivery, puerperium and the newborn in cases of mitral valve stenosis, asymptomatic at conception. METHOD Sixty-two pregnant women, 30 with mitral valve stenosis (GE group) and 32 without cardiac disease (GN group) had their functional class, kind of delivery, anesthetic technique and newborn characteristics evaluated during gestation. RESULTS In GE group 16 (53.3%) patients changed from functional class (FC) I/II to FC III and 10 (33.3%) to FC IV. In GN group 18 (56.2%) changed from FC I to II during the gestation. Delivery was vaginal in 21 patients (70%); anesthetic technique was regional block in 17 (56.6%). These findings were not statistically different between (p > 0.1) the groups. Premature (20.0%) and small babies for gestational age (36.7%) were higher (p > 0.001) in GE group. There were no cases of maternal death. CONCLUSION The majority of GE women who started pregnancy in FC I/II changed to FC III/IV during gestation. Probably adequate medical treatment and valvoplasty in one case allowed fetal viability; but we had higher incidence of pre-term and small for gestation age babies in the GE group.
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Affiliation(s)
- W S Avila
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP
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Souza AJ, Tarasoutchi F, Cardoso LF, Pommerantzeff PM, Grinberg M. [Aortic dissection associated with systemic lupus erythematosus]. Arq Bras Cardiol 1992; 59:127-30. [PMID: 1341157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
A 33-year-old female patient, with a 4-year history of hypertension plus a 3-year history of systemic lupus erythematosus, who had been taking high dosages of corticosteroids, has shown repetitive respiratory infections and congestive heart failure for the past 8 months. Angiocardiography confirmed the diagnosis of aortic insufficiency with aneurysmatic dilation of Valsalva's posterior sinus, ascending aorta of normal diameter and normal coronary arteries. Aortic dissection causing aortic insufficiency due to collapse of aortic leaflets was spotted during the surgery and was corrected by a bovine pericardial tube and suspension of aortic valve. The postoperative (PO) period was complicated by left-sided seizures followed by left hemiparesis and respiratory infection. She was discharged on the 25th PO day with mild left hemiparesis and in functional class I (NYHA), using medicines. We emphasize the need to consider the diagnosis of aortic dissection in patients with systemic lupus erythematosus and aortic insufficiency, specially in those who have a history of systemic arterial hypertension and long-term corticosteroid therapy.
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Affiliation(s)
- A J Souza
- Instituto do Coração, Hospital das Clínicas, FMUSP
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38
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Cardoso LF, Ratti MA, Grinberg M, Medeiros CC, Tarasoutchi F, Rossi EG, Avila WS, Pomerantzeff PM, de Moraes AV, Arie S. [Mitral valvuloplasty by balloon catheter. Early results and one-year follow-up]. Arq Bras Cardiol 1992; 58:445-51. [PMID: 1340723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To evaluate percutaneous mitral balloon valvuloplasty (PMBV) results immediately and one year follow-up. METHODS One hundred and four procedures in 103 patients, 89 (87%) were women and mean age was 33. Ninety five (91%) had mitral stenosis, 7 (7%) mitral restenosis and 2 (2%) stenotic bioprosthesis. Twelve (10%) patients were in functional class (FC) II (NYHA), 73 (70%) in FC III and 19 (18%) in FC IV. Ninety three (89%) were in sinusal rhythm, 10 (10%) had atrial fibrillation and 1 (1%) junctional rhythm. In 99% cases the transseptal access was used. RESULTS The comparative haemodynamic results late x immediately after-PMBV were mitral valve area (cm2) 0.75 +/- 0.27 x 1.68 +/- 0.48 (p < 0.0001), gradient AE-VE average (mmHg) 19.52 +/- 8.03 x 5.44 +/- 4.38 (p < 0.0001); average pressure AE (mmHg) 24.72 +/- 8.76 x 9.63 +/- 6.11 (p < 0.0001), cardiac index (L/min/m2) 2.55 +/- 0.69 x 2.92 x 0.77 (p < 0.0001); average pressure PA (mmHg) 40.17 +/- 16.52 x 25.65 +/- 13.77 (p < 0.0001). The echocardiography results pré-PMBV, post-PMBV, 6 and 12 months after PMBV were respectively: mitral valve area (cm2) 0.89 +/- 0.23 x 1.87 +/- 0.41 x 1.72 +/- 0.43 x 1.64 +/- 0.44 and mitral transvalvar gradient (mmHg) 13.12 +/- 4.66 x 6.44 +/- 2.93 x 7.72 +/- 3.24 x 8.30 +/- 4.17. There was one death immediately after-PMBV in a patient with pulmonary thromboembolism. Four (4%) had severe mitral regurgitation and went to surgery (1 death). There were 2 mitral reestenosis. CONCLUSION For selected patients PMBV is a safe method and the good results are maintained in 1 year follow-up.
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Affiliation(s)
- L F Cardoso
- Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo
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Medeiros CC, de Moraes AV, Cardoso LF, Rati MA, Abensur H, de Azevedo JG, Parga Filho JR, Martins TC, Grinberg M, Moffa PJ. [Do mitral valve components have the same predictive value in percutaneous balloon mitral valvuloplasty? Doppler echocardiography study]. Arq Bras Cardiol 1991; 57:17-20. [PMID: 1823756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To evaluate the predictive value of mitral valve components in percutaneous balloon mitral valvuloplasty (PBMV). METHODS 53 patients undergoing PBMV were submitted to an echocardiographic analysis of mitral valve in order to note mobility, thickness, calcification of leaflets and subvalvar apparatus (SV). Mitral valve area (VA) before and after PBMV was obtained using continuous wave Doppler. Patients were divided in group 1 (VA enhance inferior to 50%) and 2 (VA enhance equal or superior to 50%) and subgroups A (VA post PBMV inferior to 1.5 sqcm) and B (VA post PBMV equal or superior to 1.5 sqcm). Correlations between the score of each component of mitral valve and the results were established. RESULTS Concerning to the total score, there was no significant difference between the groups and subgroups. Differences were significant when SV was analysed separately (p less than or equal to 0.001). VA average in patients with SV compromising grade 3 (1.28 +/- 0.26 sqcm) was inferior to those with grade 1 or 2 (p less than or equal to 0.001). CONCLUSION SV has a higher predictive value in the success of PBMV.
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Affiliation(s)
- C C Medeiros
- Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo
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Tarasoutchi F, Grinberg M, de Figueiredo Neto JA, de Assis RV, Cardoso LF, Parga Filho JR, Bellotti G. [Mitral valve aneurysm associated with mitral insufficiency in absence of aortic insufficiency]. Arq Bras Cardiol 1991; 56:231-4. [PMID: 1888291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Two 31 year old patients were interned with cardiac insufficiency (functional class III). Case number one infective endocarditis with mitral valve 8 months before. Case number two had previous rheumatic disease. Both had severe mitral insufficiency and were submitted to replacement of mitral valve. Surgical findings included the presence of aneurysm mitral leaflet (posterior in case one and both in case two). The pathologic study showed mitral valve prolapse and signs of previous endocarditis in case one and rheumatic lesion in the other case.
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Affiliation(s)
- F Tarasoutchi
- Instituto do Coração do Hospital das Clínicas, FMUSP
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Cardoso LF, Grinberg M, Rati MA, Medeiros CC, Tarasoutchi F, Pomerantzeff P, de Moraes AV, Ariê S, Bellotti G, Pileggi F. [Surgical intervention in patients undergoing a procedure for mitral valvoplasty by balloon catheterization]. Arq Bras Cardiol 1990; 55:109-12. [PMID: 2073169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To study the characteristics of patients undergoing catheter-balloon mitral valvoplasty (CBVM) procedure who needed surgical intervention after CBMV. PATIENTS AND METHODS One hundred and five patients submitted a CBMV were divided in to Group I (GI) of eighteen surgical patients and Group II (GII) of eighty-seven non-surgical patients. The following parameters were analyzed. 1) age; 2) sex; 3) mitral valve area (MVA) and mean transvalvular gradient (G) by echodopplercardiography (2D); 4) Character of CBMV; 6) Relation of time between CBMV and Surgery with surgical indication; 7) Surgical findings; 8) Surgical procedure and 9) Post-operative evolution. RESULTS Mean age of 34 (17-56) years old in GI and 33 (15-69) years old in GII; 2) Similar distribution of men and women in GI and GII; 3) Similar MVA and G in GI and GII; 4) 100% of elective character in GI and 94% in GII; 5) Transseptal via in 17 (94%) of GI and 87 (83%) of GII, retrograde arterial via in 1 (5.5%) of GI and in another (1%) of GII; 6) immediate: cardiac tamponade (28%); until 30 days: unsuccessful CBMV (39%); mitral insufficiency (MI) post-CBMV (11%), cardiac tamponade (5.5%), between 30 and 60 days: MI post-CBMV (22%), Mitral restenosis post-CBVM (5.5%); 7) Mitral stenosis (72%), MI post-CBVM (22%), hemopericardium (6%); 8) Mitral Commissurotomy (7), Mitral bioprosthesis implant (5), Commissurotomy plus Atrioseptoplasty (1), Mitral plasty (1), Pericardium drainage (1); 9) One (5.5%) death in immediate post-operative of the MI correction, 17 (94%) in functional class I/II (NYHA) 14.3 (8-27) months after surgery. CONCLUSION Age, Sex, VMA G and Urgency character were not discriminative factors in the formation of GI and GII. The procedures for CBVM didn't interfere with post-operative prognosis.
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Affiliation(s)
- L F Cardoso
- Instituto do Coração do Hospital das Clínicas, FMUSP
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Tarasoutchi F, Auler JO, Dallan LA, Cardoso LF, Terra Filho M, Grinberg M, Bellotti GM, Oliveira SA, Jatene A. [Bilateral diaphragmatic paralysis in the immediate postoperative period after cardiac surgery]. Arq Bras Cardiol 1990; 55:51-3. [PMID: 2073161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
A 56 years old man was submitted to an aortic replacement with mechanical prosthesis and to saphenous vein graft to the right coronary artery. He developed respiratory insufficiency after surgery which was finally related to bilateral diaphragmatic paralysis whose diagnosis was confirmed through thorax ultrasonography. The patient remained under ventilatory assistance with positive pressure for 75 days. The introduction of thorax ventilatory negative pressure (VNP), jacket type, allowed the tracheostomy closure. The patient gradually recovered his spontaneous breathing and was discharged after 90 days with instructions to use VNP at night. He returned to his normal professional activities, without auxiliary respiratory support, 40 days after his discharge.
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Affiliation(s)
- F Tarasoutchi
- Instituto do Coração do Hospital das Clínicas--FMUSP, São Paulo
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Grinberg M, Cardoso LF, Bellotti G. [Percutaneous balloon valvuloplasty in mitral stenosis. A change in the established therapeutic orientation?]. Arq Bras Cardiol 1989; 53:1-3. [PMID: 2619587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Arie S, Arato Gonçalves MT, Rati MA, Tarasoutchi F, Cardoso LF, Grinberg M, Bellotti G, Pileggi F. Balloon dilatation of a stenotic dura mater mitral bioprosthesis. Am Heart J 1989; 117:201-2. [PMID: 2911977 DOI: 10.1016/0002-8703(89)90681-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- S Arie
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
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Tarasoutchi F, Cardoso LF, Grinberg M, Parro Júniro A, Pomerantzeff P, Lavitola PL, Bellotti G, Jatene A, Pillegi F. [Tricuspid stenosis. Diagnostic peculiarities]. Arq Bras Cardiol 1988; 51:377-80. [PMID: 3255253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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46
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Medeiros CC, De Albuquerque AM, Avila WS, Cardoso LF, Martins TC, De Azevedo JG, Camarano GP, Ribeiro IG, Parga Filho JR, De Moraes AV. [Fetal echocardiography. Initial experience]. Arq Bras Cardiol 1988; 50:247-51. [PMID: 3228378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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47
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Tarasoutchi F, Grinberg M, Ferlante LS, Cardoso LF, Lavítola PDL, Rati M, Pomerantzeff P, Bellotti G, Jatene A, Pileggi F. [Relation between preoperative left ventricular function and postoperative course in aortic stenosis]. Arq Bras Cardiol 1987; 48:293-7. [PMID: 3446127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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