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Saraiva FA, Cerqueira RJ, Ferreira AF, Moreira R, Amorim MJ, Barros AS, Pinho P, Lourenco AP, Leite-Moreira AF. Off-pump versus on-pump coronary artery bypass grafting: a propensity score-matching analysis of safety and long-term results. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2250] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The role and the indications for using off-pump coronary artery bypass surgery (OPCAB), instead of the traditional on-pump (ONCAB), is still to be addressed.
Aim
To describe our centre experience and to compare 15-years survival and early safety outcomes between OPCAB and ONCAB.
Methods
Single-centre retrospective cohort including 9-years of isolated first CABG (2005–2013). Multi-vessel disease with at least 2 surgical grafts patients were considered and the first 50 surgeries of each surgeon with each technique were excluded to account for the learning curve effect. Emergent surgeries and on-pump beating heart procedures were also excluded. A propensity-score matching (PSM) analysis was performed to balance groups and both survival and early outcomes comparison was done within the matched cohort using Kaplan-Meier or Cox stratified and paired tests, respectively. The median follow-up was 9 years, maximum 15 years.
Results
From 3012 multi-vessel patients with at least 2 surgical grafts, 2503 were included at the main analysis: 1487 ONCAB and 1016 OPCAB. ONCAB patients presented more frequently 3-vessels disease and left ventricular dysfunction, but received similar number of grafts than OPCAB, who in turn, received more frequently multiple arterial grafts. The surgical completeness of revascularization (CR) was similar, but hybrid procedures were more frequent in OPCAB raising CR rate in this group. After PSM (646 pairs), both groups were similar regarding pre and peri-operative characteristics. The long-term survival was similar (HR stratified by pair: 1.02 (0.81–1.30), but OPCAB evidenced benefits at early term results including bleeding, postoperative atrial fibrillation and stroke incidence.
Conclusion
At our centre, OPCAB performed by experienced surgeons provides rates of complete revascularization and long-term survival similar to ONCAB. In-hospital results favoured OPCAB.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Universidade do Porto/FMUP; Social European Fund; FCT-Fundação para a Ciência e a Tecnologia
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Affiliation(s)
- F A Saraiva
- Faculty of Medicine University of Porto, Surgery and Physiology, Cardiovascular R&D Center, Porto, Portugal
| | - R J Cerqueira
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - A F Ferreira
- Faculty of Medicine University of Porto, Surgery and Physiology, Cardiovascular R&D Center, Porto, Portugal
| | - R Moreira
- Faculty of Medicine University of Porto, Surgery and Physiology, Cardiovascular R&D Center, Porto, Portugal
| | - M J Amorim
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - A S Barros
- Faculty of Medicine University of Porto, Surgery and Physiology, Cardiovascular R&D Center, Porto, Portugal
| | - P Pinho
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - A P Lourenco
- Faculty of Medicine University of Porto, Surgery and Physiology, Cardiovascular R&D Center, Porto, Portugal
| | - A F Leite-Moreira
- Faculty of Medicine University of Porto, Surgery and Physiology, Cardiovascular R&D Center, Porto, Portugal
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Moreira S, Saraiva FA, Cerqueira RJ, Melo R, Lourenco AP, Amorim MJ, Almeida J, Pinho P, Leite-Moreira AF. P3520Low vs. high-gradient severe aortic stenosis: clinical results and ventricular remodeling. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Moreira
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - F A Saraiva
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - R J Cerqueira
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - R Melo
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - A P Lourenco
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - M J Amorim
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - J Almeida
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - P Pinho
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - A F Leite-Moreira
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
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Ferreira AF, Saraiva FA, Cerqueira RJ, Moreira R, Amorim MJ, Pinho P, Lourenco AP, Moreira AL. P1243Postoperative atrial fibrillation after coronary artery bypass grafting surgery. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A F Ferreira
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - F A Saraiva
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - R J Cerqueira
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - R Moreira
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - M J Amorim
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - P Pinho
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - A P Lourenco
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - A L Moreira
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
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Saraiva FA, Cerqueira RJ, Amorim MJ, Gavina C, Pinho P, Lourenco AP, Leite-Moreira AF. 3274Prognostic value of cardiac troponin after coronary artery bypass grafting. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- F.-A Saraiva
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - R J Cerqueira
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - M J Amorim
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - C Gavina
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - P Pinho
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - A P Lourenco
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - A F Leite-Moreira
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
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Saraiva FA, Girerd N, Cerqueira RJ, Ferreira JP, Vilas-Boas N, Pinho P, Barros AS, Amorim MJ, Lourenco AP, Leite-Moreira AF. P4567Do women benefit from bilateral internal mammary artery bypass grafting? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F.-A Saraiva
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - N Girerd
- University of Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Nancy, France
| | - R J Cerqueira
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - J P Ferreira
- University of Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Nancy, France
| | - N Vilas-Boas
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - P Pinho
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - A S Barros
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - M J Amorim
- Sao Joao Hospital, Cardiothoracic Surgery, Porto, Portugal
| | - A P Lourenco
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
| | - A F Leite-Moreira
- Faculty of Medicine University of Porto, Surgery and Physiology, Porto, Portugal
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Colli A, DiBartolomeo R, Mangino D, Pardini A, Agrifoglio M, Gherli T, Amorim MJ, Gerosa G. 070-I * TRIBECA STUDY: (TRI)FECTA (B)IOPROSTHESES (E)VALUATION VERSUS (C)ARPENTIER MAGNA-EASE IN (A)ORTIC POSITION. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.70] [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: 11/13/2022] Open
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Amorim MJ, Sousa JP, Nogueira AJA, Soares AMVM. Bioavailability and toxicokinetics of (14)C-lindane (gamma-HCH) in the enchytraeid Enchytraeus albidus in two soil types: the aging effect. Arch Environ Contam Toxicol 2002; 43:221-228. [PMID: 12115048 DOI: 10.1007/s00244-002-1162-y] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Enchytraeids are important members of the soil fauna living in the true soil layer instead of the humus like most earthworms, resulting in a different interaction with chemicals in soil. It is well known that the detectable concentration of contaminants in the soil cannot fully predict a biological effect; therefore bioaccumulation studies are of great importance. In this study the bioaccumulation pattern of the pesticide lindane ([(14)C]gamma-HCH) in Enchytraeus albidus was analyzed in two different soil types, an artificial Organisation for Economic Co-operation and Development (OECD) soil and a natural agricultural soil. The effect of aging on bioaccumulation and bioavailability was also analyzed. Aging experiments consisted of having the same procedures at different times after soil contamination: Immediately after contamination and 1, 2, 4, 6, and 10 months after that. Major differences occurred within the first month. Considering the overall data (10 months), it is possible to observe that in OECD soil there is a correlation between concentration in soil and in the organisms, but that was not observed for the natural soil. The decrease patterns for concentration in soil and in watery soil extracts were different: monophasic behavior occurred in OECD soil, and a biphasic pattern was measured in natural soil. It was observed that the bioavailable ( i.e., water-extractable) fraction of lindane in the natural soil decreased faster than the total soil concentration. In natural soil the decrease of concentration appeared faster than in OECD soil; this may be related to the lower amount of organic matter content.
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Affiliation(s)
- M J Amorim
- Departamento de Biologia, Universidade de Aveiro, 3810-193 Aveiro, Portugal.
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Abstract
Several different peptides and proteins, such as the pancreatic trypsin inhibitor, growth factors and trefoil peptides, are known to play important roles in maintaining the structure and function of the gastrointestinal wall. With the advent of recombinant biotechnology, it has become feasible to test some of these proteins as therapeutics in different inflammatory conditions of the intestines. However, the harsh pH and enzymatic conditions of the stomach can lead to their inactivation. This research was aimed at the development of particulate, gastric-resistant pharmaceutical forms, incorporating those bioactive molecules. Mixtures of proteins in powder form were coated with cellulose acetate phthalate, Eudragit S100 or Eudragit RS PO, using simple preparation techniques based on single emulsion/solvent evaporation. Using aprotinin as a model drug, it was found that these procedures were effective in microencapsulating protein in the solid form without affecting its biological activity. Furthermore, and in particular with the first two polymers above, particles showed adequate in vitro release patterns for the applications envisioned.
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Affiliation(s)
- M J Amorim
- Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Dr António Bernardino de Almeida, 4200-072 Porto, Portugal
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Abstract
The authors describe an acquired atrioventricular septal defect that has resulted from a blunt chest trauma. Besides being an uncommon traumatic heart injury, this case has the particularities of the non-involvement of other adjacent anatomical structures and the long delay between the accident and the occurrence of the myocardial rupture.
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MESH Headings
- Adolescent
- Cardiac Catheterization
- Cardiac Surgical Procedures
- Echocardiography, Transesophageal
- Heart Injuries/complications
- Heart Injuries/diagnosis
- Heart Injuries/surgery
- Heart Septal Defects, Atrial/diagnosis
- Heart Septal Defects, Atrial/etiology
- Heart Septal Defects, Atrial/surgery
- Heart Septal Defects, Ventricular/diagnosis
- Heart Septal Defects, Ventricular/etiology
- Heart Septal Defects, Ventricular/surgery
- Heart Septum/injuries
- Heart Septum/surgery
- Humans
- Male
- Tomography, X-Ray Computed
- Wounds, Nonpenetrating/complications
- Wounds, Nonpenetrating/diagnosis
- Wounds, Nonpenetrating/surgery
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Affiliation(s)
- M J Amorim
- Center of Thoracic Surgery, S. João Hospital, Oporto, Portugal
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Loures DR, Brofman PR, de Carvalho RG, Ribeiro EJ, Pereira MA, Rossi PR, Almeida RM, Amorim MJ, Krichenko A, Bueno RL. [Multiple valve replacements]. Arq Bras Cardiol 1986; 47:37-40. [PMID: 3579642] [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: 01/06/2023] Open
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