Navegando por Palavras-chave "Implante de prótese vascular"

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    Implante de tubo valvulado bioprótese stentless em posição aórtica: estudo experimental em ovinos
    (Sociedade Brasileira de Cirurgia Cardiovascular, 2002-03-01) Santos, Paulo César [UNIFESP]; Gerola, Luís Roberto [UNIFESP]; Pessa, Clodualdo J.N. [UNIFESP]; Branco, João Nelson Rodrigues [UNIFESP]; Casagrande, Ivan Sergio Joviano; Buffolo, Enio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Labcor Centro de Pesquisa
    INTRODUCTION: Often, studies on aortic prosthetic valves analyze their performance not at the primitive position, but using tricuspid and mitral ones or inserting it in the descending aortic area. Taking that into account, it would be relevant to observe results in those studies in which the conclusions are based on their original implantation. MATERIAL AND METHODS: Thirty young sheep, 28 males and 2 females, were operated on. Ages ranged 4.4 to 6.3 months and weights 25 to 37 Kg. Extra corporeal circulation (ECC) was applied to all the animals, always guided by the conventional criteria, that is to say, the arterial cannula was inserted in the thoracic aorta just past the arterious ducts and the venous cannulae, a single one, was placed in the right atrium. The operation was performed according to the principle of moderately low body temperature- 29ºC- and cold cristalloid cardioplegia, in the aortic root, to induce; but otherwise was utilized blood to the maintenance. Following with the technique proposed, the aortic valve of the animal heart was completely excised and finally implanted the valved tube stentless, not forgetting the refixation of the coronary main. The sheep were kept in clinical and laboratorial observation during thirty days in what was included a echocardiogram in the end. RESULTS: The results demonstrated 8 intraoperatory deaths (26.6%), and 6 during the following (27.7%). The mean time of ECC was 98 minutes. The dimension of the majority prothetics valves were 21 and 23. Only two valves evoluted with mild insufficiency, none denoted evidences of the endocarditis neither of leaflets perfuration, the mean fraction of ejection was 74%, the left ventricle had its wall preserved in all cases. CONCLUSION: This experimental model can certainly reproduce nearly the reality, confirming good parameters of prothetics stentless evaluation in the aortic position. And the sheep declared itself to be pleasant, which helps us its control during the whole study.
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    Tratamento endovascular nos aneurismas verdadeiros e na dissecção aórtica do tipo B: fase intra-hospitalar, seguimento de médio prazo e uma reflexão sobre seleção de pacientes
    (Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista - SBHCI, 2009-01-01) Alves, Claudia Maria Rodrigues [UNIFESP]; Fonseca, José Honório de Almeida Palma da [UNIFESP]; Souza, José Augusto Marcondes de [UNIFESP]; Kim, Hyung Chun [UNIFESP]; Esher, Guilherme [UNIFESP]; Buffolo, Enio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: Endovascular treatment of thoracic aortic diseases is a well established procedure although late results and differences among demographic groups are unknown. METHOD: From December/1996 to December/2004, 92 patients with true aneurysms or penetrating ulcers (G1) and 130 patients with type B dissection or intramural hematoma (G2) were submitted to primary or complementary endovascular treatment. Clinical success was defined as sustained technical success without death or surgical conversion. Late failure was defined as death of any cause, surgical conversion or re-intervention. RESULTS: G1 mean age was 65 ± 11 years and 56 ± 11 years in G2 (P < 0.0001). A high frequency of previous stroke was observed in G1 (8.7% vs. 0; P = 0.0007). Clinical success was observed in 71% in G1 and 84% in G2 (P = 0.02) with higher in-hospital death rates in G1 (14% vs. 4.6%; P = 0.01). Neurologic complications were similar (6.5% vs. 3%, respectively; P = 0.32), with a mild prevalence of paraplegia in G1 (3.2% vs. 0.8%; P = 0.3). Late failure rates of 60% were observed in G1 and 43% in G2 (P = 0.09) at 33 ± 27 months of follow-up. CONCLUSIONS: Endovascular treatment in patients with true aneurysms may be slightly inferior to those achieved in patients with type B dissection. This might be due to demographic differences between groups and technical difficulties related to aortic anatomy. The knowledge and understanding of these peculiarities enables better patient selection for the procedure resulting in decreased mortality rates.