RESUMEN
Apresentamos o caso debutante na América Latina de reparos transcateteres edge- to-edge nas valvas mitral e tricúspide em um único procedimento em paciente de alto risco para cirurgia. A paciente evoluía com insuficiência cardíaca e limitações em suas atividades diárias quando foi submetida ao procedimento, no qual foram realizados os reparos transcateteres das valvas mitral e tricúspide. Aos 6 meses de evolução, estava assintomática e realizando suas atividades diárias. Debatemos as recomendações mais atualizadas sobre a terapia transcateter para coexistência dessas doenças valvares, assim como expomos as lacunas no conhecimento.
We present the first case in Latin America of transcatheter edge-to-edge mitral and tricuspid valve repair in a single procedure, in a patient at high risk for surgery. The patient progressed to heart failure and limitation in her daily living activities when she was submitted to transcatheter mitral and tricuspid valve repair. Six months later, she was asymptomatic and performing her daily living activities. We discuss the most updated recommendations for transcatheter repair when both valvar conditions coexist, and show the knowledge gaps.
RESUMEN
Tricuspid regurgitation progression after left-sided surgery and its correlation with worse postoperative and long-term outcomes is a highly debated topic. Some studies support prophylactic tricuspid repair based on annulus dimension rather than on tricuspid regurgitation severity only, while others are in favor of a more conservative management. Furthermore, the advent of percutaneous tricuspid valve intervention and its promising short-term outcomes has introduced a new factor to be taken into account on the tricuspid intervention decision-making process. We present a review on prophylactic tricuspid valve intervention, covering currently available data, as well as the role of transcatheter tricuspid valve intervention in this equation.
RESUMEN
In this study, we evaluated the toxic and genotoxic potential of zinc oxide nanoparticles (ZnO NPs) of 20 nm and the mutagenic potential of these ZnO NPs as well as that of an amorphous ZnO. Toxicity was assessed by XTT colorimetric assay. ZnO NPs were toxic at concentrations equal to or higher than 240.0 µM. Genotoxicity was assessed by in vitro Cytokinesis Block Micronucleus Assay (CBMN) in V79 cells. ZnO NPs were genotoxic at 120.0 µM. The mutagenic potential of amorphous ZnO and the ZnO NPs was assayed using the wing Somatic Mutation and Recombination Test (SMART) of Drosophila melanogaster. In the Standard cross, the amorphous ZnO and ZnO NPs were not mutagenic. Nevertheless, Marker trans-heterozygous individuals from the High bioactivation cross treated with amorphous ZnO (6.25 mM) and ZnO NPs (12.50 mM) displayed a significant increased number of mutant spots when compared with the negative control. In conclusion, the results were not dose related and indicate that only higher concentrations of ZnO NPs were toxic and able to induce genotoxicity in V79 cells. The increase in mutant spots observed in D. melanogaster was generated due to mitotic recombination, rather than mutational events.
