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1.
Braz J Cardiovasc Surg ; 34(5): 525-534, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31719006

RESUMO

OBJECTIVE: To evaluate the factors impacting on the conversion to sinus rhythm and on the postoperative rhythm findings in the six-month follow-up period of a mitral valve surgery combined with cryoablation Cox-Maze III procedure, in patients with atrial fibrillation. METHODS: In this study, we evaluated 80 patients who underwent structural valve disease surgery in combination with cryoablation. Indications for the surgical procedures were determined in the patients according to the presence of rheumatic or non-rheumatic structural disorders in the mitral valve as evaluated by echocardiography. Cox-Maze III procedure and left atrial appendix closure were applied. RESULTS: The results of receiver operating characteristics analysis indicated that the rate of conversion to the sinus rhythm was significantly higher in patients with left atrial diameters ≥ 45.5 mm and with ejection fraction (EF) ≥ 48.5%. However, the statistical differences disappeared in the sixth month. Thromboembolic (TE) events were seen only in three patients in the early period and no more TE events occurred in the six-month follow-up period. CONCLUSION: The EF and the preoperative left atrial diameter were determined to be the factors impacting on the conversion to sinus rhythm in patients who underwent mitral valve surgery in combination with cryoablation. Mitral valve surgery in combination with ablation for atrial fibrillation does not affect mortality and morbidity in the experienced health centers; however, it remains controversial whether it will provide additional health benefits to the patients compared to those who underwent only mitral valve surgery.


Assuntos
Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/cirurgia , Criocirurgia/métodos , Frequência Cardíaca/fisiologia , Implante de Prótese de Valva Cardíaca/métodos , Valva Mitral/cirurgia , Adulto , Fibrilação Atrial/prevenção & controle , Eletrocardiografia , Feminino , Átrios do Coração/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/fisiopatologia , Período Pós-Operatório , Período Pré-Operatório , Valores de Referência , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Fatores de Tempo , Resultado do Tratamento
2.
Rev. bras. cir. cardiovasc ; 34(5): 525-534, Sept.-Oct. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1042053

RESUMO

Abstract Objective: To evaluate the factors impacting on the conversion to sinus rhythm and on the postoperative rhythm findings in the six-month follow-up period of a mitral valve surgery combined with cryoablation Cox-Maze III procedure, in patients with atrial fibrillation. Methods: In this study, we evaluated 80 patients who underwent structural valve disease surgery in combination with cryoablation. Indications for the surgical procedures were determined in the patients according to the presence of rheumatic or non-rheumatic structural disorders in the mitral valve as evaluated by echocardiography. Cox-Maze III procedure and left atrial appendix closure were applied. Results: The results of receiver operating characteristics analysis indicated that the rate of conversion to the sinus rhythm was significantly higher in patients with left atrial diameters ≥ 45.5 mm and with ejection fraction (EF) ≥ 48.5%. However, the statistical differences disappeared in the sixth month. Thromboembolic (TE) events were seen only in three patients in the early period and no more TE events occurred in the six-month follow-up period. Conclusion: The EF and the preoperative left atrial diameter were determined to be the factors impacting on the conversion to sinus rhythm in patients who underwent mitral valve surgery in combination with cryoablation. Mitral valve surgery in combination with ablation for atrial fibrillation does not affect mortality and morbidity in the experienced health centers; however, it remains controversial whether it will provide additional health benefits to the patients compared to those who underwent only mitral valve surgery.

3.
Asian Cardiovasc Thorac Ann ; 27(4): 251-255, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30818961

RESUMO

BACKGROUND: Recently, the role of inflammation in coronary artery disease and the association of inflammatory biomarkers with adverse outcomes have been investigated in many studies. We investigated the relationship between high serum mobility group box 1 protein levels and established risk factors for coronary artery disease. METHODS: Fifty-five patients who presented to our Cardiovascular Surgery Clinic and subsequently underwent coronary artery bypass surgery for coronary artery disease and 50 healthy subjects presenting to the cardiology outpatient clinic without any cardiovascular problem were included in the study. The mean age was 61.47 ± 9.38 years for patients and 58.20 ± 10.15 years for controls. RESULTS: There was no statistically significant difference between groups with respect to age or sex. Family history of coronary artery disease, aspirin use, hypertension, and type 2 diabetes were significantly more prevalent in the patient group versus the control group. A significant difference was found between patients and healthy controls with respect to high mobility group box 1 protein levels ( p = 0.001). CONCLUSIONS: Serum high mobility group box 1 protein was significantly increased in patients with coronary artery disease in comparison to healthy subjects. No associations were found between high mobility group box 1 protein level and certain risk factors for coronary artery disease.


Assuntos
Doença da Artéria Coronariana/sangue , Proteína HMGB1/sangue , Idoso , Biomarcadores/sangue , Estudos de Casos e Controles , Angiografia Coronária , Ponte de Artéria Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Regulação para Cima
4.
Vasc Endovascular Surg ; 50(1): 47-51, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26767802

RESUMO

PURPOSE: To compare endovenous laser ablation (EVLA) and radiofrequency venous ablation (RFA) in different legs in the same patients with venous insufficiency. METHODS: Sixty patients with bilateral saphenous vein insufficiency were included. Endovenous laser ablation or RFA was applied to one of the patient's legs and the remaining procedure, RFA or EVLA, to the other leg. RESULTS: Minor complications in EVLA and RFA were hyperemia at 20.7% and 31.0%, ecchymosis at 31.0% and 51.7% and edema at 27.6% and 65.5%, respectively. The rate of recanalization was 6.8% in the RFA group. No recanalization was observed in the EVLA group. The level of patients satisfied with EVLA was 51.7%, compared to 31.0% for RFA, while 17.2% of patients were satisfied with both the procedures. Times to return to daily activity were 0.9 days in the EVLA group and 1.3 days in the RFA group. CONCLUSION: The EVLA procedure may be superior to RFA in certain respects.


Assuntos
Ablação por Cateter , Terapia a Laser , Veia Safena/cirurgia , Varizes/cirurgia , Insuficiência Venosa/cirurgia , Adulto , Ablação por Cateter/efeitos adversos , Feminino , Humanos , Terapia a Laser/efeitos adversos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Recuperação de Função Fisiológica , Fatores de Risco , Veia Safena/diagnóstico por imagem , Fatores de Tempo , Resultado do Tratamento , Varizes/diagnóstico por imagem , Insuficiência Venosa/diagnóstico por imagem
5.
Anadolu Kardiyol Derg ; 11(3): 237-43, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21466993

RESUMO

OBJECTIVE: The aim of this study was to investigate whether bacterial and viral infectious agents can be demonstrated in atherosclerotic lesions of patients with coronary artery disease (CAD) as well as in stenotic aortic and mitral valves from patients undergoing heart valve replacement. METHODS: In this cross-sectional study, the presence of Chlamydophila pneumoniae, Mycoplasma pneumoniae, Cytomegalovirus (CMV), and Epstein-Barr virus (EBV) was investigated by polymerase chain reaction in atherosclerotic and non-atherosclerotic vascular samples taken from patients undergoing coronary artery bypass surgery due to CAD, and from patients undergoing aortic (AVR) and/or mitral valve replacement (MVR) secondary to valvular stenosis. For statistical analyses ANOVA, Chi-square test or Fisher's exact test were used. RESULTS: The presence of C. pneumoniae, M. pneumoniae, and CMV in atherosclerotic versus non-atherosclerotic samples was as follows: 30% vs. 16.7% (p=0.222), 6.7% vs. 3.3% (p=0.554), and 10% vs. 0% (p=0.076), respectively. In valve group, same pathogens were present in AVR and MVR patients as follows: 24.2% vs. 21.4% (p=0.773), 9.1% vs. 7.1% (p=0.758), and 21.2% vs. 11.9% (p=0.275). EBV DNA was not detected in any of vascular specimens, but in one (3%) patient with AVR (p=0.256). CONCLUSION: Our results suggest that C. pneumoniae, M. pneumoniae, and CMV are present with similar frequency both in atherosclerotic and non-atherosclerotic vessels. We conclude that although non-atherosclerotic, vascular samples of CAD patients are invaded by infectious agents as like as atherosclerotic vessels. We further conclude that C. pneumoniae, M. pneumoniae, and CMV are present in stenotic aortic and mitral valves and atherosclerotic tissues with similar frequency indicating that atherosclerosis and valvular stenosis might share a common etiology related to infection.


Assuntos
Chlamydophila pneumoniae/isolamento & purificação , Doença da Artéria Coronariana/microbiologia , Citomegalovirus/isolamento & purificação , Herpesvirus Humano 4/isolamento & purificação , Mycoplasma pneumoniae/isolamento & purificação , Adolescente , Adulto , Idoso , Valva Aórtica/microbiologia , Valva Aórtica/virologia , Estenose da Valva Aórtica/etiologia , Estenose da Valva Aórtica/microbiologia , Estenose da Valva Aórtica/virologia , Calcinose/complicações , Calcinose/microbiologia , Calcinose/virologia , Infecções por Chlamydophila/complicações , Chlamydophila pneumoniae/genética , Doença da Artéria Coronariana/virologia , Vasos Coronários/microbiologia , Vasos Coronários/patologia , Vasos Coronários/virologia , Citomegalovirus/genética , Infecções por Citomegalovirus/complicações , Infecções por Vírus Epstein-Barr/complicações , Feminino , Herpesvirus Humano 4/genética , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/microbiologia , Valva Mitral/virologia , Estenose da Valva Mitral/etiologia , Estenose da Valva Mitral/microbiologia , Estenose da Valva Mitral/virologia , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/complicações , Reação em Cadeia da Polimerase , Cardiopatia Reumática/complicações , Cardiopatia Reumática/microbiologia , Cardiopatia Reumática/virologia , Adulto Jovem
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