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1.
Braz J Cardiovasc Surg ; 32(3): 156-161, 2017 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28832792

RESUMO

Objective:: To present the results of a new experimental device developed to facilitate the transapical access in endovascular treatment of structural heart diseases. It aims to reduce the risk of bleeding and complications in this type of access and demonstrate the device as a safe, fast and effective alternative. Methods:: CorPoint is composed of three parts: introducer, base with coiled spring, and closing capsule. By rotating movements, the spring is introduced into the myocardium and progressively approaches the base to the surface of the heart. Guidewires and catheters are inserted through the hollow central part and, at the end of the procedure, the capsule is screwed over the base, therefore stopping any bleeding. Results:: The device was implanted in 15 pigs, weighing 60 kg each, through an anterolateral thoracotomy, while catheters were introduced and guided by fluoroscopy. All animals had minimal bleeding; introducers with diameter up to 22 Fr were used and various catheters and guidewires were easily handled. After finishing the procedure, the closing capsule was attached and no bleeding was observed at the site. Conclusion:: This new device has proved effective, fast and secure for the transapical access. This shows great potential for use, especially by ensuring an easier and direct access to the mitral and aortic valves; the shortest distance to be traveled by catheters; access to the ascending and descending aorta; decreased bleeding complications; decreased surgical time; and the possibility of allowing the technique to evolve and become totally percutaneous.


Assuntos
Valva Aórtica/cirurgia , Cateterismo Cardíaco/instrumentação , Desenho de Equipamento/métodos , Ventrículos do Coração/cirurgia , Valva Mitral/cirurgia , Substituição da Valva Aórtica Transcateter/instrumentação , Animais , Valva Aórtica/patologia , Perda Sanguínea Cirúrgica , Cateterismo Cardíaco/métodos , Feminino , Ventrículos do Coração/patologia , Masculino , Valva Mitral/patologia , Modelos Animais , Reprodutibilidade dos Testes , Fatores de Risco , Suínos , Fatores de Tempo , Substituição da Valva Aórtica Transcateter/métodos
2.
Rev. bras. cir. cardiovasc ; 32(3): 156-161, May-June 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-897908

RESUMO

Abstract Objective: To present the results of a new experimental device developed to facilitate the transapical access in endovascular treatment of structural heart diseases. It aims to reduce the risk of bleeding and complications in this type of access and demonstrate the device as a safe, fast and effective alternative. Methods: CorPoint is composed of three parts: introducer, base with coiled spring, and closing capsule. By rotating movements, the spring is introduced into the myocardium and progressively approaches the base to the surface of the heart. Guidewires and catheters are inserted through the hollow central part and, at the end of the procedure, the capsule is screwed over the base, therefore stopping any bleeding. Results: The device was implanted in 15 pigs, weighing 60 kg each, through an anterolateral thoracotomy, while catheters were introduced and guided by fluoroscopy. All animals had minimal bleeding; introducers with diameter up to 22 Fr were used and various catheters and guidewires were easily handled. After finishing the procedure, the closing capsule was attached and no bleeding was observed at the site. Conclusion: This new device has proved effective, fast and secure for the transapical access. This shows great potential for use, especially by ensuring an easier and direct access to the mitral and aortic valves; the shortest distance to be traveled by catheters; access to the ascending and descending aorta; decreased bleeding complications; decreased surgical time; and the possibility of allowing the technique to evolve and become totally percutaneous.

3.
Rev. bras. cir. cardiovasc ; 25(4): 527-533, out.-dez. 2010. ilus, tab
Artigo em Inglês | LILACS | ID: lil-574749

RESUMO

OBJECTIVE: The aim of the present study was to assess the behavior of cardiovascular variables during an in-hospital cardiovascular rehabilitation program in patients following myocardial revascularization surgery. METHODS: A total of 14 patients (mean age: 55.4 ± 6.4 years, 78.6 percent male) participated in the study, all of whom had a previous diagnosis of coronary insufficiency and indication for elective surgery. The protocol consisted of a group of low-impact (2-3 METs) upper/lower extremity and walking exercises performed both pre and post-operatively (3rd and 4th days). The following variables were evaluated at rest and following the exercise program: heart rate (HR, bpm); systolic arterial pressure (SAP, mmHg); diastolic arterial pressure (DAP, mmHg); mean arterial pressure (MAP, mmHg); double product (DPr, bpm/mmHg); and the Rating of Perceived Exertion (RPE) scale. RESULTS: There was a significant increase in HR and DPr in the individual analysis (P<0.001) as well as in between days (P<0.001 for HR and P<0.05 for DPr), but only attaining maximal values that were < 30 percent of predicted. Moreover, a negative correlation was found between the RPE scale and both SAP and MAP. CONCLUSION: The exercises proposed proved to be safe with the change in key physiologic variables throughout the experiment below recommended values for the hospitalization phase. Furthermore, the RPE scale appears to have a correlation with some hemodynamic variables and thus may be a useful tool for this group of patients.


OBJETIVO: O objetivo do presente estudo foi avaliar o comportamento das variáveis cardiovasculares durante um programa de reabilitação cardiovascular hospitalar em pacientes submetidos à cirurgia de revascularização do miocárdio. MÉTODOS: Um total de 14 pacientes (idade média: 55,4 ± 6,4 anos, 78,6 por cento do sexo masculino) participaram do estudo, todos apresentavam diagnóstico prévio de insuficiência coronariana e indicação de cirurgia eletiva. O protocolo consistiu de um grupo de exercícios de baixo impacto (2-3 METs) para extremidade superior e inferior e exercícios de caminhada realizados no pré e pós-operatório (3 e 4 dias). As seguintes variáveis foram avaliadas em repouso e após o programa de exercício: frequência cardíaca (FC, bpm), pressão arterial sistólica (PAS, mmHg), pressão arterial diastólica (PAD, mmHg), pressão arterial média (MAP,mmHg), duplo produto (DPr, bpm/mmHg) e escala de Índice de Percepção de Esforço (IPE). RESULTADOS: Houve aumento significativo da FC e DPr na análise individual (P <0,001), bem como na análise entre os dias de avaliação (P <0,001 para FC e P <0,05 para DPr), mas apenas atingindo valores máximos que foram < 30 por cento do previsto. Além disso, ocorreu correlação negativa entre a escala IPE e SAP e MAP. CONCLUSÃO: Os exercícios propostos mostraram-se seguros com a mudança de variáveis fisiológicas fundamentais em todo o experimento abaixo do valor recomendado para a fase de hospitalização. Além disso, a escala percepção de esforço parece ter correlação com algumas variáveis hemodinâmicas e, portanto, pode ser uma ferramenta útil para este grupo de pacientes.


Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pressão Sanguínea/fisiologia , Ponte de Artéria Coronária , Doença da Artéria Coronariana/reabilitação , Exercício/fisiologia , Frequência Cardíaca/fisiologia , Análise de Variância , Doença da Artéria Coronariana/cirurgia , Estatísticas não Paramétricas
4.
Rev. bras. cardiol. invasiva ; 17(1): 46-51, jan.-mar. 2009. ilus, tab
Artigo em Português | LILACS | ID: lil-521583

RESUMO

O tratamento endovascular das doenças da aorta é procedimento estabelecido, mas com resultados tardios e diferenças nos resultados entre diferentes grupos demográficos ainda desconhecidos. No período de dezembro de 1996 a dezembro de 2004, 92 pacientes com aneurismas verdadeiros ou úlcera penetrante de aorta em posição torácica (G!) e 130 pacientes com dissecção aórtica do tipo B ou hematoma intramural...


Assuntos
Humanos , Masculino , Idoso , Aneurisma Aórtico/patologia , Implante de Prótese de Valva Cardíaca/métodos , Stents , Seguimentos
6.
Arq. bras. cardiol ; 70(6): 389-392, Jun. 1998.
Artigo em Português | LILACS | ID: lil-320316

RESUMO

PURPOSE: We present four cases of dissection of the thoracic descending aorta that underwent treatment with an auto expandable dácron-covered stent. METHODS: The stent was deployed through the femoral artery in the hemodynamic laboratory after sedation, local anesthesia in both inguinal areas and systemic heparinization. The catheter with the stent was introduced through a cutdown in the left femoral artery until the area in the thoracic aorta with the previously diagnosed tear. RESULTS: The stent was expanded with immediate occlusion of the false lumen. The whole procedure took 90 minutes and the patients were discharged without complications. CONCLUSION: Stent utilization is an important step to improve treatment results in type B aortic dissection.


Assuntos
Humanos , Pessoa de Meia-Idade , Aneurisma da Aorta Torácica/cirurgia , Aneurisma Dissecante , Stents , Doença Aguda , Idoso de 80 Anos ou mais , Aneurisma da Aorta Torácica , Aneurisma Dissecante , Artéria Femoral
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