Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 38
Filtrar
6.
Arq Bras Cardiol ; 115(5): 1006-1043, 2020 Nov.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33295473
8.
Hajjar, Ludhmila Abrahão; Costa, Isabela Bispo Santos da Silva da; Lopes, Marcelo Antônio Cartaxo Queiroga; Hoff, Paulo Marcelo Gehm; Diz, Maria Del Pilar Estevez; Fonseca, Silvia Moulin Ribeiro; Bittar, Cristina Salvadori; Rehder, Marília Harumi Higuchi dos Santos; Rizk, Stephanie Itala; Almeida, Dirceu Rodrigues; Fernandes, Gustavo dos Santos; Beck-da-Silva, Luís; Campos, Carlos Augusto Homem de Magalhães; Montera, Marcelo Westerlund; Alves, Sílvia Marinho Martins; Fukushima, Júlia Tizue; Santos, Maria Verônica Câmara dos; Negrão, Carlos Eduardo; Silva, Thiago Liguori Feliciano da; Ferreira, Silvia Moreira Ayub; Malachias, Marcus Vinicius Bolivar; Moreira, Maria da Consolação Vieira; Valente Neto, Manuel Maria Ramos; Fonseca, Veronica Cristina Quiroga; Soeiro, Maria Carolina Feres de Almeida; Alves, Juliana Barbosa Sobral; Silva, Carolina Maria Pinto Domingues Carvalho; Sbano, João; Pavanello, Ricardo; Pinto, Ibraim Masciarelli F; Simão, Antônio Felipe; Dracoulakis, Marianna Deway Andrade; Hoff, Ana Oliveira; Assunção, Bruna Morhy Borges Leal; Novis, Yana; Testa, Laura; Alencar Filho, Aristóteles Comte de; Cruz, Cecília Beatriz Bittencourt Viana; Pereira, Juliana; Garcia, Diego Ribeiro; Nomura, Cesar Higa; Rochitte, Carlos Eduardo; Macedo, Ariane Vieira Scarlatelli; Marcatti, Patricia Tavares Felipe; Mathias Junior, Wilson; Wiermann, Evanius Garcia; Val, Renata do; Freitas, Helano; Coutinho, Anelisa; Mathias, Clarissa Maria de Cerqueira; Vieira, Fernando Meton de Alencar Camara; Sasse, André Deeke; Rocha, Vanderson; Ramires, José Antônio Franchini; Kalil Filho, Roberto.
Arq. bras. cardiol ; 115(5): 1006-1043, nov. 2020. tab, graf
Artigo em Português | LILACS, Sec. Est. Saúde SP, CONASS, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1142267
9.
Heart ; 106(24): 1898-1905, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33060261

RESUMO

INTRODUCTION: During the COVID-19 pandemic, excess mortality has been reported, while hospitalisations for acute cardiovascular events reduced. Brazil is the second country with more deaths due to COVID-19. We aimed to evaluate excess cardiovascular mortality during COVID-19 pandemic in 6 Brazilian capital cities. METHODS: Using the Civil Registry public database, we evaluated total and cardiovascular excess deaths, further stratified in specified cardiovascular deaths (acute coronary syndromes and stroke) and unspecified cardiovascular deaths in the 6 Brazilian cities with greater number of COVID-19 deaths (São Paulo, Rio de Janeiro, Fortaleza, Recife, Belém, Manaus). We compared observed with expected deaths from epidemiological weeks 12-22 of 2020. We also compared the number of hospital and home deaths during the period. RESULTS: There were 65 449 deaths and 17 877 COVID-19 deaths in the studied period and cities for 2020. Cardiovascular mortality increased in most cities, with greater magnitude in the Northern capitals. However, while there was a reduction in specified cardiovascular deaths in the most cities, the Northern capitals showed an increase of these events. For unspecified cardiovascular deaths, there was a marked increase in all cities, which strongly correlated to the rise in home deaths (r=0.86, p=0.01). CONCLUSION: Excess cardiovascular mortality was greater in the less developed cities, possibly associated with healthcare collapse. Specified cardiovascular deaths decreased in the most developed cities, in parallel with an increase in unspecified cardiovascular and home deaths, presumably as a result of misdiagnosis. Conversely, specified cardiovascular deaths increased in cities with a healthcare collapse.

13.
Arq. bras. cardiol ; 115(3): 515-524, out. 2020. tab, graf
Artigo em Português | LILACS-Express | LILACS, Sec. Est. Saúde SP | ID: biblio-1131307

RESUMO

Resumo Fundamento A intervenção percutânea em pacientes com disfunção de prótese biológica mitral apresenta-se como uma alternativa ao tratamento cirúrgico convencional. Objetivo Relatar a primeira experiência brasileira de implante transcateter de bioprótese valve-in-valve mitral via transeptal (TMVIV-via transeptal). Métodos Foram incluídos pacientes portadores de disfunção de bioprótese cirúrgica submetidos ao TMVIV-transeptal em 12 hospitais brasileiros. Foram considerados estatisticamente significativos valores de p<0,05. Resultados Entre junho/2016 e fevereiro/2019, 17 pacientes foram submetidos ao TMVIV-via transeptal. A mediana de idade foi 77 anos (IIQ,70-82), a mediana do escore STS-PROM foi 8,7% (IIQ,7,2-17,8). Todos os pacientes tinham sintomas limitantes de insuficiência cardíaca (CF≥III), tendo 5 (29,4%) sido submetidos a mais de uma toracotomia prévia. Obteve-se sucesso do TMVIV-via transeptal em todos os pacientes. A avaliação ecocardiográfica demonstrou redução significativa do gradiente médio (pré-intervenção, 12±3,8 mmHg; pós-intervenção, 5,3±2,6 mmHg; p<0,001), assim como aumento da área valvar mitral (pré-intervenção, 1,06±0,59 cm2; pós-intervenção, 2,18±0,36 cm2; p<0,001) sustentados em 30 dias. Houve redução significativa e imediata da pressão sistólica de artéria pulmonar, com redução adicional em 30 dias (pré-intervenção, 68,9±16,4 mmHg; pós-intervenção, 57,7±16,5 mmHg; 30 dias, 50,9±18,7 mmHg; p<0,001). Durante o seguimento, com mediana de 162 dias (IIQ, 102-411), observou-se marcada melhora clínica (CF≤II) em 87,5%. Um paciente (5,9%) apresentou obstrução de via de saída de ventrículo esquerdo (VSVE), evoluindo para óbito logo após o procedimento, e outro morreu aos 161 dias de seguimento.Conclusão: A primeira experiência brasileira de TMVIV-transeptal demonstra a segurança e a efetividade dessa nova técnica. A obstrução da VSVE é uma complicação potencialmente fatal, reforçando a importância da seleção dos pacientes e do planejamento do procedimento. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)


Abstract Background Percutaneous intervention in patients with bioprosthetic mitral valve dysfunction is an alternative to conventional surgical treatment. Objectives To report the first Brazilian experience with transseptal transcatheter bioprosthetic mitral valve-in-valve implantation (transseptal-TMVIV). Methods Patients with surgical bioprosthetic dysfunction submitted to transseptal-TMVIV in 12 Brazilian hospitals were included. The significance level adopted was p<0.05. Results From June/2016 to February/2019, 17 patients underwent transseptal-TMVIV. Their median age was 77 years (IQR,70-82) and median Society of Thoracic Surgeons predicted risk of mortality (STS-PROM) score was 8.7% (IQR,7.2-17.8). All patients had limiting symptoms of heart failure (FC≥III) and 5 (29.4%) had undergone more than one previous thoracotomy. Transseptal-TMVIV was successful in all patients. Echocardiographic assessment showed a significant reduction in mean mitral valve gradient (pre-intervention, 12±3.8 mmHg; post-intervention, 5.3±2.6 mmHg; p<0.001), in addition to an increase in mitral valve area (pre-intervention, 1.06±0.59 cm2; post-intervention, 2.18±0.36 cm2; p<0.001) sustained for 30 days. There was a significant and immediate reduction in the pulmonary artery systolic pressure, with an additional reduction in 30 days (pre-intervention, 68.9±16.4 mmHg; post-intervention, 57.7±16.5 mmHg; 30 days, 50.9±18.7 mmHg; p<0.001). During follow-up (median, 162 days; IQR, 102-411), significant clinical improvement (FC≤II) was observed in 87.5% of the patients. One patient (5.9%) had left ventricular outflow tract (LVOT) obstruction and died right after the procedure, and another died at 161 days of follow-up. Conclusion The first Brazilian experience with transseptal-TMVIV shows the safety and effectivity of the new technique. The LVOT obstruction is a potentially fatal complication, reinforcing the importance of patients' selection and of procedural planning. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

14.
Arq. bras. cardiol ; 115(4): 720-775, out. 2020. tab, graf
Artigo em Português | LILACS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1131346
17.
Arq Bras Cardiol ; 115(1): 111-126, 2020 07.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32813825

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures.


Assuntos
Betacoronavirus , Doenças Cardiovasculares/cirurgia , Procedimentos Cirúrgicos Cardiovasculares/estatística & dados numéricos , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Guias de Prática Clínica como Assunto , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Transmissíveis Emergentes/epidemiologia , Infecções por Coronavirus/epidemiologia , Ecocardiografia , Humanos , Pandemias , Pneumonia Viral/epidemiologia
19.
Arq Bras Cardiol ; 114(6): 1078-1087, 2020 06.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32638902

RESUMO

Care for patients with cardiac arrest in the context of the coronavirus disease 2019 (COVID-19) pandemic has several unique aspects that warrant particular attention. This joint position statement by the Brazilian Association of Emergency Medicine (ABRAMEDE), Brazilian Society of Cardiology (SBC), Brazilian Association of Intensive Care Medicine (AMIB), and Brazilian Society of Anesthesiology (SBA), all official societies representing the corresponding medical specialties affiliated with the Brazilian Medical Association (AMB), provides recommendations to guide health care workers in the current context of limited robust evidence, aiming to maximize the protection of staff and patients alike. It is essential that full aerosol precautions, which include wearing appropriate personal protective equipment, be followed during resuscitation. It is also imperative that potential causes of cardiac arrest of particular interest in this patient population, especially hypoxia, cardiac arrhythmias associated with QT prolongation, and myocarditis, be considered and addressed. An advanced invasive airway device should be placed early. Use of HEPA filters at the bag-valve interface is mandatory. Management of cardiac arrest occurring during mechanical ventilation or during prone positioning demands particular ventilator settings and rescuer positioning for chest compressions which deviate from standard cardiopulmonary resuscitation techniques. Apart from these logistical issues, care should otherwise follow national and international protocols and guidelines, namely the 2015 International Liaison Committee on Resuscitation (ILCOR) and 2019 American Heart Association (AHA) guidelines and the 2019 Update to the Brazilian Society of Cardiology Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Guideline.


Assuntos
Reanimação Cardiopulmonar/normas , Infecções por Coronavirus/terapia , Coronavirus , Pandemias , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Comitês Consultivos , Betacoronavirus , Brasil/epidemiologia , Reanimação Cardiopulmonar/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Sociedades Médicas , Estados Unidos
20.
Arq. bras. cardiol ; 115(1): 111-126, jul. 2020. graf
Artigo em Português | LILACS-Express | LILACS, Sec. Est. Saúde SP | ID: biblio-1131250

RESUMO

Resumo A pandemia da doença causada pelo novo coronavírus (COVID-19) trouxe grandes desafios para o sistema de saúde devido ao aumento exponencial do número de pacientes acometidos. A racionalização de recursos e a indicação correta e criteriosa de exames de imagem e procedimentos intervencionistas tornaram-se necessárias, priorizando a segurança do paciente, do ambiente e dos profissionais da saúde. Esta revisão visa auxiliar e orientar os profissionais envolvidos na realização desses exames e procedimentos a fazê-los de forma eficaz e segura.


Abstract The coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...