Volume 25 - Número 2
ORIGINAL ARTICLE
Always improving: our challenge!
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Change the Qualis criteria!
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Risk score elaboration for mediastinitis after coronary artery bypass grafting
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Introduction: The mediastinitis is a serious postoperative complication of cardiac surgery, with an incidence of 0.4 to 5% and mortality between 14 and 47%. Several models were proposed to assess risk of mediastinitis after cardiac surgery. However, most of these models do not evaluate the postoperative morbidity. Objective: This study aims to develop a score risk model to predict the risk of mediastinitis for patients undergoing coronary artery bypass grafting. Methods: The study sample included data from 2,809 adult patients undergoing coronary artery bypass grafting between January 1996 and December 2007 at Hospital São Lucas - PUCRS. Logistic regression was used to examine the relationship between risk factors and the development of mediastinitis. Data from 1,889 patients were used to develop the model and its performance was evaluated in the remaining data (n=920). The definitive model was created with the data analisys of 2,809 patients. Results: The rate of mediastinitis was 3.3%, with mortality of 26.6%. In the multivariate analysis, five variables remained independent predictors of the outcome: chronic obstructive pulmonary disease, obesity, surgical reintervention, blood transfusion and stable angina class IV or unstable. The area under the ROC curve was 0.72 (95% CI, 0.67-0.78) and P=0.61. Conclusion: The risk score was constructed for use in daily practice to calculate the rate of mediastinitis after coronary artery bypass grafting. The score includes routinely collected variables and is simple to use.
Keywords: Mediastinitis; Risk factors; Myocardial revascularization
Correlation between right atrial venous blood gasometry and cardiac index in cardiac surgery postoperative period
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Objective: To determine, even during postoperative period, the confiability of the cardiac index correlate with the data data given by a central atrial venous blood gasometry in patients who underwent cardiac surgery. Methods: From the sample of arterial and venous blood of right atrium gathered in postoperative of cardiac surgery, it was determinated the hemoglobin concentration and the gasometric study through what was observed of the venous oxygen saturation (SvO2) and the partial pressure of oxygen from venous blood gathered in right atrium (PvO2), add to the calculation of artery-venous difference of the oxygen content - radial artery/right atrium (C(a-v)O2). Afterwards, these parameters were compared with the cardiac index determined by thermodilution. Results: There was good correlation between SvO2, C(a-v)O2 of the venous right atrial blood and cardiac index meansured by termodiluition method, with sensibility and especificity good and high positive predict value and negative predict value. The PvO2 demonstrated poor sensibility in the estimative of low output. Conclusion: In cardiac surgery postoperative, the SvO2 and the C(a-v)O2 were safe parameters correlated with low cardiac output. The PvO2 demonstrated poor sensibility in the estimative of low output in postoperative cardiac surgery.
Keywords: Cardiac output; Oxygen; Blood gas analysis; Cardiac surgical procedures
Complications that increase the time of Hospitalization at ICU of patients submitted to cardiac surgery
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Objective: To show the complications that increase the permanence at intensive care unit (ICU) of the patients submitted to cardiac surgery. Methods: Eighty-five handbooks of patients submitted to cardiac surgery had been analyzed, retrospectively, from March to May 2009 at Santa Casa de Misericórdia de Juiz de Fora (MG) - Brazil - and 14 (16.47%) patients had been studied. They remained more than 5 days at ICU. In 85 patients occurred three deaths: two patients operated in urgency character and this increases the morbidity; one patient who remained in mechanical ventilation (MV) by 21 days. Results: Complications that had increased the time of hospitalization at ICU had been respiratory and metabolic in accordance with literature. Conclusion: Complications that increase the time of permanence at ICU are those related to respiratory function, chronic obstructive pulmonary disease, tabagism, pulmonary congestion, time of permanence under MV, diabetes, infections, renal insufficiency, stroke and hemodynamic instability.
Keywords: Postoperative complications; Cardiovascular surgical procedures; Length of stay; Intensive care units
Quality of service provided to heart surgery patients of the Single Health System-SUS
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Objective: To evaluate the service quality provided to heart surgery patients during their hospital stay, identifying the patient's expectations and perceptions. To associate service quality with: gender, age and the use of extracorporeal circulation. Methods: We studied 82 elective heart surgery patients (52.4% females and 47.6% males), operated by midsternal thoracotomy, age: 31 to 83 years (60.4±13.2 years); period: March to September 2006. Service quality was evaluated in two instances: the expectations at pre-operative and the perceptions of the service received on the 6th post-operative; through the application of the modified SERVQUAL scale (SERVQUAL-Card). The result was obtained by the difference of the sum of the scores on perception minus those of the expectations, and through statistical analysis. Results: The SERVQUAL-Card scale was statistically validated, showing adequate level of internal consistency. We found a higher frequency of myocardial revascularization 55 (67.0%); first heart surgery 72 (87.8%) and the use of ECC 69 (84.1%). We noticed high mean values for expectations and perceptions with significant results (P<0.05). We observed a significant relationship between the quality of service with: gender, in empathy (P= 0.04) and age, in reliability (P = 0.02). There was no significant association between ECC and quality of service. Conclusion: Service quality was satisfactory. The patient demonstrated a high expectation to hospital medical service. Women present a higher perception of quality in empathy and younger people in reliability. The use of ECC is not related to service quality in this sample. The data obtained in this study suggest that the quality of this health service can be monitored through the periodical application of the SERVQUAL scale.
Keywords: Cardiac surgical procedures; Scales; Quality indicators, health care; Quality of Health Care; Single health system
Risk index proposal to predict atrial fibrillation after cardiac surgery
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Objective: Atrial fibrillation (AF) is a common complication following cardiac surgery and is associated with an increased patient morbidity and mortality. The objective of this study was to develop a risk index proposal to predict AF after cardiac surgery. Methods: A prospective observational study in that 452 patients were selected to assess the incidence and risk factors associated with postoperative AF. Only patients following cardiac surgery were selected. Continuous cardiac monitor and daily electrocardiogram were assessed. The most associated in a multivariable logistic model were selected for the risk index. Results: The average incidence of AF was 22.1%. The most associated factors with AF were: patients older than 75 years of age, mitral valve disease, no use of a beta blocker, withdrawal of a beta-blocker and a positive fluid balance. The absence risk factor determined 4.6% chance to postoperative AF, and for one, two and three or more risk factors, the chance was 16.6%, 25.9% and 46.3%, respectively. Conclusion: In a multivariable logistic model was possible to develop a risk index proposal to predict postoperative AF with a major risk of 46.3% in the presence of three or more risk factors.
Keywords: Atrial fibrillation; Thoracic surgery; Risk factors; Risk assessment
Perioperative variables of ventilatory function and physical capacity in heart transplant patients
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Introduction: Heart transplantation is currently the only widely accepted surgical alternative to treat patients with severe heart failure (HF) drug therapy cannot maintain optimal quality of life appropriate. Objective: To describe and to compare the values between pre-and postoperative physical capacity and pulmonary patients who underwent heart transplantation. Methods: A retrospective cohort composed of patients undergoing heart transplantation between January 2001 to March 2005 in IC-FUC/RS. Results: Were included in the 21 individuals. We observed decreased levels of volume and lung capacity (FEV1 and FVC) in the first days after surgery compared to preoperatively (P <0.001) and recovery of these values in the 14th postoperative day (P <0.001). The values of muscle strength showed similar trends in reducing post-operative period compared to preoperative (P <0.001) and recovered on the 14th postoperative day (P <0.001). A useful functional capacity, measured by testing 6-minute walk test (T6') showed improvement in the 14th postoperative day in relation to pre-operatively (P <0.001). Conclusion: Changes in ventilatory function of subjects undergoing cardiac transplantation are predictable, but these recover respiratory muscle strength and lung capacity within two weeks, and improve functional capacity useful in relation to pre-operative, the transplantation, when indicated, associated with good functional rehabilitation is very god treatment strategy.
Keywords: Heart transplantation; Respiratory function tests; Forced expiratory flow rates; Exercise therapy
Comparative study of traditional long incision vein harvesting and multiple incisions with small skin bridges in patients with coronary artery bypass grafting at King Abdullah University Hospital - Jordan
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Objective: Saphenous vein harvesting can be associated with wound complications, incision pain, infection, and poor cosmetic outcome. The objective of our study to determine the difference in wound complication and infection rates between two saphenous vein harvesting techniques, long incision versus multiple short interrupted incisions (tunneling) for coronary artery bypass grafting at King Abdullah University Hospital - Jordan. Methods: Retrospectively we analyzed data from 1.050 consecutive elective coronary artery bypass procedures performed from May 5, 2003, to December 31, 2007, in our institution. Saphenectomy using traditional Long incision vein harvesting (Group 1) performed in six hundred and fifty patients (n=650), while saphenectomy using multiple incisions with small skin bridges - tunneling (Group 2) performed in four hundred patients (n=400). Saphenectomy performed by cardiac surgery registrar or cardiac surgeon. Inflammation, dehiscence, cellulites, lymphangitis, drainage, necrosis, or abscess necessitating dressing, antibiotics or debridement before complete healing without eschar were defined as wound complications. There was no statistical difference in preoperative risk factors in both groups. Test results were considered significant when P <0.05. Results: Leg wound complications observed more in traditional long incision vein harvesting technique (P=0.0005). Female sex, obesity, diabetes are associated with an increased incidence of wound problems (P<0.05). Conclusions: Saphenous vein harvested using saphenous vein tunneling was associated with fewer wound complications than the traditional longitudinal method.
Keywords: Cardiac surgical procedures; Myocardial revascularization; Saphenous vein/surgery; Coronary artery bypass; Surgical wound infection
Endovascular techniques and procedures, methods for removal of intravascular foreign bodies
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Introduction: The incidence of intravascular embolization of venous catheters reported in the world medical literature corresponds to 1% of all the described complications. However, its mortality rate may vary between 24 to 60%. Catheter malfunction is the most likely signal of embolization, since patients are usually asymptomatic. Objective: To report the method of removing intravascular foreign bodies, catheters with the use of various endovascular techniques and procedures. Methods: This is a two-year retrospective study of 12 patients: seven women and five men. The average age was 29 years (ranging from two months to 65 years). Results: Technical performance was 100% successful. Ten port-a-caths, one intra-cath and one PICC were extracted. The most common sites for the lodging of one of the ends of the intravascular foreign bodies were the right atrium (41.6%) and the right ventricle (33.3%). In 100% of the cases, only one venous access was used for extraction of foreign bodies, and in 91.6% of the cases (11 catheters) the femoral access was used. The loop-snare was used in 10 cases (83.3%). The most common cause of intravascular foreign body insertion was a catheter fracture, which occurred in 66.6% of the cases (eight cases). One major complication, the atrial fibrillation, occurred (8.3%), which was related to the intravascular foreign body extraction. The mortality rate in 30 days was zero. Conclusion: Percutaneous retrieval of intravascular foreign bodies is considered gold standard treatment because it is a minimally invasive, relatively simple, safe procedure, with low complication rates compared to conventional surgical treatment.
Keywords: Catheters, indwelling; Embolism; Foreign-body migration; Device removal
Application of the EuroSCORE in coronary artery bypass surgery in public hospitals in Rio de Janeiro, Brazil
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Background: Risk stratification models are used to assess the risk of death in surgery. Objective: To conduct a critical analysis of the EuroSCORE logistic model (ES) application in 2,692 patients undergoing Coronary Artery Bypass Grafting (CABG) in four public hospitals in the Rio de Janeiro Municipality, from 1999 through to December 2003. Methods: Random samples of 150 medical records for surviving and deceased patients were selected at four public hospitals in the City of Rio de Janeiro. The ES was applied, using the logistical model. The observed lethality rate and that forecast by the model were compared. The measurement of the discriminatory power was estimated by the area under the ROC curve. Results: 546 of the 600 selected medical records were located. A significant difference was noted between the prevalence rates for the risk factors in the Brazilian and European populations. The forecast lethality rate was 3.62% (CI-95%: 3.47-3.78) while the estimated observed rate was 12.22% (CI-95%- 10.99-13.46). In all risk ranges, the predicted lethality rate is under-estimated, with notable differences between the predicted and observed rates. The area under the ROC curve was estimated at 0.62. Conclusion: The differences in the prevalence rates for the risk factors constituting the ES, associated with its low power of discrimination, hamper any recommendation of the use of this model in Brazil, without the necessary adjustments.
Keywords: Myocardial revascularization; Risk factors; Risk assessment; Coronary diseases
Comparison of patency between radial artery and saphenous vein in a coronary artery bypass grafting postoperative with return of the symptoms
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
OBJECTIVE: To compare the radial artery and saphenous vein's patency in patients with recurrence of symptoms in a coronary artery bypass grafting (CABG). METHODS: Retrospective study. From January 1998 to December 2005, 469 CABGs were performed using the radial artery as a graft, in Vera Cruz Hospital in Belo Horizonte/ MG. Among the patients who underwent those surgeries, 94 presented ischemic changes in early or late postoperative period, which led them to be re-evaluated by coronary angiography. The grafts were divided in three groups: internal thoracic artery (ITA), radial artery (RA) and saphenous vein (SV), and they were stratified according to the severity of injury: uninjured or patent (< 70%), severe obstruction (70 to 99%) and occlusion. RESULTS: For the 94 patients in the study, 86 grafts of ITA, 94 of RA and 111 of SV were used. For the 86 ITA grafts, 73 (84.88%) were found patent. For the 94 RA grafts, 55 (58.51%) were found patent, and for the 111 SV grafts, 73 (65.76%) were uninjured. A statistically significant difference (P= 0.001) was found between RA and SV grafts, with a higher patency found for VS graft. For the RA grafts, women presented a worse result concerning the RA patency (65.7% and 40.7%), with P = 0.006. Concerning coronary revascularization, a statistically significant difference was found only for the grafts used for the right coronary, with a better result for the SV (P = 0.036). CONCLUSION: Radial artery (RA) presented worse results when compared to Saphenous vein (SV) as a second graft in a CABG, especially in women who were anastomosed in the right coronary artery.
Keywords: Myocardial revascularization; Radial artery; Mammary arteries; Saphenous vein
Changes in functional capacity of patients two years after coronary artery bypass grafting surgery
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Objective: To check changes in the functional capacity of patients undergoing coronary artery bypass grafting (CABG) by testing six-minute walk test (6MWT) following two years. Methods: A prospective cohort study where 215 patients were enrolled who underwent CABG, 13 did not meet the criteria for inclusion. 202 patients were evaluated preoperatively, 13 died during hospitalization and 6 in the follow up of two years. Four patients were considered lost follow up. This study followed 179 patients for two years classified into active and sedentary, according to physical activity in leisure time and to the 6MWT preoperatively and 2 years later. Results: One hundred and twenty patients were evaluated in the day before CABGS, being 67% male with an average age of 63 (±9.75) years. Before surgery and 2 years later, 52 were active and the 6MWT distances performed had been 359m (±164.47) and 439m (±171.34), respectively; P= 0.016. Forty five patients were classified as sedentary before and 2 years after surgery. The 6MWT distances walked before and after surgery had been 255m (±172.15) and 376m (±210.92), respectively; P< 0.001. Eighty two patients transited between these two groups, 71 passed from sedentary to active and had walked before and after surgery 289m (±157.15) and 380m (±125.44), respectively; P= 0.001. The 11 patients who were active and passed to the sedentary group walked 221m (±191.91) and 384m (±63.73), respectively; P= 0.007. Conclusion: The functional capacity of the patients submitted to CABGS had a significant improvement in a medium period of follow-up.
Keywords: Myocardial revascularization; Functional residual capacity; Total lung capacity; Walking
Outcomes after coronary artery bypass in aged patients
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
OBJECTIVES: Analyze the octogenarians patients submitted to the surgical myocardium revascularization (CABG) with and without extracorporeal comparing the clinical outcomes and its survival curves. METHODS: Observational study of the cohort type involving 396 octogenarians submitted to the CABG between 01/01/ 2000 and 01/01/2007. Elaboration of an itinerary for collection of data of the handbooks containing 36 variables. Comparison between groups using t test for independent samples, chisquare and survival curves using Kaplan Meier. RESULTS: We analyzed 290 patients that possessed appropriate information. The first group G1, of the patients operated without extracorporeal, was constituted of 111 patients and the second group G2, of the operated ones with extracorporeal was constituted of 179 patients. The univariate analyzes had presented statistics significance for the variables: cardiac insufficiency functional class preoperative (P=0.000), tobacco smoking (P=0.050), number of performed grafts (P=0.050), graft type (P=0,000), associates procedures (P=0.000), preoperative use of intra-aortic balloon (P=0.000), hospital mortality (P=0.000) and type of death (P=0.020). In the postoperative outcomes stroke (P=0,036), re-internment for angina (P=0,038). The analyze of the survival curves presented statistic difference (P=0,009). CONCLUSIONS: Hospital mortality and stroke were bigger in the G2 In the long time the patients of the G1 had respectively presented greater number of re-internments for angina and the late mortality was larger in G2 for the largest prevalence of cardiac deaths.
Keywords: Coronary artery bypass; Coronary artery bypass, off-pump; Coronary disease; Aged, 80 and over
Pulmonary complications in pediatric cardiac surgery at a university hospital
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
OBJECTIVE: To identify the prevalence of pulmonary complications in children undergone cardiac surgery, as well as demographic and clinical characteristics of this population. METHODS: The sample comprised 37 children of both genders, underwent cardiac surgery at the Hospital Universitário Presidente Dutra, São Luis (MA) during the year of 2007. There were not included patients who had lung disease in pre-operative period, patients with neurological disorders, intra-operative death besides lack of data in medical records. The data were obtained from general medical and nursing staff of their medical records. RESULTS: The population of the study was predominantly composed by female children, from the countryside and at school age. Pathologies considered low risk were the majority, especially the patent ductus arteriosus, interventricular communication and interatrial communication. It was observed that the largest share of children made use of cardiopulmonary bypass for more than 30 minutes, with a median of 80 minutes, suffered a median sternotomy, using only the mediastinal drain and made use of mechanical ventilation after surgery, with the median about 6.6 hours. Only three (8.1%) patients developed pulmonary complications, and of these, two died. CONCLUSION: Most of the sample was female, school aged and from the countryside. The low time of cardiopulmonary bypass and mechanical ventilation, and congenital heart disease with low risk, may have been factors that contributed to the low rate of pulmonary complications postoperative.
Keywords: Heart defects, congenital/surgery; Postoperative complications
Comparative study between on-pump and off-pump coronary artery bypass graft in women
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
BACKGROUND: It has been well documented that women have higher morbidity and mortality rates than men following coronary artery bypass graft (CABG) surgery. In view of this evidence, it is necessary to know if there is benefit to off-pump CABG surgery in women in comparison to on-pump CABG. OBJECTIVES: Compare outcomes between off-pump CABG and on-pump CABG in women. METHODS: Retrospective study. Our investigation analyzes comparatively clinical profile, thirteen procedure complications and mortality of a population of 941 consecutive women undergoing CABG surgery (549 off-pump and 392 on-pump) at two hospitals for the period January 2000 to December 2005. RESULTS: Mortality rate for women undergoing off-pump CABG surgery is lower than for women undergoing on-pump surgery, however, not statistically significant (3.1% vs 5.3%; P=0.134). The complication rates analyzed (hemorrhagic shock, neurologic, respiratory, acute renal failure, adult respiratory distress syndrome, septicemia, pneumonia, atrial fibrillation) were lower (significant statistically difference) for women off-pump than women on-pump, with the exception of low cardiac output and wound infection. CONCLUSIONS: Evidence suggests that off-pump CABG surgery may be better for women than on-pump CABG surgery because it appears to reduce morbimortality rates. Ten of 13 complications investigated demonstrated an advantage for women undergoing off-pump surgery relative to those receiving on-pump surgery.
Keywords: Coronary Artery Bypass, Off-Pump; Women; Surgery
SPECIAL ARTICLE
The article of the future
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Technological advances and the Internet have contributed to the increased disclosure and updating of knowledge and science. Scientific papers are considered the best form of disclosure of information and have been undergoing many changes, not on their way of development, but on the structure of publication. The Future paper, a name for this new structure, uses hypermediatic resources, allowing a quick, easy and organized access to these items online. The exchange of information, comments and criticisms can be performed in real time, providing agility in science disclosure. The trend for the future of documents, both from professionals or enterprises, is the "cloud computing", in which all documents will be developed and updated with the use of various equipments: computer, palm, netbook, ipad, without need to have the software installed on your computer, requiring only an Internet connection.
Keywords: Education, distance; Internet; Publications; Selective dissemination of information; Online systems; Medical informatics
Cardiogenic shock due to citomegalovirus myocarditis: successful clinical treatment
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Objective: Cytomegalovirus (CMV) systemic disease and myocarditis in healthy persons is infrequently reported in the literature, although in increasing numbers in recent years. The importance of the recognition of the syndrome that usually has an initial picture of a mononucleosis like infection in an otherwise healthy person, is the available therapeutic agent, ganciclovir, that can cure the infectious disease. Methods: We analyzed the clinical result of pulsotherapy with steroids in a patient with CMV myocarditis after 7 days of etiological treatment, with ganciclovir, intravenous vasodilators, and the conventional treatment for congestive heart failure. Results: The clinical condition of the patient improved accordingly to the better function of the left ventricle, and the ganciclovir was kept for 21 days, most of it in an out patient basis. The patient was dismissed from the hospital, with normal myocardial function. Conclusion: Potentially curable forms of myocarditis, like M pneumoniae and CMV, for example, can have an initial disproportionate aggression to the myocardium, by the acute inflammatory reaction, that can by itself make worse the damage to the LV function. In our opinion, the blockade of this process by pulsotherapy with steroids can help in the treatment of these patients. We understand that the different scenario of immunosuppressive treatments for the possible auto immunity of the more chronic forms of the presumably post viral cardiomyopathy has been in dispute in the literature, and has stolen the focus from the truly acute cases.
Keywords: Cardiogenic shock; Ganciclovir; Myocarditis; Pulse therapy, drug
BRIEF COMMUNICATION
Canulation tatics in upper ministernotomy for the surgical treatment of congenital heart disease
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
INTRODUCTION: The present report describes the technique for "inverted L" upper ministernotomy with central canulation for the treatment of simple congenital cardiopathies and presents the initial results. METHODS: Ten patients (mean age: 7 ± 4.2 years; mean weight 29.1 ± 13.5 kg) were operated on between January 2006 and July 2007. RESULTS: All defects were corrected. No death was observed and no complication that required reintervention occurred. CONCLUSION: The described technique showed to be feasible and safe for the correction of certain congenital cardiopathies, with less surgical trauma, besides the aesthetic benefit and an expectation of diminished thoracic deformity in the future.
Keywords: Cardiovascular surgical procedures/methods; Hemostatic techniques; Heart defects, congenital
CASE REPORT
In situ reconstruction with bovine pericardial tubular graft for aortic graft infection
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Prosthetic graft infection is a serious complication of abdominal aorta surgery. Its removal is always indicated because it prevents potential significant complications, but reconstruction is a technical challenge. The authors present a case of an in situ reconstruction with corrugated bovine pericardial tubular graft.
Keywords: Vascular surgical procedures; Infection; Aortic aneurysm, abdominal; Pericardium
Supravalvular aortic stenosis surgical repair using modified Sousa's technique
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Report of a patient with seven years old and effort intolerance progressing. The child had tachycardia, pansystolic murmur in the aortic focus. Echocardiography showed left ventricle hypertrophy and aortic narrowing at the level of sinotubular junction with sistolic gradient of 190 mmHg. Cardiac catheterization confirmed the diagnostic suggesting left coronary ostium stenosis. The surgery was performed modification the technique, described by Sousa. Immediate post-operative has presented no complications, with gradient of 23 mmHg, and good leaflets mobility.
Keywords: Heart defects, congenital/surgery; Aorta/pathology; Aorta/surgery; Aortic valve stenosis; Heart valves/surgery; Aortic valve/surgery
Surgical treatment of superior vena cava syndrome caused by invasive thymoma
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
We report on a case of a 57 years-old white male, patient, who presented superior vena cava syndrome (SVC) for 3 months, derived from an invasive thymoma in the medium and anterior mediastinum, compromising intrinsic and extrinsic to the SVC. After evaluation by computed tomography and magnetic angioresonance of the thorax, the patient underwent radical resection of the thymoma - bypass from left subclavian vein to right atrium, using polytetrafluoroethylene tube. Relevant case of invasive thymoma causing the occlusion of SVC. The clinic evolution of the patient after 7 months was considered satisfactory.
Keywords: Superior vena cava syndrome; Thymus neoplasms; Thymoma
Cardiovascular surgery in Brazil: achievements and opportunities
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Homage: Dr. Itacir Arlindo Franceschini (February 28, 1940 - September 27, 2009)
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Study by Dr. Paulo Pêgo Fernandes and colleagues receives award in Congress of Socesp
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
CLINICAL-SURGICAL CORRELATION
Heart transplantation in child with noncompacted myocardium
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
NEWS
Full Professor Pablo Pomerantzeff and colleagues publish in the INNOVATIONS Journal
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Study by Dr. João Breda receives award at the V Integrated Cardiovascular Repair Workshop 2010
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
LETTERS TO THE EDITOR
Radius of the vessel, resistance and coronary flow
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025
Transposição das grandes artérias com comunicação interventricular e estenose pulmonar: qual a melhor opção cirúrgica?
Braz J Cardiovasc Surg 25;
Publish in: 8/2/2025