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Impact of COVID-19 Pandemic in a Pediatric and Congenital Cardiovascular Surger...
Miana,Leonardo A.; Manuel,Valdano; Caneo,Luiz Fernando; Strabelli,Tânia Mara Varejão; Arita,Elisandra Trevisan; Monteiro,RosângelaAbstract Introduction: The coronavirus disease 2019 (COVID-19) has negatively impacted healthcare services worldwide. We hypothesized that the pandemic would affect our case mix and mortality. Our objective was to study this impact. Methods: We retrospectively studied all patients who underwent congenital heart surgeries from March 21st to August 21st in 2019 and 2020 using the institutional electronic database...
Translation and Validation of the Boston Technical Performance Score in a Devel...
Miana,Leonardo A.; Nathan,Meena; Tenório,Davi Freitas; Manuel,Valdano; Guerreiro,Gustavo; Fernandes,Natália; Campos,Carolina Vieira de; Gaiolla,Paula V.Abstract Introduction: The Technical Performance Score (TPS) was developed and subsequently refined at the Boston Children's Hospital. Our objective was to translate and validate its application in a developing country. Methods: The score was translated into the Portuguese language and approved by the TPS authors. Subsequently, we studied 1,030 surgeries from June 2018 to October 2020. TPS could not be assigned...
Preoperative Neutrophil-Lymphocyte Ratio Can Predict Outcomes for Patients Unde...
Manuel,Valdano; Miana,Leonardo A.; Guerreiro,Gustavo Pampolha; Turquetto,Aida; Santos,Rômullo Medeiros; Fernandes,Natália; Tenório,Davi FreitasAbstract Introduction: Elevated neutrophil-lymphocyte ratio (NLR) has been associated with poorer outcomes in cyanotic patients undergoing single ventricle palliation. Little is known about this biomarker on patients with tetralogy of Fallot (TOF), the most common cyanotic congenital heart disease. Our objective is to study the impact of preoperative NLR on outcomes of TOF patients undergoing total repair. Meth...
Surgical Correction of Ascending Aortic Aneurysm Without Coronary Dilatation Af...
Santos,Rômullo M; Massoti,Maria Raquel B; Coronel,Monica Raquel Gonzalez; Maia,Frederico Faria; Miana,Leonardo Augusto; Jatene,Marcelo BiscegliAbstract Kawasaki disease (KD) is an inflammatory condition that may affect genetically predisposed individuals in pediatric ages after infectious/environmental triggering. An infrequent finding associated with KD is ascending aortic aneurysm during or after the acute phase of the disease. In this Multimedia presentation, we describe a three-year-old girl submitted to surgical treatment.
Analysis of >100,000 Cardiovascular Surgeries Performed at the Heart Institu...
Mejia,Omar A.V.; Lisboa,Luiz Augusto Ferreira; Caneo,Luiz Fernando; Arita,Elisandra Trevisan; Brandão,Carlos Manuel de Almeida; Dias,Ricardo RibeiroAbstract Background: The current challenge of cardiovascular surgery (CVS) is to improve the outcomes in increasingly severe patients. In this respect, continuous quality improvement (CQI) programs have had an impact on outcomes. Objective: To assess the evolution of the incidence and mortality due to CVS, as well as the current outcomes of the Hospital das Clínicas Heart Institute of the University of São Paul...
Outcomes of the Conversion of the Fontan-Kreutzer Operation to a Total Cavopulm...
Fernandes,Gabriel Carmona; Silva,Guilherme Viotto Rodrigues da; Caneo,Luiz Fernando; Tanamati,Carla; Turquetto,Aida Luiza RibeiroAbstract Background: The Fontan-Kreutzer procedure (FK) was widely performed in the past, but in the long-term generated many complications resulting in univentricular circulation failure. The conversion to total cavopulmonary connection (TCPC) is one of the options for treatment. Objective: To evaluate the results of conversion from FK to TCPC. Methods: A retrospective review of medical records for patients wh...
Collaborative Quality Improvement in the Congenital Heart Defects: Development ...
Carmona,Fabio; Manso,Paulo Henrique; Ferreira,Mariana Nicoletti; Ikari,Nana Miura; Jatene,Marcelo Biscegli; Amato,Luciana; Turquetto,Aida LuizaAbstract Objective: ASSIST is the first Brazilian initiative in building a collaborative quality improvement program in pediatric cardiology and congenital heart disease. The purposes of this manuscript are: (a) to describe the development of the ASSIST project, including the historical, philosophical, organizational, and infrastructural components that will facilitate collaborative quality improvement in conge...
Use of Short-term Circulatory Support as a Bridge in Pediatric Heart Transplant...
Canêo,Luiz Fernando; Miana,Leonardo Augusto; Tanamati,Carla; Penha,Juliano Gomes; Shimoda,Monica Satsuki; Azeka,Estela; Miura,NanaBackground:Heart transplantation is considered the gold standard therapy for the advanced heart failure, but donor shortage, especially in pediatric patients, is the main limitation for this procedure, so most sick patients die while waiting for the procedure.Objective:To evaluate the use of short-term circulatory support as a bridge to transplantation in end-stage cardiomyopathy.Methods:Retrospective clinical ...
Palliative Senning in the Treatment of Congenital Heart Disease with Severe Pul...
Penha,Juliano Gomes da; Zorzanelli,Leina; Barbosa-Lopes,Antonio Augusto; Atik,Edimar; Miana,Leonardo Augusto; Tanamati,Carla; Caneo,Luiz FernandoBackground:Transposition of the great arteries (TGA) is the most common cyanotic cardiopathy, with an incidence ranging between 0.2 and 0.4 per 1000 live births. Many patients not treated in the first few months of life may progress with severe pulmonary vascular disease. Treatment of these patients may include palliative surgery to redirect the flow at the atrial level.Objective:Report our institutional experi...
Post-cardiotomy ECMO in pediatric and congenital heart surgery: impact of team ...
Miana,Leonardo Augusto; Canêo,Luiz Fernando; Tanamati,Carla; Penha,Juliano Gomes; Guimarães,Vanessa Alves; Miura,NanaAbstract Introduction: Post-cardiotomy myocardial dysfunction requiring mechanical circulatory support occurs in about 0.5% of cases. In our environment, the use of extracorporeal membrane oxygenation has been increasing in recent years. Objective: To evaluate the impact of investment in professional training and improvement of equipment in the rate of weaning from extracorporeal membrane oxygenation and surviv...