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The importance of asking questions and doing things for a reason
(Source: Revista Brasileira de Cirurgia Cardiovascular)
Source: Revista Brasileira de Cirurgia Cardiovascular - February 22, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Predictive Value of White Blood Cells, Neutrophils, Platelets, Platelet to Lymphocyte and Neutrophil to Lymphocyte Ratios in Patients with Acute Aortic Dissection
Abstract Case Presentation: A case of a 49-year-old patient, male, victim of stab wound, developing belatedly cardiac tamponade and hemodynamic stability was reported. The patient underwent a pericardial window with drainage of pericardial effusion of blackened aspect; however, without visualization of the cardiac lesion, enlargement of the incision by median sternotomy was opted for. A hematoma was spotted at the left ventricle with epicardial lesion and a patch of pericardium was made with 3-0 polypropylene. The patient developed acute pulmonary edema and atrial fibrillation, which improved after the intensive care unit...
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

The 3C’s: COVID-19, Children, and Cardiac Surgery - Do we know enough?
Abstract Case Presentation: A case of a 49-year-old patient, male, victim of stab wound, developing belatedly cardiac tamponade and hemodynamic stability was reported. The patient underwent a pericardial window with drainage of pericardial effusion of blackened aspect; however, without visualization of the cardiac lesion, enlargement of the incision by median sternotomy was opted for. A hematoma was spotted at the left ventricle with epicardial lesion and a patch of pericardium was made with 3-0 polypropylene. The patient developed acute pulmonary edema and atrial fibrillation, which improved after the intensive care unit...
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Myocardial Revascularization Surgery in COVID-19: Choosing the Most Opportune Moment for Intervention
Abstract Case Presentation: A case of a 49-year-old patient, male, victim of stab wound, developing belatedly cardiac tamponade and hemodynamic stability was reported. The patient underwent a pericardial window with drainage of pericardial effusion of blackened aspect; however, without visualization of the cardiac lesion, enlargement of the incision by median sternotomy was opted for. A hematoma was spotted at the left ventricle with epicardial lesion and a patch of pericardium was made with 3-0 polypropylene. The patient developed acute pulmonary edema and atrial fibrillation, which improved after the intensive care unit...
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

A Tribute to Mauro Arruda - "A genius of surgery who will be remembered forever"
Abstract Case Presentation: A case of a 49-year-old patient, male, victim of stab wound, developing belatedly cardiac tamponade and hemodynamic stability was reported. The patient underwent a pericardial window with drainage of pericardial effusion of blackened aspect; however, without visualization of the cardiac lesion, enlargement of the incision by median sternotomy was opted for. A hematoma was spotted at the left ventricle with epicardial lesion and a patch of pericardium was made with 3-0 polypropylene. The patient developed acute pulmonary edema and atrial fibrillation, which improved after the intensive care unit...
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Late Cardiac Tamponade in a Patient Victim of Penetrating Trauma – Case Report
Abstract Case Presentation: A case of a 49-year-old patient, male, victim of stab wound, developing belatedly cardiac tamponade and hemodynamic stability was reported. The patient underwent a pericardial window with drainage of pericardial effusion of blackened aspect; however, without visualization of the cardiac lesion, enlargement of the incision by median sternotomy was opted for. A hematoma was spotted at the left ventricle with epicardial lesion and a patch of pericardium was made with 3-0 polypropylene. The patient developed acute pulmonary edema and atrial fibrillation, which improved after the intensive care unit...
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Unusual Presentation of Patent Ductus Arteriosus in Elderly Patient
We presented a case of a 56-year-old man with giant pulmonary artery aneurysm caused by a misdiagnosed patent ductus arteriosus, severe multivalvular disease and active aortic valve endocarditis successfully treated by surgery. The correct diagnosis was missed despite preoperative diagnostics because the small patent ductus arteriosus was located at the distal part of common pulmonary trunk and a huge regurgitant signal overlapped its Doppler signal. Thorough evaluation of every patient, regardless of age, is necessary to recognize and treat this congenital anomaly. (Source: Revista Brasileira de Cirurgia Cardiovascular)
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Giant Left Atrium Associated with Massive Thrombus Formation 14 Years after Orthotopic Heart Transplantation
We report the case of a 60-year-old patient who underwent orthotopic heart transplant 14 years earlier. Routine echocardiography showed giant masses in the left atrium. There were no symptoms or thromboembolic events in the past. Magnetic resonance imaging study revealed very enlarged left atrium (8.7 × 10.6 cm) occupied by irregular smooth mass (7 × 5 × 6.1 cm) with a stalk that was attached to the posterior left atrial wall in the area of graft suture lines. Intraoperative examination revealed a massive thrombus (12 × 10 cm) that filled almost the entire left atrial area. (Source: Revista Brasileira de Cirurgia Cardiovascular)
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Conservative Treatment of Unicuspid Aortic Valve with Newly Diagnosed Type A Aortic Dissection
We present a case of a 36-year-old male patient with known arthrogryposis multiplex congenita and an associated unicuspid aortic valve. The patient later developed a significant aneurysm of the ascending aorta, however refused surgical intervention and missed follow-up appointments for 5 years. During an urgent, general practitioner-initiated transthoracic echocardiography follow-up, a chronic type A aortic dissection was diagnosed as a result of progressive aortic dilatation. Due to the stationary pressure gradients and non-progressive leaflet fibrosis, a conservative approach for to the unicuspid aortic valve was chosen,...
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Coronary Artery Bypass Graft During the COVID-19 Pandemic
This article aims to aggregate to the growing evidence suggesting that perioperative infection with severe acute respiratory syndrome coronavirus 2 contributes to a more morbid evolution of the case. (Source: Revista Brasileira de Cirurgia Cardiovascular)
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Left Atrial Appendage Thrombosis and Persistent Atrial Fibrillation: combined Treatment with a Totally Thoracoscopic Approach
Abstract Minimally invasive surgical ablation is generally contraindicated in patients with atrial fibrillation and thrombosis of the left atrial appendage. We have treated three of these patients using an innovative technique based on a bilateral video-thoracoscopic approach, performing a continuous encircling lesion at the pulmonary veins outflow with radio-frequency ablation, simultaneously excluding the left atrial appendage. The postoperative course was uneventful, without neurologic events and all patients maintained a stable sinus rhythm at 1-year follow-up. This procedure represents a new mini-invasive method to tr...
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Mortality Rates of Surgical Techniques for Correcting Atrioventricular Disjunction
Abstract We compared the mortality rates of two surgical techniques for correction of atrioventricular disjunction in 10 out of 720 patients who underwent mitral valve replacement from 2005 to 2012. In group I, the mitral annulus was fixed with bovine pericardial strips; in group II, a 'patch' of bovine pericardium was sutured and extended from the base of the lateral and medial papillary muscles, covered the posterior wall of the left ventricle, went through the posterior mitral annulus, and ended in the posterior wall of the left atrium adjacent to the mitral ring. The group II technique showed a lower mortality. (Source...
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Robotic Cardiac Surgery in Colombia: Overcoming the Challenges of a Middle-income Setting
Abstract In developing countries, limited resources and low health budgets result in slow developments in the field of cardiac surgery. As a consequence, advances in surgery become a challenging process. In Colombia, most institutions do not have the capacity or infrastructure for minimally invasive and video-assisted cardiac surgery, let alone robotic assisted cardiac surgery (RACS). Despite the challenges, efforts to overcome these hurdles are critical for the future of cardiac surgery in low-income settings. Here we describe the first cases of robotic cardiac surgeries performed in Colombia. (Source: Revista Brasileira ...
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Heterotopic Heart Transplantation as a Left Ventricular Biological Assistance: a New Two-Stage Method Proposal
Abstract Since Barnard ’ s first heterotopic heart transplant in 1974, Copeland ’ s method has been the greatest contribution to heterotopic transplants but has the drawback of donor ’ s right ventricular atrophy. This new method proposes a modification in the anastomosis of the superior vena cava aiming to pre-serve donor ’ s right ventricular function by decompressing the pulmonary territory and reducing the pulmonary arterial pressure, as a biological ventricular assist device. Finally, a second intervention is proposed, where a “ twist ” is performed to place the donor ’ s heart in an orthotopic position...
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Role of Thoracic Endovascular Aortic Repair (TEVAR) of Thoracic Aortic Diseases in Patients with Connective Tissue Disorders - A Literature Review
Conclusion: Open repair remains the gold standard method of intervention in young patients with progressive CTD, especially in the setting of acute type A aortic dissection. However, TEVAR can be sought as a reliable alternative in emergency setting of diseases involving the descending thoracic aorta; yet the long-term data needs to be published to support such practice. (Source: Revista Brasileira de Cirurgia Cardiovascular)
Source: Revista Brasileira de Cirurgia Cardiovascular - December 9, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research