Pesquisa | SciELO

ABSTRACT Introduction: Early mobilization of patients in the postoperative period of cardiac surgery who are hospitalized in the intensive care unit (ICU) is a practice that has a positive impact. Methods: This is a systematic review of studies published until September 2020 in the Medical Literature Analysis and Retrieval System Online (or MEDLINE®), Embase, Physiotherapy Evidence Database (or PEDro), Scientific Electronic Library Online (or SciELO), and Latin American and Caribbean Health Sciences Literature (or LILACS) databases. Randomized clinical trials describing mobilization protocols performed early in ICU patients after cardiac surgery were included. Results: According to the eligibility criteria, only 14 of the 1,128 articles found were included in the analysis. Early mobilization protocols were initiated in the immediate postoperative period or first postoperative day. The resources and technics used were progressive mobilization, cycle ergometer, early bed activities, walking protocols, resistance exercise, and virtual reality. Intensity of the mobilization activities was determined using the Borg scale and heart rate. Conclusion: Early mobilization protocols are generalist (not individual), and low-intensity exercises are used, through progressive mobilization, with two daily physical therapy sessions, during 10 to 30 minutes.

https://doi.org/10.21470/1678-9741-2021-0140

Surviving the Struggle of COVID-19: Practical Recommendations for Pediatric/Adult Cardiology and Cardiac Surgical Programs in Resource-Limited Settings: a Review
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Pilarczyk, Kevin

; Nina, Vinicius

; Boshkov, Lynn

; Ferdman, Barbara

; Farkas, Emily A

; Burnham, Nicole

; Cifuentes, Renzo

; Ntogwiachu, Daniel

; Marath, Aubyn

Brazilian Journal of Cardiovascular Surgery

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Fev 2022, Volume 37 Nº 1 Páginas 99 - 109

Resumo: En | Texto: En | PDF: En

ABSTRACT Introduction: The primary aim of this systematic review is to provide perioperative strategies to help restore or preserve cardiovascular services under threat from financial and personnel constraints imposed by the coronavirus disease 2019 (COVID-19) pandemic. Methods: The Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBASE, Cochrane Central Register of Controlled Trials/CCTR, and Google Scholar were systematically searched using the search terms “(cardiac OR cardiology OR cardiothoracic OR surgery) AND (COVID-19 or coronavirus OR SARS-CoV-2 OR 2019-nCoV OR 2019 novel coronavirus OR pandemic)”. Additionally, the webpages of relevant medical societies, including the World Federation Society of Anesthesiologists, the Cardiothoracic Surgery Network, and the Society of Thoracic Surgeons, were screened for relevant information. Results: Whereas cardiac surgery and cardiology practices were reduced by 50-75% during the pandemic, mortality of patients with COVID-19 increased significantly. Healthcare workers are among those at high risk of infection with COVID-19. Conclusion: Hospitals must provide maximum protective equipment and training on how to use it to healthcare workers for their mutual protection. Triage management of patients — which accounts for patient’s clinical status and risk-factor profile relatable to which services are available during the COVID-19 pandemic — is recommended. A strict reorganization of the hospital resources including preoperative, intraoperative, and postoperative detailed protective measures is necessary to reduce probability of vector contamination, to protect patients and the cardiovascular teams, and to permit safe resumption of cardiological and cardiac surgical activity.

https://doi.org/10.21470/1678-9741-2021-0477

Applicability of the Disruptions in Surgery Index in the Cardiovascular Management Scenarios - A Marker for Developing Functionally Efficient Teams
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Nina, Vinicius

; Mendes, Augusto Gonçalves

; Sevdalis, Nick

; Marath, Aubyn

; Mejia, Omar Vilca

; Brandão, Carlos Manuel A.

; Monteiro, Rosangela

; Mendes, Vinícius Giuliano

; Jatene, Fabio B

Brazilian Journal of Cardiovascular Surgery

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Ago 2021, Volume 36 Nº 4 Páginas 445 - 452

Resumo: En | Texto: En | PDF: En

Abstract Introduction: To support the development of practices and guidelines that might help to reduce adverse events related to human factors, we aimed to study the response and perception by members of a cardiovascular surgery team of various error-driven or adverse features that might arise in the operating room (OR). Methods: A previously validated Disruptions in Surgery Index (DiSI) questionnaire was completed by individuals working together in a cardiovascular surgical unit. Results were submitted to reliability analysis by calculating the Cronbach’s alpha coefficient. Non-parametric Kruskal-Wallis test and Dunn’s post-test were performed to estimate differences in perceptions of adverse events or outcomes between the groups (surgeons, nurses, anesthesiologists, and technicians). P<0.05 was considered statistically significant. Results: Cronbach’s alpha reliability coefficients showed consistency within the recommended range for all disruption types assessed in DiSI: an individual’s skill (0.85), OR environment (0.88), communication (0.81), situational awareness (0.92), patient-related disruption (0.89), team cohesion (0.83), and organizational disruption (0.83). Nurses (27.4%) demonstrated significantly higher perception of disruptions than surgeons (25.4%), anesthetists (23.3%), and technicians (23.0%) (P=0.005). Study participants were more observant of their colleagues’ disruptive behaviors than their own (P=0.0001). Conclusion: Our results revealed that there is a tendency among participants to hold a positive self-perception position. DiSI appears to be a reliable and useful tool to assess surgical disruptions in cardiovascular OR teams, identifying negative features that might imperil teamwork and safety in the OR. And human factors training interventions are available to develop team skills and improve safety and efficiency in the cardiovascular OR.

https://doi.org/10.21470/1678-9741-2020-0685

Healthcare Deprived Centers Attempting Congenital Heart Surgery: what is Desirable versus what is Attainable in this Covid Era?
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Marath, Aubyn

; Nina, Vinicius J S

; Nina, Rachel Vilela de A Haickel

; Ferdman, Barbara

Brazilian Journal of Cardiovascular Surgery

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Dez 2020, Volume 35 Nº 6 Páginas I - III

Resumo: En | Texto: En | PDF: En

https://doi.org/10.21470/1678-9741-1-2020-0630 248 downloads

Comment on the study Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the Bypass Registry that was presented at the 46th Congress of the Brazilian Society of Cardiovascular Surgery, Nova Lima, BH, Brazil, April 5 and 6, 2019
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Dallan, Luís Alberto O.

; Paez, Rodrigo Pereira

; Hossne Junior, Nelson Américo

; Santo, José Amalth do Espírito

; Berwanger, Otavio

; Santos, Renato Hideo Nakagawa

; Kalil, Renato Abdala Karam

; Jatene, Fabio B.

; Cavalcanti, Alexandre Biasi

; Zilli, Alexandre Cabral

; Bettiati Jr, Luiz Carlos

; Figueira, Fernando Augusto Marinho dos Santos

; D’Azevedo, Stephanie Steremberg Pires

; Soares, Marcelo José Ferreira

; Fernandes, Marcio Pimentel

; Ardito, Roberto Vito

; Bogdan, Renata Andrea Barberio

; Campagnucci, Valquíria Pelisser

; Nakasako, Diana

; Rodrigues, Clarissa Garcia

; Rodrigues Junior, Anilton Bezerra

; Cascudo, Marcelo Matos

; Atik, Fernando Antibas

; Lima, Elson Borges

; Nina, Vinicius José da Silva

; Heluy, Renato Albuquerque

; Azeredo, Lisandro Gonçalves

; Henrique Junior, Odilon Silva

; Mendonça, José Teles de

; Silva, Katharina Kelly de Oliveira Gama

; Pandolfo, Marcelo

; Lima Júnior, José Dantas de

; Faria, Renato Max

; Santos, Jonas Gonçalves dos

; Coelho, Guilherme Henrique Biachi

; Pereira, Sergio Nunes

; Senger, Roberta

; Buffolo, Enio

; Caputi, Guido Marco

; Oliveira, Juliana Aparecida Borges de

; Gomes, Walter J.

Brazilian Journal of Cardiovascular Surgery

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Ago 2019, Volume 34 Nº 4 Páginas 504 - 506

Resumo: En | Texto: En | PDF: En

https://doi.org/10.21470/1678-9741-2019-0606 335 downloads

Acute Response to Aerobic Exercise on Autonomic Cardiac Control of Patients in Phase III of a Cardiovascular Rehabilitation Program Following Coronary Artery Bypass Grafting
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Gambassi, Bruno Bavaresco

; Almeida, Fabiano de Jesus Furtado

; Almeida, Ana Eugênia Araújo Furtado

; Ribeiro, Daniela Alves Flexa

; Gomes, Rômulo Sérgio Araújo

; Chaves, Luiz Filipe Costa

; Sousa, Thiago Matheus da Silva

; Nina, Vinicius José da Silva

Brazilian Journal of Cardiovascular Surgery

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Jun 2019, Volume 34 Nº 3 Páginas 305 - 310

Resumo: En | Texto: En | PDF: En

Abstract Objective: The aim of the present study was to investigate the acute response to aerobic exercise on autonomic cardiac control of patients undergoing coronary artery bypass grafting (CABG). Methods: The study sample consisted of eight patients (age: 58.6±7.7 years; body mass index: 26.7±3.5 kg.m2) who underwent a successful CABG (no complications during surgery and/or in the following weeks). To assess heart rate variability (HRV), participants remained in a supine position with a 30-degree head elevation for 20 minutes. Electrocardiographic signal (protocol with three derivations) was collected from 600 Hz sample rate to obtain beat-to-beat intervals (R-R interval). This assessment was performed before, after one hour and after 24 hours of the exercise session. All patients underwent a 35 minutes aerobic exercise session (AES) (low-moderate intensity) on the cycle ergometer. Results: Significant differences were found in the time domain, with positive changes in root mean square of successive RR interval differences (rMSSD) (ms) (parasympathetic component) (one [P=0.017] and 24 hours [P=0.007] post-session). In the frequency domain, we found a significant difference in high frequency (HF) (ms2) (parasympathetic component) (one hour [P=0.048] post-session). The low frequency (LF)/HF ratio (sympathetic and parasympathetic components with a predominance of the sympathetic component) reached statistical significance only 24 hours (P=0.018) post-session. Additionally, the largest effect size was observed only for the LF/HF ratio at one (d=-0.8) and 24 hours (d=-1.3) after one AES. Conclusion: The practice of (acute) aerobic exercise improved autonomic cardiac control in patients undergoing CABG.

https://doi.org/10.21470/1678-9741-2019-0030 709 downloads

Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry
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Paez, Rodrigo Pereira

; Hossne Junior, Nelson Américo

; Santo, José Amalth do Espírito

; Berwanger, Otavio

; Santos, Renato Hideo Nakagawa

; Kalil, Renato Abdala Karam

; Jatene, Fabio B.

; Cavalcanti, Alexandre Biasi

; Zilli, Alexandre Cabral

; Bettiati Jr, Luiz Carlos

; Figueira, Fernando Augusto Marinho dos Santos

; D'Azevedo, Stephanie Steremberg Pires

; Soares, Marcelo José Ferreira

; Fernandes, Marcio Pimentel

; Ardito, Roberto Vito

; Bogdan, Renata Andrea Barberio

; Campagnucci, Valquíria Pelisser

; Nakasako, Diana

; Rodrigues, Clarissa Garcia

; Rodrigues Junior, Anilton Bezerra

; Cascudo, Marcelo Matos

; Atik, Fernando Antibas

; Lima, Elson Borges

; Nina, Vinicius José da Silva

; Heluy, Renato Albuquerque

; Azeredo, Lisandro Gonçalves

; Henrique Junior, Odilon Silva

; Mendonça, José Teles de

; Silva, Katharina Kelly de Oliveira Gama

; Pandolfo, Marcelo

; Lima Júnior, José Dantas de

; Faria, Renato Max

; Santos, Jonas Gonçalves dos

; Coelho, Guilherme Henrique Biachi

; Pereira, Sergio Nunes

; Senger, Roberta

; Buffolo, Enio

; Caputi, Guido Marco

; Oliveira, Juliana Aparecida Borges de

; Gomes, Walter J.

Brazilian Journal of Cardiovascular Surgery

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Abr 2019, Volume 34 Nº 2 Páginas 142 - 148

Resumo: En | Texto: En | PDF: En

Abstract Introduction: Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015. Objective: To analyze the profile, risk factors and outcomes of patients undergoing CABG in Brazil, as well as to examine the predominant surgical strategy, based on the data included in the BYPASS Registry. Methods: A cross-sectional study of 2292 patients undergoing CABG surgery and cataloged in the BYPASS Registry up to November 2018. Demographic data, clinical presentation, operative variables, and postoperative hospital outcomes were analyzed. Results: Patients referred to CABG in Brazil are predominantly male (71%), with prior myocardial infarction in 41.1% of cases, diabetes in 42.5%, and ejection fraction lower than 40% in 9.7%. The Heart Team indicated surgery in 32.9% of the cases. Most of the patients underwent cardiopulmonary bypass (87%), and cardioplegia was the strategy of myocardial protection chosen in 95.2% of the cases. The left internal thoracic artery was used as a graft in 91% of the cases; the right internal thoracic artery, in 5.6%; and the radial artery in 1.1%. The saphenous vein graft was used in 84.1% of the patients, being the only graft employed in 7.7% of the patients. The median number of coronary vessels treated was 3. Operative mortality was 2.8%, and the incidence of cerebrovascular accident was 1.2%. Conclusion: CABG data in Brazil provided by the BYPASS Registry analysis are representative of our national reality and practice. This database constitutes an important reference for indications and comparisons of therapeutic procedures, as well as to propose subsequent models to improve patient safety and the quality of surgical practice in the country.

https://doi.org/10.21470/1678-9741-2018-0313 1270 downloads

Humanitarian Missions: a Call for Action and Impact from Cardiovascular Surgeons
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Nina, Vinicius José da Silva

; Farkas, Emily A.

; Nina, Rachel V. A. H.

; Marath, Aubyn

Brazilian Journal of Cardiovascular Surgery

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Dez 2017, Volume 32 Nº 6 Páginas III - V

Resumo: En | Texto: En | PDF: En

https://doi.org/10.21470/1678-9741-2017-0197 529 downloads

10.

Pre-validation Study of the Brazilian Version of the Disruptions in Surgery Index (DiSI) as a Safety Tool in Cardiothoracic Surgery
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Nina, Vinicius José da Silva

; Jatene, Fabio B.

; Sevdalis, Nick

; Mejía, Omar Asdrúbal Vilca

; Brandão, Carlos Manuel de Almeida

; Monteiro, Rosangela

; Caneo, Luiz Fernando

; Scudeller, Paula Gobi

; Mendes, Augusto Dimitry

; Mendes, Vinícius Giuliano

; Romano, Bellkiss Wilma

Brazilian Journal of Cardiovascular Surgery

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Dez 2017, Volume 32 Nº 6 Páginas 451 - 461

Resumo: En | Texto: En | PDF: En

Abstract Introduction: Most risk stratification scores used in surgery do not include external and non-technical factors as predictors of morbidity and mortality. Objective: The present study aimed to translate and adapt transculturally the Brazilian version of the Disruptions in Surgery Index (DiSI) questionnaire, which was developed to capture the self-perception of each member of the surgical team regarding the disruptions that may contribute to error and obstruction of safe surgical flow. Methods: A universalist approach was adopted to evaluate the conceptual equivalence of items and semantics, which included the following stages: (1) translation of the questionnaire into Portuguese; (2) back translation into English; (3) panel of experts to draft the preliminary version; and (4) pre-test for evaluation of verbal comprehension by the target population of 43 professionals working in cardiothoracic surgery. Results: The questionnaire was translated into Portuguese and its final version with 29 items obtained 89.6% approval from the panel of experts. The target population evaluated all items as easy to understand. The mean overall clarity and verbal comprehension observed in the pre-test reached 4.48 ± 0.16 out of the maximum value of 5 on the psychometric Likert scale. Conclusion: Based on the methodology used, the experts' analysis and the results of the pre-test, it is concluded that the essential stages of translation and cross-cultural adaptation of DiSI to the Portuguese language were satisfactorily fulfilled in this study.

https://doi.org/10.21470/1678-9741-2017-0141 621 downloads

11.

Modified Hybrid Procedure in Hypoplastic Left Heart Syndrome: Initial Experience of a Center in Northeastern Brazil
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Faria, Renato Max

; Pacheco, Juliana Torres

; Oliveira, Itamar Ribeiro de

; Vidal, José Madson

; Rodrigues Junior, Anilton Bezerra

; Costa, Ana Luiza Lafeta

; Nina, Vinicius José da Silva

; Cascudo, Marcelo Matos

Brazilian Journal of Cardiovascular Surgery

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Jun 2017, Volume 32 Nº 3 Páginas 210 - 214

Resumo: En | Texto: En | PDF: En

Abstract Introduction: Although it only corresponds to 2.5% of congenital heart defects, hypoplastic left heart syndrome (HLHS) is responsible for more than 25% of cardiac deaths in the first week of life. Palliative surgery performed after the second week of life is considered an important risk factor in the treatment of HLHS. Objective: The aim of this study is to describe the initial experience of a medical center in Northeastern Brazil with a modified off-pump hybrid approach for palliation of HLHS. Methods: From November 2012 through November 2015, the medical records of 8 patients with HLHS undergoing hybrid procedure were retrospectively evaluated in a tertiary private hospital in Northeastern Brazil. The modified off-pump hybrid palliation consisted of stenting of the ductus arteriosus guided by fluoroscopy without contrast and banding of the main pulmonary artery branches. Demographic and clinical variables were recorded for descriptive analysis. Results: Eight patients were included in this study, of whom 37.5% were female. The median age and weight at the time of the procedure was 2 days (p25% and p75% = 2 and 4.5 days, respectively) and 3150 g (p25% and p75% = 3077.5 g and 3400 g, respectively), respectively. The median length in intensive care unit stay was 6 days (p25% and p75% = 3.5% and 8 days, respectively). There were no in-hospital deaths. Four patients have undergone to the second stage of the surgical treatment of HLHS. Conclusion: In this series, the initial experience with the modified off-pump hybrid procedure showed to be safe, allowing a low early mortality rate among children presenting HLHS.

https://doi.org/10.21470/1678-9741-2017-0058 861 downloads

12.

The Brazilian Registry of Adult Patient Undergoing Cardiovascular Surgery, the BYPASS Project: Results of the First 1,722 Patients
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Gomes, Walter J.

; Moreira, Rita Simone

; Zilli, Alexandre Cabral

; Bettiati Jr, Luiz Carlos

; Figueira, Fernando Augusto Marinho dos Santos

; D' Azevedo, Stephanie Steremberg Pires

; Soares, Marcelo José Ferreira

; Fernandes, Marcio Pimentel

; Ardito, Roberto Vito

; Bogdan, Renata Andrea Barberio

; Campagnucci, Valquíria Pelisser

; Nakasako, Diana

; Kalil, Renato Abdala Karam

; Rodrigues, Clarissa Garcia

; Rodrigues Junior, Anilton Bezerra

; Cascudo, Marcelo Matos

; Atik, Fernando Antibas

; Lima, Elson Borges

; Nina, Vinicius José da Silva

; Heluy, Renato Albuquerque

; Azeredo, Lisandro Gonçalves

; Henrique Junior, Odilon Silva

; Mendonça, José Teles de

; Silva, Katharina Kelly de Oliveira Gama

; Pandolfo, Marcelo

; Lima Júnior, José Dantas de

; Faria, Renato Max

; Santos, Jonas Gonçalves dos

; Paez, Rodrigo Pereira

; Coelho, Guilherme Henrique Biachi

; Pereira, Sergio Nunes

; Senger, Roberta

; Buffolo, Enio

; Caputi, Guido Marco

; Santo, José Amalth do Espírito

; Oliveira, Juliana Aparecida Borges de

; Berwanger, Otavio

; Cavalcanti, Alexandre Biasi

; Jatene, Fabio B.

Brazilian Journal of Cardiovascular Surgery

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Abr 2017, Volume 32 Nº 2 Páginas 71 - 76

Resumo: En | Texto: En | PDF: En

Abstract Objective: To report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients. Methods: Data collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1). The study population consists of patients over 18 years of age, and the types of operations recorded were: coronary artery bypass graft (CABG), mitral valve, aortic valve (either conventional or transcatheter), surgical correction of atrial fibrillation, cardiac transplantation, mechanical circulatory support and congenital heart diseases in adults. Results: 83.1% of patients came from the public health system (SUS), 9.6% from the supplemental (private insurance) healthcare systems; and 7.3% from private (out-of -pocket) clinic. Male patients comprised 66%, 30% were diabetics, 46% had dyslipidemia, 28% previously sustained a myocardial infarction, and 9.4% underwent prior cardiovascular surgery. Patients underwent coronary artery bypass surgery were 54.1% and 31.5% to valve surgery, either isolated or combined. The overall postoperative mortality up to the 7th postoperative day was 4%; for CABG was 2.6%, and for valve operations, 4.4%. Conclusion: This first report outlines the consecution of the Brazilian surgical cardiac database, intended to serve primarily as a tool for providing information for clinical improvement and patient safety and constitute a basis for production of research protocols.

https://doi.org/10.21470/1678-9741-2017-0053 1883 downloads

13.

Sex Differences in Mortality After CABG Surgery
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Figueiredo Neto, José Albuquerque de

; Barroso, Lea Coutinho

; Nunes, Joana Kátya Veras Rodrigues Sampaio

; Nina, Vinicius José da Silva

Brazilian Journal of Cardiovascular Surgery

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Dez 2015, Volume 30 Nº 6 Páginas 610 - 614

Resumo: En | Texto: En | PDF: En

ABSTRACT INTRODUCTION: Numerous studies have shown that women undergoing coronary artery bypass graft surgery present higher mortality rate during hospitalization, and often complications when compared to men. OBJECTIVE: To compare the mortality of men and women undergoing coronary artery bypass graft surgery and identify factors related to differences occasionally found. METHODS: Retrospective cohort study conducted with 215 consecutive patients who underwent coronary bypass surgery. RESULTS: Women had a higher average age. Low body surface and dyslipidemia were more prevalent in women (1.65 vs . 1.85, P<0.001: 53% vs . 30%, P =0.001), whereas history of smoking and previous myocardial infarction were more prevalent in men (35% vs .14.7%, P =0.001; 20% vs . 2.7%, P =0.007). Regarding complications in the postoperative period, there was a higher rate of blood transfusions in women. The overall mortality rate was 5.6%, however there was no statistically significant difference in mortality between men and women. It was observed that among the patients who died, the average body surface area was lower than that of patients who did not have this complication. CONCLUSION: There was no difference in mortality between the sexes after coronary artery bypass graft in this service.

https://doi.org/10.5935/1678-9741.20150073 1111 downloads

14.

Acute kidney injury after coronary artery bypass grafting: assessment using RIFLE and AKIN criteria
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Nina, Vinicius José da Silva

; Matias, Maryanne Miranda

; Brito, Dyego José de Araújo

; Figueiredo Neto, José Albuquerque de

; Coutinho, Léa Barroso

; Rodrigues, Rayssa Fiterman

; Mendes, Vinícius Giuliano Gonçalves

; Gaspar, Shirlyne Fabianni Dias

Brazilian Journal of Cardiovascular Surgery

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Jun 2013, Volume 28 Nº 2 Páginas 231 - 237

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

OBJETIVO: Comparar os critérios RIFLE (Risk, Injury, Failure, Loss and EndStage Renal Failure) e AKIN (Acute Kidney Injury Network) para diagnóstico de lesão renal aguda em pacientes no pós-operatório de revascularização do miocárdio. MÉTODOS: Coorte retrospectiva, a partir dos prontuários de 169 pacientes submetidos à cirurgia de revascularização do miocárdio, de janeiro de 2007 a dezembro de 2008. As informações foram inseridas em um banco de dados e analisadas pelo software STATA 9.0. RESULTADOS: A média de idades dos pacientes foi de 63,43 1 9,01 anos, havendo predominância do gênero masculino (66,86%). A lesão renal aguda foi detectada em 33,14% pelo AKIN e 29,59% pelo RIFLE. A hemodiálise foi necessária em 3,57% e em 4% dos pacientes, quando o AKIN e RIFLE foram aplicados, respectivamente. Foram a óbito 4% e 3,57% dos pacientes com Lesão Renal Aguda pelos critérios RIFLE e AKIN, respectivamente. Em 88,76% dos casos, ambos os métodos demonstraram boa concordância para detecção (kappa=0,7380) e estratificação (kappa=0,7515) de lesão renal aguda. CONCLUSÃO: O presente estudo permitiu concluir que os critérios RIFLE e AKIN possuem boa concordância na detecção e estratificação da lesão renal aguda no pós-operatório de revascularização do miocárdio.

OBJECTIVE: To compare the RIFLE (Risk, Injury, Failure, Loss and End-stage Renal Failure) and AKIN (Acute Kidney Injury Network) criteria for diagnosis of acute kidney injury after coronary artery bypass grafting. METHODS: Retrospective cohort. 169 patients who underwent coronary artery bypass grafting from January 2007 through December 2008 were analyzed. Information was entered into a database and analyzed using STATA 9.0. RESULTS: Patients' mean age was 63.43 1 9.01 years old. Predominantly male patients (66.86%) were studied. Acute Kidney Injury was present in 33.14% by AKIN and in 29.59% by RIFLE. Hemodialysis was required by 3.57% and 4.0% of the patients when AKIN and RIFLE were applied respectively. There was 4.0% and 3.57% mortality of patients with Acute Kidney Injury according to the RIFLE and AKIN criteria, respectively. In 88.76% of the cases, there was good agreement between the two methods in the detection (kappa=0.7380) and stratification (kappa=0.7515) of Acute Kidney Injury. CONCLUSION: This study showed that the RIFLE and AKIN criteria have a good agreement in the detection and stratification of acute kidney injury after coronary artery bypass grafting.

https://doi.org/10.5935/1678-9741.20130033 2744 downloads

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Nina, Vinicius José da Silva

; Gomes, Walter José

; Braile, Domingo Marcolino

Brazilian Journal of Cardiovascular Surgery

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Jun 2011, Volume 26 Nº 2 Páginas vi - vii

Resumo: Pt | Texto: Pt | PDF: Pt

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