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Trends in tracheal, bronchial and lung cancer attributed to smoking in South America: Global Burden of Disease analysis 1990-2019
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Salerno, Pedro Rafael Vieira de Oliveira

; Palma Dallan, Luis Augusto

; Rodrigues Pereira, Gabriel Tensol

; Pego Fernandes, Paulo Manuel

; Mingarini Terra, Ricardo

; Rajagopalan, Sanjay

; Al-Kindi, Sadeer G

; Oliveira Salerno, Juliana Vieira de

Revista Panamericana de Salud Pública

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2024, Volume 48 elocation e30

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo. Investigar a carga de câncer de traqueia, brônquios e pulmão (TBP) decorrente da exposição ao tabaco nos últimos 30 anos em 12 países da América do Sul. Métodos. A função de exposição-resposta do estudo Carga Global de Doença (GBD, na sigla em inglês) 2019 foi usada para analisar o número de mortes e de anos de vida ajustados por incapacidade (AVAI) por câncer de TBP relacionado à exposição total ao tabaco e ao tabagismo e ao fumo passivo em 12 países da América do Sul entre 1990 e 2019. Os índices foram descritos em números absolutos ou taxas por 100 mil pessoas. A variação relativa da carga foi avaliada comparando-se os períodos de 1990 a 1994 e de 2015 a 2019. Resultados. Em 2019, os números de mortes e de AVAI por câncer de TBP associado à exposição ao tabaco na América do Sul, em todas as idades, foram, respectivamente, 29.348 e 658.204 em homens e 14.106 e 318.277 em mulheres. As taxas de mortalidade e os AVAI ajustados por idade na região foram, respectivamente, 182,8 e 4.035 em homens e 50,8 e 1.162 em mulheres em 2019. Em homens, 10 dos 12 países registraram uma diminuição relativa das taxas de mortalidade por câncer de TBP atribuído à exposição ao tabaco, mas somente 4 países obtiveram uma redução da mortalidade em mulheres. Conclusão. Apesar dos consideráveis esforços atuais para o controle do tabaco na América do Sul, ainda há uma expressiva carga de câncer de TBP na região, com disparidades significativas entre os sexos. É necessário dispor de mais dados primários sobre câncer de TBP e exposição ao tabaco específicos para cada país para aprimorar as estratégias de atenção à saúde e melhorar a compreensão das tendências regionais.

ABSTRACT Objective. To investigate the burden of tracheal, bronchus, and lung (TBL) cancer due to tobacco exposure in the last 30 years in 12 South American countries. Methods. We used the Global Burden of Disease (GBD) 2019 exposure-response function to analyze the total tobacco, smoking, and secondhand smoke exposure-related TBL cancer deaths and disability-adjusted life years (DALYs), for 12 South American countries, between 1990 and 2019. Metrics were described as absolute numbers or rates per 100 000 individuals. The relative change in burden was assessed by comparing the 1990-1994 to 2015-2019 periods. Results. In 2019, the all-ages number of TBL cancer deaths and DALYs associated with tobacco exposure in South America was 29 348 and 658 204 in males and 14 106 and 318 277 in females, respectively. Age-adjusted death and DALYs rates for the region in 2019 were 182.8 and 4035 in males and 50.8 and 1162 in females, respectively. In males, 10/12 countries observed relative declines in TBL death rates attributed to tobacco exposure while only 4 countries reduced their mortality in females. Conclusion. While significant efforts on tobacco control are under place in South America, substantial burden of TBL cancer persists in the region with significant sex-specific disparities. Increased country-specific primary data on TBL cancer and tobacco exposure is needed to optimize healthcare strategies and improve comprehension of regional trends.

RESUMEN Objetivo. Investigar la carga del cáncer de tráquea, bronquios y pulmón por exposición al tabaco en los últimos 30 años en 12 países de Sudamérica. Métodos. Se utilizó la función de relación entre exposición y respuesta de la carga mundial de morbilidad del 2019 para analizar las muertes por cáncer de tráquea, bronquios y pulmón asociadas a la exposición total al tabaco, al tabaquismo activo y al tabaquismo pasivo, así como los años de vida ajustados en función de la discapacidad (AVAD), en 12 países de Sudamérica, entre 1990 y el 2019. Los resultados se presentaron en forma de número absoluto o de tasa por 100 000 personas. Se evaluó el cambio relativo de la carga mediante la comparación de los períodos 1990-1994 y 2015-2019. Resultados. En el 2019, el número de muertes por cáncer de tráquea, bronquios y pulmón y los AVAD asociados a la exposición al tabaco para todas las edades en Sudamérica fueron de 29 348 y 658 204 en los hombres y de 14 106 y 318 277 en las mujeres, respectivamente. La tasa de mortalidad y los AVAD ajustados por la edad correspondientes al 2019 en la región fueron de 182,8 y 4035 en los hombres y de 50,8 y 1162 en las mujeres, respectivamente. En el caso de los hombres, en 10 de los 12 países se observaron disminuciones relativas de la tasa de mortalidad por cáncer de tráquea, bronquios y pulmón atribuido a la exposición al tabaco, mientras que en el caso de las mujeres solo en 4 países hubo una reducción de la mortalidad. Conclusión. Aunque en Sudamérica se están llevando a cabo iniciativas importantes para el control del tabaco, en esta región persiste una carga considerable de cáncer de tráquea, bronquios y pulmón, con diferencias significativas en función del sexo. Es preciso contar con más datos primarios específicos de cada país sobre el cáncer de tráquea, bronquios y pulmón, así como sobre la exposición al tabaco, para optimizar las estrategias de atención de salud y mejorar la comprensión de las tendencias regionales.

https://doi.org/10.26633/rpsp.2024.30

Difference Between Cardiopulmonary Bypass Time and Aortic Cross-Clamping Time as a Predictor of Complications After Coronary Artery Bypass Grafting CrossClamping Cross Clamping
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Jucá, Fabiano Gonçalves

; Freitas, Fabiane Letícia de

; Goncharov, Maxim

; Pes, Daniella de Lima

; Jucá, Maria Eduarda Coimbra

; Dallan, Luis Roberto Palma

; Lisboa, Luiz Augusto Ferreira

; Jatene, Fábio B.

; Mejia, Omar Asdrúbal Vilca

Brazilian Journal of Cardiovascular Surgery

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2024, Volume 39 N. 2 elocation e20230104

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Along with cardiopulmonary bypass time, aortic cross-clamping time is directly related to the risk of complications after heart surgery. The influence of the time difference between cardiopulmonary bypass and cross-clamping times (TDC-C) remains poorly understood. Objective: To assess the impact of cardiopulmonary bypass time in relation to cross-clamping time on immediate results after coronary artery bypass grafting in the Registro Paulista de Cirurgia Cardiovascular (REPLICCAR) II. Methods: Analysis of 3,090 patients included in REPLICCAR II database was performed. The Society of Thoracic Surgeons outcomes were evaluated (mortality, kidney failure, deep wound infection, reoperation, cerebrovascular accident, and prolonged ventilation time). A cutoff point was adopted, from which the increase of this difference would affect each outcome. Results: After a cutoff point determination, all patients were divided into Group 1 (cardiopulmonary bypass time < 140 min., TDC-C < 30 min.), Group 2 (cardiopulmonary bypass time < 140 min., TDC-C > 30 min.), Group 3 (cardiopulmonary bypass time > 140 min., TDC-C < 30 min.), and Group 4 (cardiopulmonary bypass time > 140 min., TDC-C > 30 min.). After univariate logistic regression, Group 2 showed significant association with reoperation (odds ratio: 1.64, 95% confidence interval: 1.01-2.66), stroke (odds ratio: 3.85, 95% confidence interval: 1.99-7.63), kidney failure (odds ratio: 1.90, 95% confidence interval: 1.32-2.74), and in-hospital mortality (odds ratio: 2.17, 95% confidence interval: 1.30-3.60). Conclusion: TDC-C serves as a predictive factor for complications following coronary artery bypass grafting. We strongly recommend that future studies incorporate this metric to improve the prediction of complications. Introduction crossclamping cross clamping surgery TDCC TDC C (TDC-C understood Objective (REPLICCAR Methods 3090 090 3,09 performed mortality, (mortality infection accident time. . time) adopted outcome Results determination 14 min min. , min.) min.. regression odds ratio 164 64 1.64 95 interval 1.012.66, 101266 1.01 2.66 01 66 1.01-2.66) 385 85 3.85 1.997.63, 199763 1.99 7.63 99 7 63 1.99-7.63) 190 90 1.90 1.322.74, 132274 1.32 2.74 32 74 1.32-2.74) inhospital hospital 217 17 2.17 1.303.60. 130360 1.30 3.60 60 1.30-3.60) Conclusion 309 09 3,0 16 6 1.6 9 012 1.012.66 10126 101 1.0 266 2.6 0 1.01-2.66 38 8 3.8 997 1.997.63 19976 199 1.9 763 7.6 1.99-7.63 19 322 1.322.74 13227 132 1.3 274 2.7 1.32-2.74 21 2.1 303 1.303.60 13036 130 360 3.6 1.30-3.60 3, 1. 1.012.6 1012 10 26 2. 1.01-2.6 3. 1.997.6 1997 76 7. 1.99-7.6 1.322.7 1322 13 27 1.32-2.7 1.303.6 1303 36 1.30-3.6 1.012. 1.01-2. 1.997. 1.99-7. 1.322. 1.32-2. 1.303. 1.30-3. 1.012 1.01-2 1.997 1.99-7 1.322 1.32-2 1.303 1.30-3 1.01- 1.99- 1.32- 1.30-

https://doi.org/10.21470/1678-9741-2023-0104

Official Scientific Statement from the Brazilian Society of Cardiovascular Surgery - The 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization and the 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for Chronic Coronary Disease 202 ACCAHASCAI ACC AHA SCAI AHAACCACCPASPCNLAPCNA ACCP ASPC NLA PCNA 20 2
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Hossne Jr, Nelson A.

; Dallan, Luís Roberto Palma

; Lisboa, Luiz Augusto Ferreira

; Murad, Henrique

; Gomes, Walter José

Brazilian Journal of Cardiovascular Surgery

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2024, Volume 39 N. 2 elocation e20240990

Abstract: En | Text: En | PDF: En

https://doi.org/10.21470/1678-9741-2024-0990

Preditores de Readmissão Hospitalar até 30 Dias de CRM em Banco de Dados Multicêntrico: Estudo de Coorte Transversal 3 Multicêntrico
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Silva, Rene Augusto Gonçalves e

; Borgomoni, Gabrielle Barbosa

; de Freitas, Fabiane Letícia

; Maia, Adnaldo da Silveira

; Farias do Vale Junior, Cleóstones

; Pereira, Eva da Silva

; Silvestre, Leonardy Guilherme Ibrahim

; Dallan, Luís Roberto Palma

; Lisboa, Luiz Augusto

; Dallan, Luís Alberto Oliveira

; Jatene, Fabio Biscegli

; Mejia, Omar Asdrúbal Vilca

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 N. 9 elocation e20230768

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: A análise de indicadores como taxa de readmissão hospitalar é crucial para aprimorar a qualidade dos serviços e gestão em processos hospitalares. Objetivo: Identificar as variáveis correlacionadas a readmissão hospitalar até 30 dias após cirurgia de revascularização miocárdica (CRM). Métodos: Estudo de coorte transversal no banco de dados Registro Paulista de Cirurgia Cardiovascular II (REPLICCAR II)(N=3.392), de junho de 2017 a junho de 2019. Avaliaram-se retrospectivamente 150 pacientes para identificar os fatores correlacionados a readmissão hospitalar até 30 dias após-CRM via regressão logística univariada e multivariada. As análises foram realizadas no software R, com significância de 0,05 e intervalos de confiança de 95%. Resultados: Cento e cinquenta pacientes foram readmitidos até 30 dias após a alta hospitalar de CRM (150/3.392, 4,42%) principalmente por infecções (mediastinite, ferida operatória e sepse) totalizando 52 casos (52/150, 34,66%), outras causas foram: complicações cirúrgicas (14/150, 9,33%) e pneumonia (13/150, 8,66%). Os preditores de readmissão identificados foram: O modelo de regressão multivariada apontou intercepto (OR: 1,098, p<0,00001), apneia do sono (OR: 1,117, p=0,0165), arritmia cardíaca (OR: 1,040, p=0,0712) e uso de balão intra-aórtico (OR: 1,068, p=0,0021) como preditores do desfecho, com uma AUC de 0,70. Conclusão: 4,42% dos pacientes foram readmitidos pós-CRM, principalmente por infecções. Fatores como apneia do sono (OR: 1,117, p=0,0165), arritmia cardíaca (OR: 1,040, p=0,0712) e uso de balão intra-aórtico (OR: 1,068, p=0,0021) foram preditores de readmissão, com uma discriminação de risco moderada (AUC: 0,70). Fundamento hospitalares Objetivo 3 CRM. . (CRM) Métodos REPLICCAR IIN=3.392, IIN3392 IIN N=3.392 , N 392 II)(N=3.392) 201 2019 Avaliaramse Avaliaram se 15 apósCRM R 005 0 05 0,0 95 95% Resultados 150/3.392, 1503392 (150/3.392 442 4 42 mediastinite, mediastinite (mediastinite sepse 5 52/150, 52150 (52/150 34,66%, 3466 34,66% 34 66 34,66%) 14/150, 14150 14 (14/150 9,33% 933 9 33 13/150, 13150 13 (13/150 8,66%. 866 8,66% 8 8,66%) OR (OR 1098 1 098 1,098 p<0,00001, p000001 p p<0,00001 00001 p<0,00001) 1117 117 1,117 p=0,0165, p00165 p=0,0165 0165 p=0,0165) 1040 040 1,040 p=0,0712 p00712 0712 intraaórtico intra aórtico 1068 068 1,068 p=0,0021 p00021 0021 desfecho 070 70 0,70 Conclusão 4,42 pósCRM, pósCRM pós CRM, pós-CRM (AUC 0,70) (CRM IIN=3.392 IIN339 N3392 N=3.39 39 II)(N=3.392 20 00 0, 150/3.392 150339 (150/3.39 44 52/150 5215 (52/15 346 34,66 6 14/150 1415 (14/15 9,33 93 13/150 1315 (13/15 86 8,66 109 09 1,09 p00000 p<0,0000 0000 111 11 1,11 p0016 p=0,016 016 104 04 1,04 p=0,071 p0071 071 106 06 1,06 p=0,002 p0002 002 07 7 0,7 4,4 IIN=3.39 IIN33 N339 N=3.3 II)(N=3.39 2 150/3.39 15033 (150/3.3 52/15 521 (52/1 34,6 14/15 141 (14/1 9,3 13/15 131 (13/1 8,6 10 1,0 p0000 p<0,000 000 1,1 p001 p=0,01 01 p=0,07 p007 p=0,00 p000 4, IIN=3.3 IIN3 N33 N=3. II)(N=3.3 150/3.3 1503 (150/3. 52/1 (52/ 34, 14/1 (14/ 9, 13/1 (13/ 8, 1, p<0,00 p00 p=0,0 IIN=3. N3 N=3 II)(N=3. 150/3. (150/3 52/ (52 14/ (14 13/ (13 p<0,0 p0 p=0, IIN=3 N= II)(N=3 150/3 (150/ (5 (1 p<0, p=0 IIN= II)(N= 150/ (150 ( p<0 p= II)(N (15 p<

Abstract Background: The analysis of indicators such as hospital readmission rates is crucial for improving the quality of services and management of hospital processes. Objectives: To identify the variables correlated with hospital readmission up to 30 days following coronary artery bypass grafting (CABG). Methods: Cross-sectional cohort study by REPLICCAR II database (N=3,392) from June 2017 to June 2019. Retrospectively, 150 patients were analyzed to identify factors associated with hospital readmission within 30 days post-CABG using univariate and multivariate logistic regression. Analysis was conducted using software R, with a significance level of 0.05 and 95% confidence intervals. Results: Out of 3,392 patients, 150 (4,42%0 were readmitted within 30 days post-discharge from CABG primarily due to infections (mediastinitis, surgical wounds, and sepsis) accounting for 52 cases (34.66%). Other causes included surgical complications (14/150, 9.33%) and pneumonia (13/150, 8.66%). The multivariate regression model identified an intercept (OR: 1.098, p<0.00001), sleep apnea (OR: 1.117, p=0.0165), cardiac arrhythmia (OR: 1.040, p=0.0712), and intra-aortic balloon pump use (OR: 1.068, p=0.0021) as predictors of the outcome, with an AUC of 0.70. Conclusion: 4.42% of patients were readmitted post-CABG, mainly due to infections. Factors such as sleep apnea (OR: 1.117, p=0.0165), cardiac arrhythmia (OR: 1.040, p=0.0712), and intra-aortic balloon pump use (OR: 1.068, p=0.0021) were predictors of readmission, with moderate risk discrimination (AUC: 0.70). Background processes Objectives 3 CABG. . (CABG) Methods Crosssectional Cross sectional N=3,392 N3392 N 392 (N=3,392 201 2019 Retrospectively 15 postCABG post R 005 0 05 0.0 95 intervals Results 3392 3,39 4,42%0 4420 4 42 (4,42% postdischarge discharge mediastinitis, mediastinitis (mediastinitis wounds sepsis 5 34.66%. 3466 34.66% 34 66 (34.66%) 14/150, 14150 14 (14/150 9.33% 933 9 33 13/150, 13150 13 (13/150 8.66%. 866 8.66% 8 8.66%) OR (OR 1098 1 098 1.098 p<0.00001, p000001 p p<0.00001 , 00001 p<0.00001) 1117 117 1.117 p=0.0165, p00165 p=0.0165 0165 p=0.0165) 1040 040 1.040 p=0.0712, p00712 p=0.0712 0712 p=0.0712) intraaortic intra aortic 1068 068 1.068 p=0.0021 p00021 0021 outcome 070 70 0.70 Conclusion 442 4.42 postCABG, CABG, (AUC 0.70) (CABG N=3,39 N339 39 (N=3,39 20 00 0. 339 3,3 4,42% (4,42 346 34.66 6 (34.66% 14/150 1415 (14/15 9.33 93 13/150 1315 (13/15 86 8.66 109 09 1.09 p00000 p<0.0000 0000 111 11 1.11 p0016 p=0.016 016 104 04 1.04 p0071 p=0.071 071 106 06 1.06 p=0.002 p0002 002 07 7 0.7 44 4.4 N=3,3 N33 (N=3,3 2 3, 4,42 (4,4 34.6 (34.66 14/15 141 (14/1 9.3 13/15 131 (13/1 8.6 10 1.0 p0000 p<0.000 000 1.1 p001 p=0.01 01 p007 p=0.07 p=0.00 p000 4. N=3, N3 (N=3, 4,4 (4, 34. (34.6 14/1 (14/ 9. 13/1 (13/ 8. 1. p<0.00 p00 p=0.0 N=3 (N=3 4, (4 (34. 14/ (14 13/ (13 p<0.0 p0 p=0. N= (N= ( (34 (1 p<0. p=0 (N (3 p<0 p= p<

https://doi.org/10.36660/abc.20230768

Is It Safe to Use Arterial Grafts in Patients with Acute Myocardial Infarction? Short-Mid-Term Propensity Analysis Infarction ShortMidTerm Short Mid Term
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Lacava, Leonardo

; Borgomoni, Gabrielle Barbosa

; Lopes, Leticia de Mendonça

; Freitas, Leonardo Passaglia de

; Freitas, Fabiane Leticia

; Dallan, Luís Roberto Palma

; Lisboa, Luiz Augusto Ferreira

; Nicolau, José Carlos

; Jatene, Fabio B.

; Mejia, Omar Asdrúbal Vilca

Brazilian Journal of Cardiovascular Surgery

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2024, Volume 39 N. 6 elocation e20230384

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: The use of multiple arterial grafts (MAGs) has an impact on patient survival; however, preference for its use in the acute phase of myocardial infarction (AMI) has not yet been established. This study aimed to compare the short-mid-term clinical results of AMI patients undergoing coronary artery bypass grafting (CABG) with a single arterial graft (SAG) vs. MAGs. Methods: This is a cross-sectional cohort study of 4,053 patients from the Registro Paulista de Cirurgia Cardiovascular II (REPLICCAR II). CABG in the AMI was considered when performed between one and seven days after diagnosis (n=238). Thirty-five patients underwent surgery with ≥ 2 arterial grafts (MAG group), population adjustment in SAG group was performed using the propensity score matching (PSM). Clinical follow-up was performed by telephone to assess need for readmission, new AMI, reoperation, and death. Results: After PSM, 70 patients were evaluated. During hospitalization, a significant statistical difference was observed in the surgery duration: the MAG group had a median of 4.78 hours while the SAG group had 4.11 hours (P=0.040). Within the MAG group, there was a predominance use of bilateral internal thoracic artery (62.86%), followed by radial graft associated with the use of left internal thoracic artery (28.57%) and the combination of the three grafts (8.57%). There were no significant differences between the groups in terms of outcomes up to 30 days after CABG or up to five years after CABG. Conclusion: In REPLICCAR II, usage of MAGs in the AMI was not associated with clinical worsening of patients until the mid-term follow-up. Introduction (MAGs survival however (AMI established shortmidterm short mid term (CABG (SAG vs Methods crosssectional cross sectional 4053 4 053 4,05 II. . II) n=238. n238 n n=238 238 (n=238) Thirtyfive Thirty , group) PSM. PSM (PSM) followup follow readmission reoperation death Results 7 evaluated hospitalization duration 478 78 4.7 411 11 4.1 P=0.040. P0040 P P=0.040 0 040 (P=0.040) 62.86%, 6286 62.86% 62 86 (62.86%) 28.57% 2857 28 57 (28.57% 8.57%. 857 8.57% 8 (8.57%) 3 Conclusion midterm followup. up. 405 05 4,0 n23 n=23 23 (n=238 (PSM 47 4. 41 1 P004 P=0.04 04 (P=0.040 628 62.86 6 (62.86% 28.57 285 5 (28.57 85 8.57 (8.57% 40 4, n2 n=2 (n=23 P00 P=0.0 (P=0.04 62.8 (62.86 28.5 (28.5 8.5 (8.57 n= (n=2 P0 P=0. (P=0.0 62. (62.8 28. (28. 8. (8.5 (n= P=0 (P=0. (62. (28 (8. (n P= (P=0 (62 (2 (8 (P= (6 ( (P

https://doi.org/10.21470/1678-9741-2023-0384

Excesso de Pressão Arterial Sistólica Associada com Poluição Aérea por Material Particulado Fino Acima da Diretriz da OMS no Brasil
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Salerno, Pedro Rafael Vieira de Oliveira

; Motairek, Issam

; Dallan, Luis Augusto Palma

; Bourges-Sevenier, Brendan

; Rajagopalan, Sanjay

; Al-Kindi, Sadeer G.

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 11 elocation e20230347

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.36660/abc.20230347

Resultados Imediatos após Múltiplos Enxertos Arteriais em Cirurgia de Revascularização Miocárdica no Estado de São Paulo: Estudo de Coorte Paulo
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Paredes, Raúl Armando Micalay

; Borgomoni, Gabrielle Barbosa

; Micalay, Anny Kátia Puchalski

; Camacho, José Carlos Arteaga

; Dallan, Luís Roberto Palma

; Lisboa, Luiz Augusto Ferreira

; Dallan, Luís Alberto de Oliveira

; Mejia, Omar Asdrúbal Vilca

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 3 elocation e20220627

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento Os resultados a curto prazo após o uso de enxertos arteriais ainda suscitam questionamentos e dúvidas na sociedade médica. Objetivo Comparar os resultados imediatos de pacientes submetidos à cirurgia de revascularização do miocárdio com enxerto arterial único versus enxertos arteriais múltiplos. Métodos Estudo de coorte transversal no Registro Paulista de Cirurgia Cardiovascular II (REPLICCAR II). Os dados perioperatórios de 3122 pacientes foram agrupados pelo número de enxertos arteriais utilizados e seus desfechos foram comparados: reoperação, infecção profunda da ferida torácica (IPFT), acidente vascular cerebral, lesão renal aguda, intubação prolongada (>24 horas), tempo de internação curta (<6 dias), tempo de internação prolongada (>14 dias), morbidade e mortalidade. O Propensity Score Matching (PSM) correspondeu a 1062 pacientes, ajustado para o risco de mortalidade. Resultados Após PSM, o grupo enxerto arterial único apresentou pacientes com idade avançada, mais ex-fumantes, hipertensos, diabéticos, portadores de angina estável e infarto do miocárdio prévio. Nos enxertos arteriais múltiplos houve predomínio do sexo masculino, pneumonia recente e cirurgias de urgência. Após o procedimento, houve maior incidência de derrame pleural (p=0,042), pneumonia (p=0,01), reintubação (p=0,006), IPFT (p=0,007) e desbridamento esternal (p=0,015) no grupo de enxertos multiarteriais, porém, menor necessidade de hemotransfusão (p=0,005), infecções de extremidades (p=0,002) e menor tempo de internação (p=0,036). O uso bilateral da artéria torácica interna não foi relacionado ao aumento da taxa de IPFT, e sim a hemoglobina glicosilada >6,40% (p=0,048). Conclusão Pacientes submetidos a técnica multiarterial apresentaram maior incidência de complicações pulmonares e IPFT, sendo que a hemoglobina glicosilada ≥6,40% teve maior influência no resultado infeccioso do que a escolha dos enxertos. médica REPLICCAR II. . II) 312 comparados reoperação , (IPFT) cerebral aguda >24 24 (>2 horas, horas horas) <6 6 (< dias, dias dias) >14 14 (>1 mortalidade PSM (PSM 106 avançada exfumantes, exfumantes ex fumantes, fumantes ex-fumantes hipertensos diabéticos prévio masculino urgência procedimento p=0,042, p0042 p p=0,042 0 042 (p=0,042) p=0,01, p001 p=0,01 01 (p=0,01) p=0,006, p0006 p=0,006 006 (p=0,006) p=0,007 p0007 007 (p=0,007 p=0,015 p0015 015 (p=0,015 multiarteriais porém p=0,005, p0005 p=0,005 005 (p=0,005) p=0,002 p0002 002 (p=0,002 p=0,036. p0036 p=0,036 036 (p=0,036) 640 40 >6,40 p=0,048. p0048 p=0,048 048 (p=0,048) ≥6,40 31 (IPFT >2 2 (> < ( >1 1 10 p004 p=0,04 04 (p=0,042 p00 p=0,0 (p=0,01 p000 p=0,00 00 (p=0,006 (p=0,00 (p=0,005 p003 p=0,03 03 (p=0,036 64 4 >6,4 (p=0,048 ≥6,4 3 > (p=0,04 p0 p=0, (p=0,0 (p=0,03 >6, ≥6, p=0 (p=0, >6 ≥6 p= (p=0 ≥ (p= (p

Abstract Background The short-term results after using arterial grafts still raise questions and doubts for medical society. Objective To compare the immediate outcomes of patients undergoing single arterial graft versus multiple arterial grafts coronary artery bypass grafting surgery. Methods Cross-sectional cohort study in the São Paulo Registry of Cardiovascular Surgery II (REPLICCAR II). Perioperative data from 3122 patients were grouped by the number of arterial grafts used, and their outcomes were compared: reoperation, deep sternal wound infection (DSWI), stroke, acute kidney injury, prolonged intubation (>24 hours), short hospital stay (<6 days), prolonged hospital stay (>14 days), morbidity and mortality. Propensity Score Matching (PSM) matched 1062 patients, adjusted for the mortality risk. Results After PSM, the single arterial graft group showed patients with advanced age, more former smokers, hypertension, diabetes, stable angina, and previous myocardial infarction. In the multiple arterial grafts, there was a predominance of males, recent pneumonia, and urgent surgeries. After the procedure, there was a higher incidence of pleural effusion (p=0.042), pneumonia (p=0.01), reintubation (p=0.006), DSWI (p=0.007), and sternal debridement (p=0.015) in the multiple arterial grafts group, however, less need for blood transfusion (p=0.005), extremity infections (p=0.002) and shorter hospital stays (p=0.036). Bilateral use of the internal thoracic artery was not related to increased DSWI rate, but glycosylated hemoglobin >6.40% (p=0.048). Conclusion Patients undergoing the multiarterial technique had a higher incidence of pulmonary complications, and DSWI, where glycosylated hemoglobin ≥6.40%, had a greater influence on the infectious outcome than the choice of grafts. shortterm term society surgery Crosssectional Cross sectional REPLICCAR II. . II) 312 used compared reoperation , (DSWI) stroke injury >24 24 (>2 hours, hours hours) <6 6 (< days, days days) >14 14 (>1 PSM (PSM 106 risk age smokers hypertension diabetes angina infarction males surgeries procedure p=0.042, p0042 p p=0.042 0 042 (p=0.042) p=0.01, p001 p=0.01 01 (p=0.01) p=0.006, p0006 p=0.006 006 (p=0.006) p=0.007, p0007 p=0.007 007 (p=0.007) p=0.015 p0015 015 (p=0.015 however p=0.005, p0005 p=0.005 005 (p=0.005) p=0.002 p0002 002 (p=0.002 p=0.036. p0036 p=0.036 036 (p=0.036) rate 640 40 >6.40 p=0.048. p0048 p=0.048 048 (p=0.048) complications ≥6.40% 31 (DSWI >2 2 (> < ( >1 1 10 p004 p=0.04 04 (p=0.042 p00 p=0.0 (p=0.01 p000 p=0.00 00 (p=0.006 (p=0.007 (p=0.005 (p=0.00 p003 p=0.03 03 (p=0.036 64 4 >6.4 (p=0.048 ≥6.40 3 > (p=0.04 p0 p=0. (p=0.0 (p=0.03 >6. ≥6.4 p=0 (p=0. >6 ≥6. p= (p=0 ≥6 (p= ≥ (p

https://doi.org/10.36660/abc.20220627

Impacto da Primeira Onda da Pandemia de COVID-19 na Cirurgia Cardiovascular no Brasil: Análise de um Centro Terciário de Referência
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Lisboa, Luiz Augusto

; Mejia, Omar Asdrúbal Vilca

; Arita, Elisandra Trevisan

; Guerreiro, Gustavo Pampolha

; Silveira, Lucas Molinari Veloso da

; Brandão, Carlos Manuel de Almeida

; Dias, Ricardo Ribeiro

; Dallan, Luís Roberto Palma

; Miana, Leonardo

; Caneo, Luiz F.

; Jatene, Marcelo Biscegli

; Dallan, Luís Alberto Oliveira

; Jatene, Fabio Biscegli

Arquivos Brasileiros de Cardiologia

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mar 2022, Volume 118 N. 3 Pages 663 - 666

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20210235

Adherence to the cardiac surgery checklist decreased mortality at a teaching hospital: A retrospective cohort study
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Mejia, Omar Asdrúbal Vilca

; Mendonça, Frederico Carlos Cordeiro de

; Sampaio, Lucimar Aparecida Barrense Nogueira

; Galas, Filomena Regina Barbosa Gomes

; Pontes, Mauricio Franklin

; Caneo, Luiz Fernando

; Dallan, Luís Roberto Palma

; Lisboa, Luiz Augusto Ferreira

; Ferreira, João Fernando Monteiro

; Dallan, Luís Alberto de Oliveira

; Jatene, Fabio Biscegli

Clinics

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2022, Volume 77 elocation 100048

Abstract: En | Text: En | PDF: En

Abstract Objectives To evaluate the impact of adherence to the cardiac surgical checklist on mortality at the teaching hospital. Methods A retrospective cohort study after the implementation of the cardiac surgical safety checklist in a reference hospital in Latin America. All patients undergoing coronary artery bypass surgery and/or heart valve surgery from 2013 to 2019 were analyzed. After the implementation of the project InCor-Checklist “Five steps to safe cardiac surgery” in 2015, the correlation between adherence and completeness of this instrument with surgical mortality was assessed. The EuroSCORE II was used as a reference to assess the risk of expected mortality for patients. Cross-sectional questionnaires were during the implementation of the InCor-Checklist. To perform the correlation, Pearson’s coefficient was calculated using R software. Results Since 2013, data from 8139 patients have been analyzed. The average annual mortality was 5.98%. In 2015, the instrument was used in only 58% of patients; in contrast, it was used in 100% of patients in 2019. There was a decrease in surgical mortality from 8.22% to 3.13% for the same group of procedures. The results indicate that the greater the checklist use, the lower the surgical mortality (r = 88.9%). In addition, the greater the InCor-Checklist completeness, the lower the surgical mortality (r = 94.1%). Conclusion In the formation of the surgical patient safety culture, the implementation and adherence to the InCor-Checklist “Five steps to safe cardiac surgery” was associated with decreased mortality after cardiac surgery. HIGHLIGHTS Checklists avoid human errors and are commonly used in high-reliability industries. The “InCor Checklist” was associated with decreased mortality over time. Adherence, completeness, and sustainability within public policies are necessary.

https://doi.org/10.1016/j.clinsp.2022.100048

10.

Multivessel Woven Coronary Artery Disease
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Dallan, Luis Roberto Palma

; Dallan, Luís Alberto Oliveira

; Moretti, Miguel

; Moragas, Ana Beatriz Camerlengo

; Dallan, Luís Augusto Palma

; B.Jatene, Fabio

Brazilian Journal of Cardiovascular Surgery

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dec 2021, Volume 36 N. 6 Pages 825 - 828

Abstract: En | Text: En | PDF: En

Abstract Woven coronary disease is a rare pathology with unknown etiology. Although initially considered benign, recent publications report myocardial ischemia caused by the affected vessel. Since most patients are asymptomatic, long-term follow-up to understand its behavior is mandatory. We report a multivessel woven disease case with documented ischemia that was submitted to coronary artery bypass grafting and remained asymptomatic for two years of follow-up.

https://doi.org/10.21470/1678-9741-2021-0153

11.

Pericardial-Peritoneal Window as an Alternative Treatment for Large and Recurrent Pericardial Effusion Post-Pericardiotomy PericardialPeritoneal Peritoneal PostPericardiotomy Post Pericardiotomy
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Dallan, Luis Roberto Palma

; Dallan, Luis Alberto Oliveira

; Mejía, Omar Vilca

; Dallan, Luis Augusto Palma

; Lisboa, Luiz Augusto Ferreira

; Jatene, Fabio B.

Brazilian Journal of Cardiovascular Surgery

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aug 2021, Volume 36 N. 4 Pages 581 - 583

Abstract: En | Text: En | PDF: En

Abstract Introduction: The presence of mild to moderate pericardial effusion after cardiac surgery is common and oral medical therapy is usually able to treat it. Larger effusions are less frequent and surgical intervention is usually necessary. However, there are some rare cases of large effusions that are recurrent even after intervention and become challenging to treat. Methods: We describe the case of a patient submitted to coronary artery bypass grafting (CABG) without any intraoperative complications, who was regularly discharged from the hospital. She was referred to our emergency department twice after surgery with large pericardial effusion that was drained. Even after those two interventions and with adequate oral medication, the large effusion recurred. Results: During follow-up, the patient had her symptoms resolved, with no need for further hospital admission. Her echocardiograms after the last intervention showed no pericardial effusion. The present surgical technique demonstrated to be easy to perform, thus it should be considered as a treatment option for these rare cases of large and repetitive effusions, which do not respond to the traditional methods. Conclusions: In challenging cases of recurrent and large pericardial effusions, the pericardial-peritoneal window is an alternative surgical technique that brings clinical improvement and diminishes the risk of cardiac tamponade. Introduction necessary However Methods CABG (CABG complications drained medication recurred Results followup, followup follow up, up follow-up resolved admission perform methods Conclusions pericardialperitoneal peritoneal tamponade

https://doi.org/10.21470/1678-9741-2020-0355 143 downloads

12.

Diretrizes da Sociedade Brasileira de Cardiologia sobre Angina Instável e Infarto Agudo do Miocárdio sem Supradesnível do Segmento ST – 2021
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Nicolau, José Carlos

; Feitosa Filho, Gilson Soares

; Petriz, João Luiz

; Furtado, Remo Holanda de Mendonça

; Précoma, Dalton Bertolim

; Lemke, Walmor

; Lopes, Renato Delascio

; Timerman, Ari

; Marin Neto, José A.

; Bezerra Neto, Luiz

; Gomes, Bruno Ferraz de Oliveira

; Santos, Eduardo Cavalcanti Lapa

; Piegas, Leopoldo Soares

; Soeiro, Alexandre de Matos

; Negri, Alexandre Jorge de Andrade

; Franci, Andre

; Markman Filho, Brivaldo

; Baccaro, Bruno Mendonça

; Montenegro, Carlos Eduardo Lucena

; Rochitte, Carlos Eduardo

; Barbosa, Carlos José Dornas Gonçalves

; Virgens, Cláudio Marcelo Bittencourt das

; Stefanini, Edson

; Manenti, Euler Roberto Fernandes

; Lima, Felipe Gallego

; Monteiro Júnior, Francisco das Chagas

; Correa Filho, Harry

; Pena, Henrique Patrus Mundim

; Pinto, Ibraim Masciarelli Francisco

; Falcão, João Luiz de Alencar Araripe

; Sena, Joberto Pinheiro

; Peixoto, José Maria

; Souza, Juliana Ascenção de

; Silva, Leonardo Sara da

; Maia, Lilia Nigro

; Ohe, Louis Nakayama

; Baracioli, Luciano Moreira

; Dallan, Luís Alberto de Oliveira

; Dallan, Luis Augusto Palma

; Mattos, Luiz Alberto Piva e

; Bodanese, Luiz Carlos

; Ritt, Luiz Eduardo Fonteles

; Canesin, Manoel Fernandes

; Rivas, Marcelo Bueno da Silva

; Franken, Marcelo

; Magalhães, Marcos José Gomes

; Oliveira Júnior, Múcio Tavares de

; Filgueiras Filho, Nivaldo Menezes

; Dutra, Oscar Pereira

; Coelho, Otávio Rizzi

; Leães, Paulo Ernesto

; Rossi, Paulo Roberto Ferreira

; Soares, Paulo Rogério

; Lemos Neto, Pedro Alves

; Farsky, Pedro Silvio

; Cavalcanti, Rafael Rebêlo C.

; Alves, Renato Jorge

; Kalil, Renato Abdala Karam

; Esporcatte, Roberto

; Marino, Roberto Luiz

; Giraldez, Roberto Rocha Corrêa Veiga

; Meneghelo, Romeu Sérgio

; Lima, Ronaldo de Souza Leão

; Ramos, Rui Fernando

; Falcão, Sandra Nivea dos Reis Saraiva

; Dalçóquio, Talia Falcão

; Lemke, Viviana de Mello Guzzo

; Chalela, William Azem

; Mathias Júnior, Wilson

Arquivos Brasileiros de Cardiologia

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jul 2021, Volume 117 N. 1 Pages 181 - 264

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20210180 3052 downloads

13.

Coronary Artery Bypass Graft During the COVID-19 Pandemic
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Silveira, Lucas Molinari Veloso da

; Guerreiro, Gustavo Pampolha

; Lisboa, Luiz Augusto Ferreira

; Mejía, Omar Asdrúbal Vilca

; Dallan, Luís Roberto Palma

; Dallan, Luís Alberto Oliveira

; Jatene, Fabio B

Brazilian Journal of Cardiovascular Surgery

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dec 2020, Volume 35 N. 6 Pages 1003 - 1006

Abstract: En | Text: En | PDF: En

Abstract Since the beginning of the coronavirus disease (COVID-19) pandemic, in March 2020, the number of people infected with COVID-19 worldwide increases continuously. Brazil is being followed with great concern in the international media, as it can, very soon, be the epicenter of the pandemic. Initial surgical data suggest that patients who acquire COVID-19 in the perioperative period are prone to a higher morbidity and mortality, however, evidence in cardiac surgery is still scarce. 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.

https://doi.org/10.21470/1678-9741-2020-0283 444 downloads

14.

Atualização da Diretriz de Ressuscitação Cardiopulmonar e Cuidados Cardiovasculares de Emergência da Sociedade Brasileira de Cardiologia - 2019
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Bernoche, Claudia

; Timerman, Sergio

; Polastri, Thatiane Facholi

; Giannetti, Natali Schiavo

; Siqueira, Adailson Wagner da Silva

; Piscopo, Agnaldo

; Soeiro, Alexandre de Matos

; Reis, Amélia Gorete Afonso da Costa

; Tanaka, Ana Cristina Sayuri

; Thomaz, Ana Maria

; Quilici, Ana Paula

; Catarino, Andrei Hilário

; Ribeiro, Anna Christina de Lima

; Barreto, Antonio Carlos Pereira

; Azevedo Filho, Antonio Fernando Barros de

; Pazin Filho, Antonio

; Timerman, Ari

; Scarpa, Bruna Romanelli

; Timerman, Bruno

; Tavares, Caio de Assis Moura

; Martins, Cantidio Soares Lemos

; Serrano Junior, Carlos Vicente

; Malaque, Ceila Maria Sant’Ana

; Pisani, Cristiano Faria

; Batista, Daniel Valente

; Leandro, Daniela Luana Fernandes

; Szpilman, David

; Gonçalves, Diego Manoel

; Paiva, Edison Ferreira de

; Osawa, Eduardo Atsushi

; Lima, Eduardo Gomes

; Adam, Eduardo Leal

; Peixoto, Elaine

; Evaristo, Eli Faria

; Azeka, Estela

; Silva, Fabio Bruno da

; Wen, Fan Hui

; Ferreira, Fatima Gil

; Lima, Felipe Gallego

; Fernandes, Felipe Lourenço

; Ganem, Fernando

; Galas, Filomena Regina Barbosa Gomes

; Tarasoutchi, Flavio

; Souza, Germano Emilio Conceição

; Feitosa Filho, Gilson Soares

; Foronda, Gustavo

; Guimarães, Helio Penna

; Abud, Isabela Cristina Kirnew

; Leite, Ivanhoé Stuart Lima

; Linhares Filho, Jaime Paula Pessoa

; Moraes Junior, João Batista de Moura Xavier

; Falcão, João Luiz Alencar de Araripe

; Ramires, Jose Antônio Franchini

; Cavalini, José Fernando

; Saraiva, José Francisco Kerr

; Abrão, Karen Cristine

; Pinto, Lecio Figueira

; Bianchi, Leonardo Luís Torres

; Lopes, Leonardo Nícolau Geisler Daud

; Piegas, Leopoldo Soares

; Kopel, Liliane

; Godoy, Lucas Colombo

; Tobase, Lucia

; Hajjar, Ludhmila Abrahão

; Dallan, Luís Augusto Palma

; Caneo, Luiz Fernando

; Cardoso, Luiz Francisco

; Canesin, Manoel Fernandes

; Park, Marcelo

; Rabelo, Marcia Maria Noya

; Malachias, Marcus Vinícius Bolívar

; Gonçalves, Maria Aparecida Batistão

; Almeida, Maria Fernanda Branco de

; Souza, Maria Francilene Silva

; Favarato, Maria Helena Sampaio

; Carrion, Maria Julia Machline

; Gonzalez, Maria Margarita

; Bortolotto, Maria Rita de Figueiredo Lemos

; Macatrão-Costa, Milena Frota

; Shimoda, Mônica Satsuki

; Oliveira-Junior, Mucio Tavares de

; Ikari, Nana Miura

; Dutra, Oscar Pereira

; Berwanger, Otávio

; Pinheiro, Patricia Ana Paiva Corrêa

; Reis, Patrícia Feitosa Frota dos

; Cellia, Pedro Henrique Moraes

; Santos Filho, Raul Dias dos

; Gianotto-Oliveira, Renan

; Kalil Filho, Roberto

; Guinsburg, Ruth

; Managini, Sandrigo

; Lage, Silvia Helena Gelas

; Yeu, So Pei

; Franchi, Sonia Meiken

; Shimoda-Sakano, Tania

; Accorsi, Tarso Duenhas

; Leal, Tatiana de Carvalho Andreucci

; Guimarães, Vanessa

; Sallai, Vanessa Santos

; Ávila, Walkiria Samuel

; Sako, Yara Kimiko

Arquivos Brasileiros de Cardiologia

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sep 2019, Volume 113 N. 3 Pages 449 - 663

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.5935/abc.20190203 54793 downloads

15.

Off-pump versus On-pump Coronary Artery Bypass Grafting in Frail Patients: Study Protocol for the FRAGILE Multicenter Randomized Controlled Trial
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Mejía, Omar Asdrúbal Vilca

; Sá, Michel Pompeu Barros Oliveira

; Deininger, Maurilio Onofre

; Dallan, Luís Roberto Palma

; Segalote, Rodrigo Coelho

; Oliveira, Marco Antonio Praça de

; Atik, Fernando Antibas

; Santos, Magaly Arrais dos

; Silva, Pedro Gabriel Melo de Barros e

; Milani, Rodrigo Mussi

; Hueb, Alexandre Ciappina

; Monteiro, Rosangela

; Lima, Ricardo Carvalho

; Lisboa, Luiz Augusto Ferreira

; Dallan, Luís Alberto Oliveira

; Puskas, John

; Jatene, Fabio Biscegli

Brazilian Journal of Cardiovascular Surgery

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oct 2017, Volume 32 N. 5 Pages 428 - 434

Abstract: En | Text: En | PDF: En

Abstract Introduction: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress. In this study, the authors introduce the new national, multicenter, randomized, controlled trial "FRAGILE", to be developed in the main cardiac surgery centers of Brazil, to clarify the potential benefit of off-pump CABG in frail patients. Methods: FRAGILE is a two-arm, parallel-group, multicentre, individually randomized (1:1) controlled trial which will enroll 630 patients with blinded outcome assessment (at 30 days, 6 months, 1 year, 2 years and 3 years), which aims to compare adverse cardiac and cerebrovascular events after off-pump versus on-pump CABG in pre-frail and frail patients. Primary outcomes will be all-cause mortality, acute myocardial infarction, cardiac arrest with successful resuscitation, low cardiac output syndrome/cardiogenic shock, stroke, and coronary reintervention. Secondary outcomes will be major adverse cardiac and cerebrovascular events, operative time, mechanical ventilation time, hyperdynamic shock, new onset of atrial fibrillation, renal replacement therapy, reoperation for bleeding, pneumonia, length of stay in intensive care unit, length of stay in hospital, number of units of blood transfused, graft patency, rate of complete revascularization, neurobehavioral outcomes after cardiac surgery, quality of life after cardiac surgery and costs. Discussion: FRAGILE trial will determine whether off-pump CABG is superior to conventional on-pump CABG in the surgical treatment of pre-frail and frail patients. Trial registration: ClinicalTrials.gov, ID: NCT02338947. Registered on August 29th 2014; last updated on March 21st 2016.

https://doi.org/10.21470/1678-9741-2017-0196 1017 downloads

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