29 results on '"Heraldo Guedis Lobo Filho"'
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2. Effect of preservation solution and distension pressure on saphenous vein’s endothelium
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Matheus Duarte Pimentel, José Glauco Lobo Filho, Heraldo Guedis Lobo Filho, Emílio de Castro Miguel, Sergimar Kennedy Pinheiro Paiva, João Igor Silva Matos, Matheus Augusto Mesquita Fernandes, and Francisco Vagnaldo Fechine Jamacaru more...
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Pulmonary and Respiratory Medicine ,Endothelial Cells ,Humans ,Saphenous Vein ,Surgery ,Endothelium, Vascular ,Coronary Artery Bypass ,Cardiology and Cardiovascular Medicine ,Dilatation, Pathologic - Abstract
OBJECTIVES Approaches to improve saphenous vein (SV) patency in coronary artery bypass graft (CABG) surgery remain relevant. This study aimed to evaluate the effects of different preservation solutions and different pressures of intraluminal distention on the endothelium of SV segments in CABG. METHODS Forty-two SV segments obtained from 12 patients undergoing CABG were divided into 7 groups. Group 1 (control) was prepared without preservation or intraluminal distension, while the other 6 groups were preserved in autologous heparinized autologous arterial blood or normal saline (NS), with distention pressures 30, 100 and 300 mmHg. To assess the effects of using these solutions and pressures on the endothelium, the grafts were analysed by scanning electron microscopy, with the measurement of endothelial damage degree. RESULTS Segments in group 1 showed minimal endothelial damage. SV grafts preserved with NS had significantly greater endothelial damage both compared to the control group and compared to groups preserved with autologous arterial blood (P CONCLUSIONS Preparation of SV using NS and with intraluminal distension pressures above 100 mmHg is factors related to increased damage to the venous endothelium. more...
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- 2022
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3. Composite graft and remodeling of the saphenous vein in coronary artery bypass graft
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José Glauco, Lobo Filho, Matheus Duarte, Pimentel, and Heraldo Guedis, Lobo Filho
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Pulmonary and Respiratory Medicine ,Surgery ,Cardiology and Cardiovascular Medicine - Published
- 2022
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4. Composite Graft for Calcified Ascending Aorta in Coronary Artery Bypass Grafting
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José Glauco Lobo Filho, Matheus Duarte Pimentel, and Heraldo Guedis Lobo Filho
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Bypass grafting ,business.industry ,Aortic Diseases ,Surgery ,medicine.anatomical_structure ,medicine.artery ,Ascending aorta ,Medicine ,Humans ,Composite graft ,Coronary Artery Bypass ,Cardiology and Cardiovascular Medicine ,business ,Aorta ,Artery - Published
- 2021
5. Dual platelet antiaggregation therapy after myocardial revascularization surgery
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Eduardo Gomes Lima, Daniel Valente Batista, Carla David Soffiatti, Mateus Paiva Marques Feitosa, Carlos Vicente Serrano Junior, Jaime Paula Pessoa Linhares Filho, and Heraldo Guedis Lobo Filho
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Ticagrelor ,medicine.medical_specialty ,Inibidores da agregação de plaquetas ,Coronary artery bypass ,Context (language use) ,Coronary Artery Disease ,Doença da artéria coronariana ,030204 cardiovascular system & hematology ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Occlusion ,medicine ,Humans ,Platelet ,030212 general & internal medicine ,Coronary Artery Bypass ,Aspirina ,Vascular Patency ,Aspirin ,lcsh:R5-920 ,business.industry ,Graft Occlusion, Vascular ,General Medicine ,Ponte de artéria coronária ,medicine.disease ,Clopidogrel ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Platelet aggregation inhibitor ,business ,lcsh:Medicine (General) ,Platelet Aggregation Inhibitors ,medicine.drug ,Artery - Abstract
SUMMARY Coronary artery bypass graft (CABG) is a consolidated treatment in patients with coronary artery disease (CAD) for both symptom control and improvement of prognosis. The patency of venous grafts is still the most vulnerable point of the surgical treatment since it presents a high prevalence of occlusion both in the immediate postoperative period and in the long-term follow-up. Aspirin plays a well-established role in this setting, and for a long time, clopidogrel use has been restricted to patients allergic to aspirin. Recently, subgroup analyses of studies with different anti-platelet therapies have shown reduced mortality and cardiovascular events in patients on dual anti-platelet antiplatelet therapy (DAPT) undergoing CABG, although such studies have not been designed to evaluate this patient profile. However, there is still an insufficient number of randomized studies using DAPT in this context, resulting in a disagreement between the European and American cardiology societies guidelines regarding their indication and generating doubts in clinical practice. RESUMO A cirurgia de revascularização miocárdica (CRM) é tratamento fundamental em pacientes com doença arterial coronariana (DAC) tanto para controle de sintomas quanto para melhora do prognóstico. A patência dos enxertos venosos ainda hoje é o ponto mais vulnerável do tratamento cirúrgico, por apresentar alta prevalência de oclusão tanto no pós-operatório imediato como no seguimento em longo prazo. A aspirina tem papel bem estabelecido neste cenário e, por muito tempo, o uso do clopidogrel ficou restrito a pacientes alérgicos a aspirina. Recentemente, análises de subgrupos de estudos com diferentes terapias antiplaquetárias demonstraram redução de mortalidade e eventos cardiovasculares em pacientes em uso de dupla antiagregação plaquetária (Dapt) submetidos à CRM, ainda que tais estudos não tenham sido desenhados para avaliar este perfil de pacientes. Contudo, há ainda uma quantidade insuficiente de estudos randomizados com uso de Dapt nesse contexto, resultando em uma discordância entre as diretrizes europeia e americana de cardiologia quanto à sua indicação e gerando dúvidas na prática clínica. more...
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- 2019
6. Bilateral internal thoracic artery versus left internal thoracic artery and saphenous vein grafting in coronary artery bypass surgery
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Heraldo Guedis Lobo Filho, Matheus Duarte Pimentel, and José Glauco Lobo Filho
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Grafting (decision trees) ,General Medicine ,Internal thoracic artery ,Surgery ,Left internal thoracic artery ,Coronary artery bypass surgery ,medicine.anatomical_structure ,medicine.artery ,medicine ,Saphenous Vein ,Coronary Artery Bypass ,Mammary Arteries ,Cardiology and Cardiovascular Medicine ,Vein ,business ,Internal Mammary-Coronary Artery Anastomosis - Published
- 2019
7. Cardiac Leiomyosarcoma
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Matheus Duarte Pimentel, Caroline Cleophas Lobo Leite, Joely Nataly Silva, José Glauco Lobo Filho, and Heraldo Guedis Lobo Filho
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- 2018
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8. Coronary Artery Bypass Grafting With Arteriovenous Composite Graft: General Considerations
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Matheus Duarte Pimentel, Heraldo Guedis Lobo Filho, and José Glauco Lobo Filho
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medicine.medical_specialty ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Bypass grafting ,business.industry ,medicine ,Composite graft ,Coronary Artery Bypass ,Cardiology and Cardiovascular Medicine ,business ,Vascular Patency ,Surgery ,Artery - Published
- 2018
9. Pathophysiology of saphenous vein valves in coronary artery bypass with composite arteriovenous grafts
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Matheus Duarte Pimentel, Heraldo Guedis Lobo Filho, and José Glauco Lobo Filho
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medicine.medical_specialty ,business.industry ,Pathophysiology ,Surgery ,medicine.anatomical_structure ,Text mining ,Your Comments ,medicine ,Arteriovenous grafts ,Cardiology and Cardiovascular Medicine ,Vein ,business ,Artery - Published
- 2019
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10. Análise do perfil das cirurgias cardiovasculares do Hospital Universitário Walter Cantídio
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Matheus Duarte Pimentel, Isadora Lopes Bessa, Carolina Oliveira Sousa, José Glauco Lobo Filho, Heraldo Guedis Lobo Filho, Gladson Fernandes Vieira, and Caroline Cleophas Lobo Leite
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lcsh:R5-920 ,lcsh:R ,lcsh:Medicine ,General Earth and Planetary Sciences ,Base de Dados ,Sistema Único de Saúde ,Procedimentos Cirúrgicos Cardiovasculares ,Base de dados ,lcsh:Medicine (General) ,Procedimentos cirúrgicos cardiovasculares ,General Environmental Science - Abstract
Objetivo: analisar o perfil das cirurgias cardiovasculares (CCV) realizadas no Hospital Universitário Walter Cantídio (HUWC) de 2009 a 2016, comparando este com o verificado no restante do Brasil. Material e Métodos: neste estudo observacional e retrospectivo, analisou-se em banco de dados os tipos de CCV no período citado, sendo estes agrupados por tipo e ano. Análise local foi então comparada com dados do DATASUS. Resultados: realizou-se 680 procedimentos no período analisado. Destes, 392 (57,72 ± 9,4%) cirurgias de revascularização do miocárdio (CRM), 199 (29,28 ± 6,16%) cirurgias orovalvares, 36 (5,54 ± 3,09%) CRM combinada a procedimentos orovalvares, 21 (3,01 ± 2,45%) correções de cardiopatias congênitas, e 33 (4,62 ± 2,70%) outros procedimentos. Nacionalmente, realizou-se, no período analisado, 354.129 procedimentos em CCV, dos quais 181.570 (51,27 ± 1,02%) foram CRM, 85.392 (24,11 ± 0,25%) cirurgias orovalvares, 16.677 (4,71 ± 0,35%) CRM associadas a troca e/ou plastia valvar, 39.086 (11,04 ± 1,29%) correções de cardiopatias congênitas e 31.404 (8,87 ± 0,26%) outros procedimentos. Conclusão: perfil das CCV do HUWC ilustra que as CRM são o procedimento mais realizado, seguido das cirurgias orovalvares, em consonância com o verificado nacionalmente. Análise contínua do banco de dados local amplia perspectivas, permitindo melhores planejamentos e resultados. more...
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- 2019
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11. Intraoperative analysis of flow dynamics in arteriovenous composite Y grafts
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Heraldo Guedis Lobo Filho, Matheus Duarte Pimentel, Camylla Santos de Souza, Marília Leitão Montenegro, Bruno Gadelha Bezerra Silva, Maria Cláudia de Azevedo Leitão, José Glauco Lobo Filho, and Francisco Vagnaldo Fechine Jamacuru more...
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Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,medicine.medical_treatment ,education ,lcsh:Surgery ,Coronary Artery Bypass, Off-Pump ,Transit time ,Fractional flow reserve ,030204 cardiovascular system & hematology ,Pharmacological stress ,Revascularization ,Intraoperative Period ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Saphenous Vein ,Prospective Studies ,Mammary Arteries ,Coronary Artery Bypass ,Internal Mammary-Coronary Artery Anastomosis ,Vascular Patency ,Aged ,business.industry ,Great saphenous vein ,lcsh:RD1-811 ,Original Articles ,General Medicine ,Blood flow ,Middle Aged ,Surgery ,Fractional Flow Reserve, Myocardial ,030228 respiratory system ,lcsh:RC666-701 ,Cardiology ,Female ,Vascular Grafting ,Vascular Resistance ,Distal segment ,Anterior interventricular artery ,Flowmeters ,Cardiology and Cardiovascular Medicine ,business ,Blood Flow Velocity - Abstract
Objective: Composite graft of left internal thoracic artery and great saphenous vein in revascularization of the left coronary system is a technique well described in literature. The aim of this study is to analyze blood flow dynamics in this configuration of composite graft especially in what concerns left internal thoracic artery's adaptability and influence of great saphenous vein segment on left internal thoracic artery's flow. Methods: Revascularization of left coronary system with composite graft, with left internal thoracic artery revascularizing the anterior interventricular artery and a great saphenous vein segment, anastomosed to the left internal thoracic artery, revascularizing another branch of the left coronary system, was performed in 23 patients. Blood flow was evaluated by transit time flowmetry in all segments of the composite graft (left internal thoracic artery proximal segment, left internal thoracic artery distal segment and great saphenous vein segment). Measures were performed in baseline condition and after dobutamine-induced stress, without and with non-traumatic temporary clamping of the distal segments of the composite graft. Results: Pharmacological stress resulted in increase of blood flow values in the analyzed segments (P more...
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- 2016
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12. Modelo experimental de infarto do miocárdio induzido por isoproterenol em ratos Experimental model of myocardial infarction induced by isoproterenol in rats
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Heraldo Guedis Lobo Filho, Nestor Lemos Ferreira, Rafael Bezerra de Sousa, Eduardo Rebouças de Carvalho, Patrícia Leal Dantas Lobo, and José Glauco Lobo Filho
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Myocardial infarction ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Ratos Wistar ,lcsh:RC666-701 ,Infarto do miocárdio ,Isoproterenol ,lcsh:Surgery ,lcsh:RD1-811 ,Rats - Abstract
OBJETIVO: Avaliar e validar, em nosso meio, o modelo de infarto do miocárdio induzido por isoproterenol em ratos por meio de análises de parâmetros hematológicos, bioquímicos, de marcadores do estresse oxidativo e histopatológicos. MÉTODOS: Trinta ratos jovens, machos, da linhagem Wistar (145 a 230 g), foram alocados aleatoriamente em dois grupos: grupo Simulado, submetido à falsa indução de infarto do miocárdio, e grupo Infarto, submetido à indução do infarto do miocárdio com isoproterenol. As aplicações, para indução do infarto, foram realizadas durante dois dias consecutivos, com intervalo de 24 horas entre elas. Após 24 horas da última aplicação, os ratos de ambos os grupos foram anestesiados e sacrificados para realização de coleta de sangue para hemograma e análise bioquímica (TGO, TGP, troponina I, ureia e creatinina) e coleta de fragmento do miocárdio para avaliação de marcadores do estresse oxidativo (atividade da catalase e concentração de glutationa) e exame histopatológico. RESULTADOS: Não houve mortalidade no grupo Simulado, enquanto a mortalidade no grupo Infarto foi de 25%. A indução do infarto do miocárdio com isoproterenol causou elevação das contagens de leucócitos e neutrófilos, dos níveis de TGO, troponina I e ureia, reduziu a atividade da catalase e os níveis teciduais de glutationa e causou alterações histopatológicas. Não acarretou alterações nas concentrações de hemoglobina, TGP e creatinina. CONCLUSÕES: O modelo de infarto do miocárdio induzido por isoproterenol em ratos foi adequadamente reproduzido em nosso laboratório, acarretando alterações em parâmetros hematológicos, bioquímicos, de marcadores de estresse oxidativo e histopatológicos.OBJECTIVE: To evaluate and validate, in our laboratory, the essay of myocardial infarction induced by isoproterenol in rats by means of analysis of hematological, biochemical, oxidative stress markers and histopathological parameters. METHODS: Thirty young, male, Wistar rats (145 to 230 g) were randomly allocated in two groups: Sham group, which underwent a virtual myocardial infarction induction, and the Infarction group, which underwent a myocardial infarction induction with isoproterenol. The administrations for the infarction induction were performed during two consecutive days and a 24-hour interval between them. Twenty-four hours after the last administration, rats from both groups were anesthetized and sacrificed for blood sample collection to evaluate complete blood count (CBC) and biochemical parameters (SGOT, SGPT, troponin I, urea and creatinin), obtain myocardial fragments for oxidative stress markers analyses (catalase activity and glutathione concentrations) as well as histopathological examinations. RESULTS: There were no death cases in the Sham group, while the mortality rate in the Infarction group was 25%. Myocardial infarction induction with isoproterenol raised leukocytes and neutrophils counts, SGOT, troponin I and urea concentrations, reduced catalase enzyme activity and glutathione concentrations in the myocardium and let to histopathological concentrations as well. It did not exert alterations in terms of hemoglobin, SGPT and creatinin concentrations. CONCLUSIONS: The isoproterenol-induced myocardial infarction essay in rats was adequately reproduced in our laboratory, causing alterations in hematological, biochemical, oxidative stress markers and histopathological parameters. more...
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- 2011
13. Aneurisma infectado de artéria braquial após endocardite infecciosa de valva mitral
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José Glauco Lobo Filho, Patrícia Leal Dantas Lobo, Eduardo R. Carvalho, and Heraldo Guedis Lobo Filho
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medicine.medical_specialty ,Antecubital Fossa ,medicine.medical_treatment ,Aneurysm ,Internal medicine ,Mitral valve ,medicine.artery ,Medicine ,cardiovascular diseases ,Brachial artery ,biology ,business.industry ,Mitral valve replacement ,General Medicine ,Streptococcus bovis ,biology.organism_classification ,medicine.disease ,Surgery ,body regions ,Axilla ,medicine.anatomical_structure ,Infective endocarditis ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitral valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis. more...
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- 2011
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14. Aneurisma infectado de artéria braquial após endocardite infecciosa de valva mitral Infected aneurysm of brachial artery after mitral valve infective endocarditis
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Heraldo Guedis Lobo Filho, Eduardo Rebouças Carvalho, José Glauco Lobo Filho, and Patrícia Leal Dantas Lobo
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lcsh:Diseases of the circulatory (Cardiovascular) system ,Endocarditis ,lcsh:RC666-701 ,Aneurisma infectado ,Endocardite ,cardiovascular system ,Aneurysm, infected ,lcsh:Surgery ,cardiovascular diseases ,Artéria braquial ,lcsh:RD1-811 ,Brachial artery - Abstract
Apresentamos um caso de aneurisma infectado de artéria braquial em paciente com endocardite infecciosa por Streptococcus bovis. Homem de 49 anos de idade se apresentou com febre, dispnéia e sopro regurgitativo em foco mitral com irradiação para axila. O ecocardiograma demonstrou vegetação em valva mitral nativa. Após troca valvar mitral com implante de prótese biológica, observou-se massa pulsátil de cinco centímetros de diâmetro em fossa antecubital direita. Foi feito o diagnóstico de aneurisma infectado de artéria braquial, e o tratamento cirúrgico foi realizado com sucesso. O objetivo desse relato de caso é apresentar uma complicação pouco comum após endocardite infecciosa.We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitral valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis. more...
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- 2011
15. Enxerto composto de artéria torácica interna esquerda e veia safena magna: estudo angiográfico após oito anos
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Jaime Paula Pessoa Linhares Filho, José Glauco Lobo Filho, Francisco José Cabral Mesquita, and Heraldo Guedis Lobo Filho
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medicine.medical_specialty ,Aorta ,integumentary system ,business.industry ,medicine.medical_treatment ,General Medicine ,Revascularization ,law.invention ,Surgery ,Left internal thoracic artery ,surgical procedures, operative ,medicine.anatomical_structure ,law ,Internal medicine ,medicine.artery ,Ascending aorta ,Cardiopulmonary bypass ,Cardiology ,Medicine ,Composite graft ,Cardiology and Cardiovascular Medicine ,business ,Vein ,Artery - Abstract
The use of a composite graft with left internal thoracic artery (LITA) and arterial or saphenous vein (SV) grafts can allow the complete revascularization of the left coronary system (LCS) without cardiopulmonary bypass (CPB) and without ascending aorta manipulation (AAM), in order to reduce some complications in the immediate postoperative. This study shows 8-year angiographic follow-up results of two patients underwent no-touch aorta off-pump coronary artery bypass grafting (CABG) using LITA and SV as a composite graft to supply LCS. more...
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- 2010
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16. Enxerto composto de artéria torácica interna esquerda e veia safena magna: estudo angiográfico após oito anos Left internal thoracic artery and saphenous vein as a composite graft: 8-year angiographic follow-up study
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José Glauco Lobo Filho, Heraldo Guedis Lobo Filho, Francisco José Cabral Mesquita, and Jaime Paula Pessoa Linhares Filho
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Mammary arteries ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Veia safena ,Myocardial revascularization ,lcsh:RC666-701 ,Coronary angiography ,cardiovascular system ,lcsh:Surgery ,Saphenous vein ,lcsh:RD1-811 ,Angiografia coronária ,Artéria torácica interna ,Revascularização miocárdica - Abstract
O uso de enxerto composto de artéria torácica interna esquerda (ATIE) com segmentos arteriais ou segmentos de veia safena magna (VSM) pode permitir a revascularização completa do sistema coronariano esquerdo (SCE) sem circulação extracorpórea (CEC) e sem manuseio da aorta ascendente (MAA), como forma de tentar reduzir alguns riscos e complicações no pós-operatório imediato. Neste trabalho, relatamos os resultados angiográficos, após oito anos, de dois pacientes submetidos à cirurgia de revascularização do SCE com enxerto composto de ATIE e VSM, sem CEC e sem MAA.The use of a composite graft with left internal thoracic artery (LITA) and arterial or saphenous vein (SV) grafts can allow the complete revascularization of the left coronary system (LCS) without cardiopulmonary bypass (CPB) and without ascending aorta manipulation (AAM), in order to reduce some complications in the immediate postoperative. This study shows 8-year angiographic follow-up results of two patients underwent no-touch aorta off-pump coronary artery bypass grafting (CABG) using LITA and SV as a composite graft to supply LCS. more...
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- 2010
17. Vineberg's Procedure Modified Technique: Flow Analysis, Immediate Postoperative Results and Angiographic Evaluation
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Antonio J. Forte, Maria Cláudia de Azevedo Leitão, André Albuquerque da Silva, Heraldo Guedis Lobo Filho, João José Aquino Machado, and José Glauco Lobo Filho
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Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Heart Ventricles ,medicine.medical_treatment ,Internal thoracic artery ,Doppler echocardiography ,Coronary Angiography ,Revascularization ,Coronary circulation ,Coronary Circulation ,medicine.artery ,Internal medicine ,medicine ,Humans ,Vascular Patency ,Mammary Arteries ,Internal Mammary-Coronary Artery Anastomosis ,Aged ,medicine.diagnostic_test ,business.industry ,Blood flow ,Middle Aged ,Tunica intima ,Echocardiography, Doppler ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Angiography ,Cardiology ,Female ,Tunica Intima ,Cardiology and Cardiovascular Medicine ,business ,Blood Flow Velocity - Abstract
BACKGROUND: The purpose of this study was to evaluate angiographic results of patients subjected to a technique variation of Vineberg's procedure, as well as their morbidity and mortality in immediate postoperative period, and to analyze the flow of grafted left internal thoracic artery (LITA) at rest and under stress. METHODS: Between September 1999 and April 2002 eight patients were operated upon, with implant of the internal thoracic artery (ITA) in the intimal layer of the left ventricle (LV) muscle. After 6 months, they underwent angiographic and Doppler evaluation. According to Doppler study of LITA, the sample was divided in two groups: "Vineberg group," formed by eight patients; and "control group" consisting of 20 patients whose LITA directly revascularize the anterior interventricular artery (AIV). Angiography showed patency of all grafts in both groups. Blood flow and flow velocity in grafts were measured by Doppler echocardiography. T-test for paired and unpaired samples were used for statistical analysis. RESULTS: There were no deaths or complications in immediate postoperative period. Angiography showed 100% patency. The total flow (TF) of Vineberg group was 55% of the flow in the control group. In both groups, the TF increased with the stress. CONCLUSIONS: This Vineberg's technique modification can be successfully used in patients who cannot undergo traditional direct revascularization due to its low rates of morbidity and mortality and a high rate of patency, providing a significant blood flow both at rest and under stress. more...
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- 2006
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18. Revascularização miocárdica com enxerto composto de artéria torácica interna esquerda em Y: análise de fluxo sangüíneo Myocardial revascularization surgery using composite Y-graft of the left internal thoracic artery: blood flow analysis
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José Glauco Lobo Filho, Maria Cláudia de Azevedo Leitão, Heraldo Guedis Lobo Filho, André Albuquerque da Silva, João José Aquino Machado, Antonio Jorge de Vasconcelos Forte, Mauro Paes Leme de Sá, Eduardo Sérgio Bastos, and Henrique Murad more...
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lcsh:Diseases of the circulatory (Cardiovascular) system ,Internal mammary-coronary artery anastomosis ,Blood flow velocity ,lcsh:Surgery ,lcsh:RD1-811 ,Echocardiography, Doppler ,Revascularização miocárdica ,Ecocardiografia sob estresse ,Myocardial revascularization ,Echocardiography, stress ,lcsh:RC666-701 ,Anastomose mamário-coronária ,Ecocardiografia Doppler ,Velocidade do fluxo sangüíneo - Abstract
OBJETIVO: Verificar o comportamento do fluxo sangüíneo na artéria torácica interna esquerda (ATIE), quando utilizada para revascularizar a artéria interventricular anterior (AIA) e mais um ramo do sistema coronariano esquerdo (SCE). MÉTODO: No presente estudo, compara-se o fluxo obtido pela ecocardiografia Doppler na ATIE, em repouso e sob estresse com dobutamina, em dois grupos de 20 pacientes cada. No grupo A, foi utilizado enxerto pediculado de ATIE anastomosada unicamente à AIA. No grupo B, a ATIE revasculariza a AIA, e um enxerto de veia safena magna, anastomosado em "Y" à ATIE, revasculariza outro ramo do SCE. O estudo angiográfico demonstrou patência de todos os enxertos em ambos os grupos. Na avaliação pela ecocardiografia Doppler foram realizadas as seguintes medidas: débitos sistólico (DS), diastólico e total, razão entre o débito total em estresse pelo débito total em repouso (DTE/DTR), velocidades de pico sistólico (VPS) e diastólico e razão entre essas velocidades. RESULTADOS: Todos os parâmetros analisados apresentaram diferença estatisticamente significativa, com exceção do DS, DTE/DTR e VPS. CONCLUSÃO: Nas condições e métodos usados neste estudo, pode-se inferir que o fluxo sangüíneo na ATIE no enxerto composto (Grupo B) é maior que no enxerto simples (Grupo A), o que demonstra a grande capacidade da ATIE em adaptar-se à demanda de fluxo.OBJECTIVE: To assess the left internal thoracic artery (LITA) flow pattern, when it was used to supply the left anterior descending artery (LADA) and another branch from the left coronary artery system (LCAS). METHODS: In the following study, the left internal thoracic artery flow was investigated by echocardiography Doppler, at rest and under dobutamine stress, in two twenty-patient groups. Group A consisted of patients who received only a pedicled LITA graft to the LADA. Group B consisted of patients who received a pedicled LITA graft associated with a vein graft to supply the LADA and another artery from the LCAS. The angiographic study showed graft patency in all patients from both groups. The following parameters were used: systolic flow (SF), diastolic flow, total flow, total flow in stress/total flow at rest ratio (TFS/TFR), systolic peak velocities (SPV), diastolic peak velocities and systolic peak velocity/diastolic peak velocity ratio. RESULTS: All analysed parameters were considered statistically significant, except SF, TFS/TFR and SPV. CONCLUSIONS: We concluded that in the same conditions and methodology, the LITA flow in the composite graft (group B) is higher than in the free graft (group A), which shows the great flow adaptability of LITA to respond to flow demand. more...
- Published
- 2004
19. Vineberg Procedure by 'Vineberg technique modified by Lobo Filho': morbidity and mortality in the imediate post operative period, angiography results and flow analyze of the left internal thoracic artery implanted Procedimento de Vineberg pela técnica de 'Vineberg modificada por Lobo Filho': morbi-mortalidade imediata, resultados angiográficos e análise do fluxo na artéria torácica interna esquerda implantada
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José Glauco Lobo Filho, Maria Cláudia de Azevedo Leitão, Heraldo Guedis Lobo Filho, André Albuquerque da Silva, and João José Aquino Machado
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lcsh:Diseases of the circulatory (Cardiovascular) system ,Myocardial revascularization ,lcsh:RC666-701 ,lcsh:Surgery ,lcsh:RD1-811 ,Artéria torácica interna esquerda ,Ecocardiografia doppler ,Echocardiography doppler ,Revascularização miocárdica ,Left internal thoracic artery - Abstract
BACKGROUND: The Vineberg procedure consists in inserting the internal thoracic artery in the ischemic left ventricle muscle. The main question is the ability of this artery to supply adequate flow for the isquemic miocardium. OBJECTIVES: To evaluate angiographic results of Vineberg procedure by the Vineberg technique modified by Lobo Filho, the morbidity and mortality in the imediate post operative period (POP) and analysis of the flow of the implanted left internal thoracic artery (LITA) at rest and under stress. METHOD: Between September 1999 and April 2002, in our service, eight patients were operated by the above describe technique, in which the implant of the internal thoracic artery in the intimacy of the left ventricle muscle is achieved using a kit used for the introduction of the endocardial leads of pacemakers through the subclavian vein. After six months, they went to angiographic and doppler evaluation. For the LITA study with the doppler we divided the sample into two groups: "Vineberg group", formed by the eigth patients mentioned above; and "control group" formed by 20 patients in whom the LITA recascularize directly the anterior interventricular artery. The angiographic study demonstrade patency of all the grafts in both groups. With the doppler, it was measured the output and flow velocity in the grafts. The analysis of data obtained was taken with T-test for paired and unpaired samples. RESULTS: There were no deaths or complications in imediate POP. The angiographic study showed 100% patency. The total output of Vineberg group was 55% of the ones in the Control group. In both groups, the total output increased with the stress. CONCLUSIONS: The Vineberg technique modified by Lobo Filho can be used with low rates of morbidity and mortality, high index of patency providing a significant blood flow at rest and under stress.INTRODUÇÃO: O procedimento de Vineberg consiste no implante da artéria torácica interna na musculatura isquêmica do ventrículo esquerdo. O principal questionamento acerca desse procedimento é a capacidade de fornecimento de fluxo sanguíneo adequado para o miocárdio isquêmico. OBJETIVOS: Avaliar os resultados angiográficos do procedimento de Vineberg pela técnica de Vineberg modificada por Lobo Filho e a morbi-mortalidade no pós-operatório imediato (POI), bem como analisar o fluxo na artéria torácica interna esquerda (ATIE) implantada, em repouso e estresse. MÉTODO: De setembro de 1999 a abril 2002, em nosso serviço, oito pacientes foram operados pela técnica supracitada, na qual a introdução da artéria torácica interna na intimidade da musculatura do ventrículo esquerdo foi realizada com auxílio de um "kit" destinado à introdução de marcapassos cardíacos endocárdicos definitivos por punção da veia subclávia. Após seis meses, os pacientes foram estudados angiograficamente e submetidos ao ecodoppler da ATIE implantada. Para estudo do fluxo da ATIE pelo ecodoppler, constituímos dois grupos: "Grupo Vineberg", composto pelos oito pacientes citados; e o "Grupo Controle", composto por vinte pacientes, nos quais a ATIE foi utilizada para revascularizar diretamente a artéria interventricular anterior. O estudo angiográfico demonstrou perviabilidade de todos os enxertos em ambos os grupos. No estudo pelo ecodoppler, foram realizadas medidas de débito e velocidade de fluxo no enxerto. A análise dos dados obtidos foi feita pelo teste-T para amostras pareadas e não pareadas. RESULTADOS: Não houve óbitos ou complicações no POI. O estudo angiográfico demonstrou perviabilidade em 100% dos casos. O débito total observado foi cerca de 55% daquele encontrado no Grupo Controle. Em ambos os grupos, o débito total aumentou do repouso para o estresse. CONCLUSÃO: A técnica de Vineberg modificada por Lobo Filho pode ser utilizada com baixas taxas de morbi-mortalidade, alto índice de perviabilidade, oferecendo fluxo sanguíneo significativo em repouso e sob estresse. more...
- Published
- 2003
20. Cirurgia de revascularização coronariana esquerda sem CEC e sem manuseio da aorta em pacientes acima de 75 anos: análise das mortalidades imediata e a médio prazo e das complicações neurológicas no pós-operatório imediato
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Maria Cláudia de Azevedo Leitão, José Sebastião de Abreu, Tereza Cristina Pinheiro Diógenes, José Nogueira Paes Júnior, José Erirtônio Façanha Barreto, Elita Borges, Arnóbio Lavor, Heraldo Guedis Lobo Filho, George Araújo Magalhães, Carmelo Silveira Carneiro Leão Filho, João Paulo Holanda Soares, José Acácio Feitosa, Francisco Martins de Oliveira, José Glauco Lobo Filho, and Odair Soares Filho more...
- Subjects
medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,lcsh:Surgery ,Revascularização miocárdica/métodos ,Anastomosis ,law.invention ,Revascularização miocárdica ,Left coronary artery ,Revascularização miocárdica/mortalidade ,law ,medicine.artery ,parasitic diseases ,Ascending aorta ,Cardiopulmonary bypass ,medicine ,Vein ,Stroke ,Circulação extracorpórea/efeitos adversos ,Aorta ,business.industry ,Circulação extracorpórea ,Revascularização miocárdica/efeitos adversos ,General Medicine ,lcsh:RD1-811 ,medicine.disease ,Surgery ,surgical procedures, operative ,medicine.anatomical_structure ,Myocardial revascularization ,lcsh:RC666-701 ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
INTRODUÇÃO: A circulação extracorpórea (CEC) e o manuseio da aorta ascendente (MAA) estão associados a alta incidência de acidente vascular cerebral (AVC) na cirurgia de revascularização do miocárdio (RM) em pacientes idosos. Esta complicação deve-se, sobretudo, ao MAA, por ocasião do pinçamento e despinçamento, quer para isolamento do coração do circuito de CEC, quer para realização das anastomoses dos enxertos na aorta ascendente. OBJETIVOS: Verificar mortalidades imediata e a médio prazo e a ocorrência de AVC no pós-operatório imediato (POI) em pacientes acima de 75 anos submetidos a cirurgia de revascularização do sistema coronariano esquerdo (SCE), sem CEC e sem MAA. MÉTODO: De janeiro de 2000 a abril de 2002, 40 pacientes acima de 75 anos (média 79,1 anos) foram submetidos a cirurgia de revascularização do SCE, com enxerto de artéria torácica interna esquerda (ATIE) para a artéria descendente anterior (DA), e enxerto(s) de veia safena magna oriundo(s) da ATIE para outro(s) ramo(s) da coronária esquerda (enxerto composto), sem CEC e sem MAA. Houve predominância do sexo masculino (67,5%). Foram realizados 89 enxertos (média 2,22 pontes por paciente), sendo 40 (44,94%) de ATIE e 49 (55,06%) de veia safena. A ocorrência de AVC foi avaliada por exames clínico e neurológico. RESULTADOS: Não foi observada ocorrência de AVC no grupo estudado. Não houve óbitos no POI. CONCLUSÃO: A cirurgia de revascularização do SCE em pacientes acima de 75 anos sem CEC e sem MAA pode ser realizada sistematicamente de modo a evitar a ocorrência de AVC, com baixa mortalidade.INTRODUCTION: Cardiopulmonary bypass (CPB) and Ascending Aorta manipulation (AAM) are associated with a high incidence of stroke in coronary surgery in patients older than 75 years. This complication is due, mostly, to the handling of the aorta by the time of the cross-clamping, either for heart isolation from CPB, or to perform saphenous vein graft anastomosis to the ascending Aorta. OBJECTIVES: To observe immediate and mid-term mortalities and occurrence of stroke in the immediate post-operative period in patients older than 75 years who underwent surgical revascularization of the Left Coronary Artery System (LCAS) without CPB and without AAM. METHOD: Between January 2000 and April 2002, 40 patients, with ages ranging from 75 to 89 years (average 79.1), underwent surgical revascularization of the LCAS, with Left internal mammary artery (LIMA) graft to the Left Anterior Descending artery (LAD), and with Saphenous Vein Graft (SVG) originated from LIMA to one or more left coronary artery branches (composite graft), without CPB and without AAM. Male gender was predominant (67.5%). Eighty-nine arterial grafts were performed, with average of 2.22 per patient, of which 40 (44.94%) of LIMA and 49 (55.06%) of saphenous vein. The occurrence of stroke was evaluated by neurological and clinical exams. RESULT: It was not observed stroke or deaths in the immediate post-operative period. CONCLUSION: Surgical revascularization of the LCAS in patients older than 75 years without CPB and without AAM can be performed systematically in order to avoid occurrence of stroke, and so, reducing the mortality of the procedure. more...
- Published
- 2002
21. Coronary Artery Bypass Grafting Without Cardiopulmonary Bypass and Without Aortic Manipulation
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José Glauco Lobo Filho, Heraldo Guedis Lobo Filho, and EduardoRebouças Carvalho
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medicine.medical_specialty ,medicine.anatomical_structure ,Bypass grafting ,business.industry ,law ,Internal medicine ,Cardiology ,medicine ,Cardiopulmonary bypass ,business ,Artery ,law.invention - Published
- 2014
22. Doppler echocardiographic criteria in patency assessment of composite grafts from left internal thoracic artery
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Francisco Vagnaldo Fechine Jamacuru, Amanda X. Couto Bem, Heraldo Guedis Lobo Filho, Maria Cláudia de Azevedo Leitão, Eduardo R. Carvalho, Manuel Odorico de Moraes Filho, Tiago Magalhães Freire, José Glauco Lobo Filho, and Marília Leitão Montenegro more...
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Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Coronary artery bypass ,Doppler echocardiography ,Revascularização miocárdica ,Mammary arteries ,Diastole ,Reference Values ,Positive predicative value ,Medicine ,Coronary Artery Bypass ,Aged, 80 and over ,medicine.diagnostic_test ,General Medicine ,Ponte de artéria coronária ,Middle Aged ,Echocardiography, Doppler ,Left internal thoracic artery ,medicine.anatomical_structure ,Ecocardiografia Doppler ,Cardiology ,symbols ,Female ,Cardiology and Cardiovascular Medicine ,Isquemia miocárdica ,Doppler effect ,Blood Flow Velocity ,Artery ,Adult ,medicine.medical_specialty ,Myocardial ischemia ,Systole ,lcsh:Surgery ,Statistics, Nonparametric ,symbols.namesake ,Internal medicine ,Humans ,Mammary Arteries ,Artéria torácica interna ,Vascular Patency ,Aged ,Receiver operating characteristic ,business.industry ,Reproducibility of Results ,Gold standard (test) ,lcsh:RD1-811 ,Myocardial revascularization ,ROC Curve ,lcsh:RC666-701 ,Surgery ,Vascular Grafting ,business - Abstract
OBJECTIVES: The purpose of our study was to establish, with an entirely noninvasive method, transthoracic Doppler echocardiography, criteria for patency of composite left internal thoracic artery grafts when placed on the left anterior descending artery and other branches of the left coronary system. METHODS: The control group comprised 20 patients with single graft and 20 patients with composite graft; all forty having their patency confirmed by coronary angiogram (CA). In this control group, two Doppler echocardiographic variables, diastolic mean velocity-time and integral diastolic peak velocity to systolic peak velocity ratio were recorded. For each variable, established cut-off points were established, using the ROC (Receiver Operator Characteristic) curves, to identify criteria which could differentiate the composite grafts. Only patients with composite grafts were included in the 159-patients study group. The criteria established by the cut-off points in the control group were then applied to detect patency using a diastolic fraction of > 0.5 as the gold standard. The sensitivity, specificity, and positive and negative predictive values of these two criteria were determined. RESULTS: In the control group, cut-off points of 0.71 and 0.09m were established for the diastolic peak velocity/systolic peak velocity ratio and for diastolic mean velocity-time integral, respectively. In the study group phase, the sensitivity and negative predictive value of the diastolic peak velocity/systolic peak velocity > 0.71 criterion were 36% and 11%, respectively. Diastolic mean velocity-time integral > 0.09m criterion, were 40% and 10.48%. The specificities and positive predictive values of each criterion were 100%. CONCLUSION: Values reaching the criteria established for each variable indicate high probability of composite graft patency. Lower values have a large proportion of false negatives and are not conclusive as patency criteria. OBJETIVO: O objetivo deste estudo é estabelecer parâmetros preditores de perviedade, avaliados por Dopplerfluxometria, do enxerto composto de artéria torácica interna esquerda, quando revasculariza a artéria interventricular anterior e outro ramo do sistema esquerdo. MÉTODOS: O grupo controle foi formado por 20 pacientes com enxerto simples e 20 pacientes com enxerto, composto cuja perviedade foi confirmada por cineangiocoronariografia. No grupo controle, as variáveis de fluxo relação velocidade pico diastólico/velocidade pico sistólico e integral da velocidade média/tempo na diástole foram registradas. Para cada variável, estabeleceram-se pontos de corte para identificar enxertos compostos, usando-se curvas ROC (receiver operator characteristic). No grupo estudo, foram avaliados 159 pacientes com enxerto composto, determinando-se os dois parâmetros de fluxo. Pontos de cortes estabelecidos no grupo controle foram usados para determinar sensibilidade, especificidade, valores preditivos positivo e negativo de cada variável relacionada à perviedade dos enxertos, tomando-se como referência a fração diastólica > 0,5. RESULTADOS: No grupo controle, os pontos de corte estabelecidos para as variáveis velocidade pico diastólico/velocidade pico sistólico e integral velocidade média/tempo na diástole foram, respectivamente, 0,71 e 0,09m. No grupo estudo, a sensibilidade para a velocidade pico diastólico/velocidade pico sistólico e integral da velocidade média/tempo na diástole, considerando seus pontos de corte, foi de 36,4% e 40%, respectivamente. Os respectivos valores preditivos negativos foram 11% e 10.48%, enquanto especificidade e valor preditivo positivo foram de 100% para os dois parâmetros. CONCLUSÃO: Valores maiores ou iguais aos estabelecidos para cada variável indicam alta probabilidade de perviedade do enxerto composto. Valores inferiores apresentam grande proporção de falsos negativos, não sendo conclusivos quanto à perviedade. more...
- Published
- 2012
23. Modelo experimental de infarto do miocárdio induzido por isoproterenol em ratos
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Patrícia Leal Dantas Lobo, Eduardo R. Carvalho, Nestor Lemos Ferreira, Heraldo Guedis Lobo Filho, Rafael Bezerra de Sousa, and José Glauco Lobo Filho
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Myocardial infarction ,Ratos Wistar ,cardiovascular system ,Infarto do miocárdio ,Isoproterenol ,Surgery ,General Medicine ,Cardiology and Cardiovascular Medicine ,Rats - Abstract
OBJETIVO: Avaliar e validar, em nosso meio, o modelo de infarto do miocárdio induzido por isoproterenol em ratos por meio de análises de parâmetros hematológicos, bioquímicos, de marcadores do estresse oxidativo e histopatológicos. MÉTODOS: Trinta ratos jovens, machos, da linhagem Wistar (145 a 230 g), foram alocados aleatoriamente em dois grupos: grupo Simulado, submetido à falsa indução de infarto do miocárdio, e grupo Infarto, submetido à indução do infarto do miocárdio com isoproterenol. As aplicações, para indução do infarto, foram realizadas durante dois dias consecutivos, com intervalo de 24 horas entre elas. Após 24 horas da última aplicação, os ratos de ambos os grupos foram anestesiados e sacrificados para realização de coleta de sangue para hemograma e análise bioquímica (TGO, TGP, troponina I, ureia e creatinina) e coleta de fragmento do miocárdio para avaliação de marcadores do estresse oxidativo (atividade da catalase e concentração de glutationa) e exame histopatológico. RESULTADOS: Não houve mortalidade no grupo Simulado, enquanto a mortalidade no grupo Infarto foi de 25%. A indução do infarto do miocárdio com isoproterenol causou elevação das contagens de leucócitos e neutrófilos, dos níveis de TGO, troponina I e ureia, reduziu a atividade da catalase e os níveis teciduais de glutationa e causou alterações histopatológicas. Não acarretou alterações nas concentrações de hemoglobina, TGP e creatinina. CONCLUSÕES: O modelo de infarto do miocárdio induzido por isoproterenol em ratos foi adequadamente reproduzido em nosso laboratório, acarretando alterações em parâmetros hematológicos, bioquímicos, de marcadores de estresse oxidativo e histopatológicos. OBJECTIVE: To evaluate and validate, in our laboratory, the essay of myocardial infarction induced by isoproterenol in rats by means of analysis of hematological, biochemical, oxidative stress markers and histopathological parameters. METHODS: Thirty young, male, Wistar rats (145 to 230 g) were randomly allocated in two groups: Sham group, which underwent a virtual myocardial infarction induction, and the Infarction group, which underwent a myocardial infarction induction with isoproterenol. The administrations for the infarction induction were performed during two consecutive days and a 24-hour interval between them. Twenty-four hours after the last administration, rats from both groups were anesthetized and sacrificed for blood sample collection to evaluate complete blood count (CBC) and biochemical parameters (SGOT, SGPT, troponin I, urea and creatinin), obtain myocardial fragments for oxidative stress markers analyses (catalase activity and glutathione concentrations) as well as histopathological examinations. RESULTS: There were no death cases in the Sham group, while the mortality rate in the Infarction group was 25%. Myocardial infarction induction with isoproterenol raised leukocytes and neutrophils counts, SGOT, troponin I and urea concentrations, reduced catalase enzyme activity and glutathione concentrations in the myocardium and let to histopathological concentrations as well. It did not exert alterations in terms of hemoglobin, SGPT and creatinin concentrations. CONCLUSIONS: The isoproterenol-induced myocardial infarction essay in rats was adequately reproduced in our laboratory, causing alterations in hematological, biochemical, oxidative stress markers and histopathological parameters. more...
- Published
- 2011
24. Experimental model of myocardial infarction induced by isoproterenol in rats
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Heraldo Guedis, Lobo Filho, Nestor Lemos, Ferreira, Rafael Bezerra de, Sousa, Eduardo Rebouças de, Carvalho, Patrícia Leal Dantas, Lobo, and José Glauco, Lobo Filho
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Male ,Cardiotonic Agents ,Troponin I ,Isoproterenol ,Myocardial Infarction ,Catalase ,Glutathione ,Rats ,Disease Models, Animal ,Oxidative Stress ,Random Allocation ,Animals ,Aspartate Aminotransferases ,Rats, Wistar ,Biomarkers - Abstract
To evaluate and validate, in our laboratory, the essay of myocardial infarction induced by isoproterenol in rats by means of analysis of hematological, biochemical, oxidative stress markers and histopathological parameters.Thirty young, male, Wistar rats (145 to 230 g) were randomly allocated in two groups: Sham group, which underwent a virtual myocardial infarction induction, and the Infarction group, which underwent a myocardial infarction induction with isoproterenol. The administrations for the infarction induction were performed during two consecutive days and a 24-hour interval between them. Twenty-four hours after the last administration, rats from both groups were anesthetized and sacrificed for blood sample collection to evaluate complete blood count (CBC) and biochemical parameters (SGOT, SGPT, troponin I, urea and creatinin), obtain myocardial fragments for oxidative stress markers analyses (catalase activity and glutathione concentrations) as well as histopathological examinations.There were no death cases in the Sham group, while the mortality rate in the Infarction group was 25%. Myocardial infarction induction with isoproterenol raised leukocytes and neutrophils counts, SGOT, troponin I and urea concentrations, reduced catalase enzyme activity and glutathione concentrations in the myocardium and let to histopathological concentrations as well. It did not exert alterations in terms of hemoglobin, SGPT and creatinin concentrations.The isoproterenol-induced myocardial infarction essay in rats was adequately reproduced in our laboratory, causing alterations in hematological, biochemical, oxidative stress markers and histopathological parameters. more...
- Published
- 2011
25. Left internal thoracic artery and saphenous vein as a composite graft: 8-year angiographic follow-up study
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José Glauco, Lobo Filho, Heraldo Guedis, Lobo Filho, Francisco José Cabral, Mesquita, and Jaime Paula Pessoa, Linhares Filho
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Male ,Coronary Artery Bypass, Off-Pump ,Humans ,Saphenous Vein ,Coronary Artery Disease ,Mammary Arteries ,Middle Aged ,Coronary Angiography - Abstract
The use of a composite graft with left internal thoracic artery (LITA) and arterial or saphenous vein (SV) grafts can allow the complete revascularization of the left coronary system (LCS) without cardiopulmonary bypass (CPB) and without ascending aorta manipulation (AAM), in order to reduce some complications in the immediate postoperative. This study shows 8-year angiographic follow-up results of two patients underwent no-touch aorta off-pump coronary artery bypass grafting (CABG) using LITA and SV as a composite graft to supply LCS. more...
- Published
- 2010
26. Infected aneurysm of brachial artery after mitral valve infective endocarditis
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Heraldo Guedis, Lobo Filho, Eduardo Rebouças, Carvalho, José Glauco, Lobo Filho, and Patrícia Leal Dantas, Lobo
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Heart Valve Prosthesis Implantation ,Male ,Streptococcus bovis ,Brachial Artery ,Humans ,Mitral Valve ,Endocarditis, Bacterial ,Middle Aged ,Aneurysm, Infected - Abstract
We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitral valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis. more...
- Published
- 2009
27. Myocardial revascularization surgery using composite Y-graft of the left internal thoracic artery: blood flow analysis
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Mauro Paes Leme de Sá, Antonio J. Forte, Heraldo Guedis Lobo Filho, Maria Cláudia de Azevedo Leitão, José Glauco Lobo Filho, Eduardo Sérgio Bastos, André Albuquerque da Silva, João José Aquino Machado, and Henrique Murad more...
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medicine.medical_specialty ,Myocardial revascularization ,Internal mammary-coronary artery anastomosis ,business.industry ,Blood flow velocity ,General Medicine ,Echocardiography, Doppler ,Surgery ,Revascularização miocárdica ,Left internal thoracic artery ,Ecocardiografia sob estresse ,Echocardiography, stress ,Anastomose mamário-coronária ,Ecocardiografia Doppler ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Velocidade do fluxo sangüíneo - Abstract
OBJETIVO: Verificar o comportamento do fluxo sangüíneo na artéria torácica interna esquerda (ATIE), quando utilizada para revascularizar a artéria interventricular anterior (AIA) e mais um ramo do sistema coronariano esquerdo (SCE). MÉTODO: No presente estudo, compara-se o fluxo obtido pela ecocardiografia Doppler na ATIE, em repouso e sob estresse com dobutamina, em dois grupos de 20 pacientes cada. No grupo A, foi utilizado enxerto pediculado de ATIE anastomosada unicamente à AIA. No grupo B, a ATIE revasculariza a AIA, e um enxerto de veia safena magna, anastomosado em "Y" à ATIE, revasculariza outro ramo do SCE. O estudo angiográfico demonstrou patência de todos os enxertos em ambos os grupos. Na avaliação pela ecocardiografia Doppler foram realizadas as seguintes medidas: débitos sistólico (DS), diastólico e total, razão entre o débito total em estresse pelo débito total em repouso (DTE/DTR), velocidades de pico sistólico (VPS) e diastólico e razão entre essas velocidades. RESULTADOS: Todos os parâmetros analisados apresentaram diferença estatisticamente significativa, com exceção do DS, DTE/DTR e VPS. CONCLUSÃO: Nas condições e métodos usados neste estudo, pode-se inferir que o fluxo sangüíneo na ATIE no enxerto composto (Grupo B) é maior que no enxerto simples (Grupo A), o que demonstra a grande capacidade da ATIE em adaptar-se à demanda de fluxo. OBJECTIVE: To assess the left internal thoracic artery (LITA) flow pattern, when it was used to supply the left anterior descending artery (LADA) and another branch from the left coronary artery system (LCAS). METHODS: In the following study, the left internal thoracic artery flow was investigated by echocardiography Doppler, at rest and under dobutamine stress, in two twenty-patient groups. Group A consisted of patients who received only a pedicled LITA graft to the LADA. Group B consisted of patients who received a pedicled LITA graft associated with a vein graft to supply the LADA and another artery from the LCAS. The angiographic study showed graft patency in all patients from both groups. The following parameters were used: systolic flow (SF), diastolic flow, total flow, total flow in stress/total flow at rest ratio (TFS/TFR), systolic peak velocities (SPV), diastolic peak velocities and systolic peak velocity/diastolic peak velocity ratio. RESULTS: All analysed parameters were considered statistically significant, except SF, TFS/TFR and SPV. CONCLUSIONS: We concluded that in the same conditions and methodology, the LITA flow in the composite graft (group B) is higher than in the free graft (group A), which shows the great flow adaptability of LITA to respond to flow demand. more...
- Published
- 2004
28. Total myocardial revascularization without cardiopulmonary bypass: a reality
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José Glauco Lobo, Filho, Maria Cláudia, Leitão, Francisco Martins, de Oliveira, Rafael, de Siqueira, Ricardo Régis, de Oliveira, Rodrigo, Landim, Eduardo, Furlani, and Heraldo Guedis Lobo, Filho
- Subjects
Adult ,Aged, 80 and over ,Male ,Cardiopulmonary Bypass ,Postoperative Complications ,Treatment Outcome ,Myocardial Revascularization ,Humans ,Coronary Disease ,Female ,Length of Stay ,Middle Aged ,Aged - Abstract
From January 1995 to June 1999 our surgical team at ICORP, Fortaleza, Ceará, Brazil, performed coronary artery surgery without cardiopulmonary bypass as a routine procedure. A total of 897 operations were performed during this period, 91.8 % (824) of them without cardiopulmonary bypass. The purpose of the present study is to evaluate the results of these 824 patients with regard to duration of hospitalization, age, sex, number of grafts, reoperations performed, morbidity and mortality. All patients underwent previous coronary arteriography.With patients admitted in the hospital for elective or emergency myocardial revascularization, all the coronary arteries were bypassed, possibly without cardiopulmonary bypass, including the marginal branches of the circumflex artery. Basic statistical analysis has been performed over the above-mentioned variables.The patients' ages ranged from 35 to 88 years, with a mean age of 61.2. The average duration of hospitalization was seven days. In all, 1,738 grafts were implanted, the number in individual patients varying from one to four (average of 2.1 per patient). The incidence of procedure-related complications was 3.15% (26 patients). Twenty-three patients (2.8%) died in the early postoperative period.Considering the data obtained from this study, we conclude that the procedure can be used in the vast majority of patients undergoing coronary artery surgery (compared to the similar studies of patients operated on with cardiopulmonary bypass). more...
- Published
- 2002
29. A novel composite coronary bypass graft strategy using the saphenous vein bridge: could the venous valves induce worse patency results?
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Marília Leitão Montenegro, Heraldo Guedis Lobo Filho, José Glauco Lobo Filho, and Matheus Duarte Pimentel
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Follow up studies ,General Medicine ,University hospital ,Venous Valves ,Surgery ,medicine.anatomical_structure ,medicine ,Humans ,Female ,Saphenous Vein ,Coronary Artery Bypass ,Cardiology and Cardiovascular Medicine ,Vein ,business - Abstract
Jose Glauco Lobo Filho*, Heraldo G. Lobo Filho, Matheus D. Pimentel and Marilia L. Montenegro a Department of Surgery, Walter Cantidio University Hospital of the Federal University of Ceara, Fortaleza, Brazil b Department of Surgery, Federal University of Ceara, Fortaleza, Brazil c Federal University of Ceara, Fortaleza, Brazil d Christus College, Fortaleza, Brazil Received 7 May 2014; accepted 12 June 2014 more...
- Published
- 2014
- Full Text
- View/download PDF
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