9 results on '"Frederico Thomaz Ultramari"'
Search Results
2. Evolução da onda P do eletrocardiograma após valvoplastia mitral em pacientes portadores de sobrecarga atrial esquerda Changes in P-wave after percutaneous mitral valvuloplasty in patients with mitral stenosis and left atrial enlargement
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José Carlos Estival Tarastchuk, Ênio Eduardo Guérios, Sônia Perreto, Ronaldo da Rocha Loures Bueno, Paulo Maurício Piá de Andrade, Deborah Cristina Nercolini, Álvaro Luiz Aranha Pacheco, Frederico Thomaz Ultramari, and Alisson Moço Faidiga more...
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Valvoplastia mitral ,sobrecarga atrial esquerda ,estenose mitral ,Percutaneous mitral valvuloplasty ,left atrial enlargement ,mitral stenosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
OBJETIVO: Investigar potenciais preditores clínicos, ecocardiográficos e/ou hemodinâmicos de regressão de sinais eletrocardiográficos (ECG) de sobrecarga atrial esquerda (SAE) após valvoplastia mitral percutânea (VMP) com sucesso. MÉTODOS: Estudaram-se 24 pacientes (75% do sexo feminino, idade média 37,1 ± 11,9 anos) com estenose mitral moderada a grave, ritmo sinusal (RS) e sinais de SAE no ECG, submetidos a VMP entre 2002 e 2004. Pelo menos seis meses após o procedimento (388,2 ± 192,9 dias), os pacientes retornaram para acompanhamento clínico, eletro e ecocardiográfico. Os pacientes foram divididos em dois grupos: Grupo 1(n = 8; 33,3%), ainda com sinais ECG de SAE, e Grupo 2 (n = 16; 66,6%), com onda P normal. Realizou-se análise multivariada de variáveis clínicas, ECG, ecocardiográficas e hemodinâmicas. RESULTADOS: A área valvar mitral (AVM) aumentou de 1,12 ± 0,15 para 1,9 ± 0,35cm² imediatamente após o procedimento (p< 0,0001), e diminuiu para 1,89 ± 0,41cm² no acompanhamento (p = NS). O diâmetro do átrio esquerdo variou de 4,8 ± 0,29 cm pré-procedimento para 4,28 ± 0,48cm na reavaliação (p = 0,0001). A duração da onda P diminuiu de 0,12 ± 0,01 seg pré-VMP para 0,09 ± 0,02 seg no controle (p = 0,0001). Uma AVM > 1,7 cm² no acompanhamento foi o único preditor independente de onda P normal após VMP (p = 0,02). CONCLUSÃO: Alterações ECG sugestivas de SAE regridem na maioria dos pacientes com estenose mitral e RS submetidos a VMP com sucesso. Uma AVM > 1,7 cm² no controle tardio é preditor independente para essa normalização.OBJECTIVE: To investigate potential clinical, echocardiographic and/or hemodynamic predictors of the regression of electrocardiographic (ECG) signs of left atrial enlargement (LAE) after successful percutaneous mitral valvuloplasty (PMV). METHODS: We studied 24 patients (75% female, mean age =37.1 ± 11.9 years) with moderate to severe mitral stenosis (MS), sinus rhythm (SR) and ECG signs of LAE who underwent successful PMV between 2002 and 2004. At least 6 months after the procedure (388.2 ± 192.9 days), the patients returned for clinical, ECG and echocardiographic follow-up. They were then divided in 2 groups: patients of group 1 (n = 8; 33.3%) still had ECG signs of LAE, and patients of group 2 (n = 16; 66.6%), had normal P wave. A multivariate analysis of clinical, ECG, echocardiographic and hemodynamic variables was performed. RESULTS: The mitral valve area (MVA) increased from 1.12 ± 0.15 cm2 to 1.9 ± 0.35 cm² immediately after the procedure (p < 0.0001) and decreased to 1.89 ± 0.41 cm² at follow-up (p = NS). Left atrium diameter decreased from 48 ± 2.9mm pre-procedure to 43 ± 4.8mm at follow-up (p = 0.0001). P-wave duration decreased from 0.12 ± 0.01 sec pre-PMV to 0.09 ± 0.02 sec at follow-up (p = 0.0001). An MVA > 1.7 cm² at follow-up was the only independent predictor of a normal P-wave after PMV (p=0.02). CONCLUSION: ECG changes suggestive of LAE regress in the majority of patients with MS and sinus rhythm that undergo a successful PMV. An MVA>1.7 cm² at late follow-up was found to be an independent predictor of such normalization. more...
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- 2006
- Full Text
- View/download PDF
Catalog
3. Epidemiological study of congenital heart defects in children and adolescents: analysis of 4,538 cases
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Nelson Itiro Miyague, Silvia Meyer Cardoso, Fabrício Meyer, Frederico Thomaz Ultramari, Fábio Henrique Araújo, Igor Rozkowisk, and Alisson Parrilha Toschi
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congenital heart disease ,epidemiology ,prevalence ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
OBJECTIVE: To analyze the frequency and prevalence of congenital heart defects in a tertiary care center for children with heart diseases. METHODS: We carried out an epidemiological assessment of the first medical visit of 4,538 children in a pediatric hospital from January 1995 to December 1997. All patients with congenital heart defects had their diagnoses confirmed at least on echocardiography. The frequency and prevalence of the anomalies were computed according to the classification of sequential analysis. Age, weight, and sex were compared between the groups of healthy individuals and those with congenital heart defects after distribution according to the age group. RESULTS: Of all the children assessed, 2,017 (44.4%) were diagnosed with congenital heart disease, 201 (4.4%) with acquired heart disease, 52 (1.2%) with arrhythmias, and 2,268 (50%) were healthy children. Congenital heart diseases predominated in neonates and infants, corresponding to 71.5% of the cases. Weight and age were significantly lower in children with congenital heart defects. Ventricular septal defect was the most frequent acyanotic anomaly, and tetralogy of Fallot was the most frequent cyanotic anomaly. CONCLUSION: Children with congenital heart defects are mainly referred during the neonatal period and infancy with impairment in gaining weight. Ventricular septal defect is the most frequent heart defect. more...
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- 2003
- Full Text
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4. Efeitos da correção cirúrgica de estenose mitral sobre o ritmo cardíaco Effects of mitral stenosis correction surgery on the cardiac rhythm
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Carlos Augusto SCHMIDLIN, Danton R. da Rocha LOURES, Roberto Gomes de CARVALHO, Leonardo Andrade MULINARI, Arleto Zacarias SILVA Jr., Maricélia BROMMELSTRÖET, Ricardo José CHOMA, Sérgio SHIBATA, Luciano Augusto LEITÃO, Fábio Rodrigues SILVA, and Frederico Thomaz ULTRAMARI more...
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Estenose da valva mitral ,Fibrilação atrial ,Freqüência cardíaca ,Mitral valve stenosis ,Atrial fibrillation ,Heart rate ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objetivo: Determinar a freqüência de reversão de fibrilação atrial (FA) ao ritmo sinusal (SA) em pacientes com estenose mitral (EM) submetidos a tratamento cirúrgico e identificar prováveis fatores favoráveis ou desfavoráveis a este evento. Casuística e Métodos: Estudo de caso-controle, envolvendo 53 pacientes com EM, sem acometimento de outras valvas, submetidos a correção cirúrgica. A população estudada apresentou as seguintes características: mulheres: 71,7%; idade média: 42,4 anos; classe funcional III: 67,9%; área mitral média: 0,92 cm²; átrio esquerdo médio: 56,0 mm; ritmo antes da operação: SA: 51,0% e FA: 49,0%. Os pacientes foram divididos em dois grupos de acordo com o ritmo apresentado no período pós-operatório tardio: grupo I, formado pelos pacientes que, após a operação, apresentavam ritmo SA e grupo II, constituído por aqueles que, no pós-operatório, estavam em FA. Resultados: Dez (18,9%) pacientes (em relação ao total; 38,5% em relação àqueles com FA) apresentavam FA no período pré-operatório e sofreram reversão para o ritmo SA no pós-operatório e em 2 pacientes (3,8% em relação ao total; 7,4% em relação àqueles em ritmo SA) houve degeneração do ritmo SA para FA. Houve diferença estatisticamente significativa (p < 0,05) entre os dois grupos apenas em relação a variável idade (p = 0,0456). Conclusões: A operação de correção de EM apresenta resultados insatisfatórios em relação à reversão da FA para ritmo SA, sugerindo a necessidade de associação de outro procedimento cirúrgico para restaurar o ritmo normal. Vários estudos tentaram identificar os fatores predisponentes à permanência e ao desenvolvimento de FA após a operação, porém foram obtidos resultados contraditórios. No presente estudo, a única variável que apresentou associação com a FA foi a idade avançada.Objective: To determine the frequency of reversion of atrial fibrillation (AF) to sinus rhythm (SR) following surgical treatment of patients with mitral stenosis (MS) and identify likely favourable or unfavourable factors to this event. Material and Methods: Retrospective case control study, analysing 53 patients with MS, without other valvar diseases, undergoing surgical correction. The baseline characteristics of the studied population were: women: 71.7%; mean age: 42.4 years; functional class III: 67.9%; mean mitral valve area: 0.92 cm²; mean left atrial size: 56.0 mm; rhythm before the surgery: SR: 51.0% and AF: 49.0%. Patients were divided in two groups according to their late postoperative rhythm: group I included the patients with SR after the surgery and group II were formed by those with AF in the postoperative period. Results: Ten (18.9%) patients out of all patients; 38.5% in respect to those with AF presented reversion of AF to SR and 2 of them (3.8% out off all patients; 7.4% out of those with SR) presented degeneration of rhythm from SR to AF. There was statistically significant difference (p < 0.05) between the groups only in respect to variable age (p = 0.0456). Conclusions: The MS correction surgery presents unsatisfactory results in respect to reversion from AF to SR, suggesting the necessity of another associated surgical proceeding to restore the SR. Many studies tried to identify the predisposing factors to the permanence or to the development of AF after the surgery, but they got contradictory results. In the present study, only the variable advanced age presented association with AF. more...
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- 2001
- Full Text
- View/download PDF
5. Intervenção coronária percutânea emergencial de tronco de coronária esquerda não-protegido em paciente com transplante do coração
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Marcos Vinícius Claussen Moura, Frederico Thomaz Ultramari, Adrian Paulo Morales Kormann, Anne Louise Marchi, Frederico Di Giovanni, and Rafael Maestri
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Angioplastia ,Transplante de coração ,Doença da artéria coronariana ,General Medicine ,Stents farmacológicos - Abstract
A doença vascular do enxerto cardíaco é a principal causa de falência do enxerto e morte depois do primeiro ano após o transplante. O melhor tratamento para lesões de tronco de coronária esquerda não-protegido em corações transplantados ainda não está estabelecido. Descrevemos o caso de uma intervenção coronária percutânea emergencial de tronco de coronária esquerda não-protegido em coração transplantado após morte súbita revertida com sucesso em paciente que aguardava cirurgia de revascularização do miocárdio. more...
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- 2013
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6. Contrast media-induced nephropathy following diagnostic and therapeutic cardiac catheterization
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Deborah C. Nercolini, Gilberto Melnik, José Carlos Estival Tarastchuk, Paulo Maurício Piá de Andrade, Alysson Moço Faidiga, Frederico Thomaz Ultramari, Ronaldo da Rocha Loures Bueno, Ênio Eduardo Guérios, and Claudio Da Cunha more...
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medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,medicine.medical_treatment ,Medicine ,Contrast (vision) ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Intensive care medicine ,Nephropathy ,media_common ,Cardiac catheterization - Abstract
Currently low-osmolar contrast media are used in approximately 75% of patients and the iso-osmolar contrast media, allegedly less toxic are becoming more popular 1 . In spite of development of new contrast media, they still represent the third main cause of nosocomialacquired acute renal failure (ARF) (10% of cases), substantially increasing hospitalization period, care costs and in-hospital morbi-mortality 3-6 more...
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- 2006
7. Changes in P-wave after percutaneous mitral valvuloplasty in patients with mitral stenosis and left atrial enlargement
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José Carlos Estival, Tarastchuk, Enio Eduardo, Guérios, Sônia, Perreto, Ronaldo da Rocha Loures, Bueno, Paulo Maurício Piá, de Andrade, Deborah Cristina, Nercolini, Alvaro Luiz Aranha, Pacheco, Frederico Thomaz, Ultramari, and Alisson Moço, Faidiga more...
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Adult ,Male ,Severity of Illness Index ,Catheterization ,Electrocardiography ,Treatment Outcome ,Echocardiography ,Predictive Value of Tests ,Humans ,Mitral Valve Stenosis ,Atrial Function, Left ,Female ,Follow-Up Studies ,Retrospective Studies - Abstract
To investigate potential clinical, echocardiographic and/or hemodynamic predictors of the regression of electrocardiographic (ECG) signs of left atrial enlargement (LAE) after successful percutaneous mitral valvuloplasty (PMV).We studied 24 patients (75% female, mean age =37.1 +/- 11.9 years) with moderate to severe mitral stenosis (MS), sinus rhythm (SR) and ECG signs of LAE who underwent successful PMV between 2002 and 2004. At least 6 months after the procedure (388.2 +/- 192.9 days), the patients returned for clinical, ECG and echocardiographic follow-up. They were then divided in 2 groups: patients of group 1 (n = 8; 33.3%) still had ECG signs of LAE, and patients of group 2 (n = 16; 66.6%), had normal P wave. A multivariate analysis of clinical, ECG, echocardiographic and hemodynamic variables was performed.The mitral valve area (MVA) increased from 1.12 +/- 0.15 cm2 to 1.9 +/- 0.35 cm2 immediately after the procedure (p0.0001) and decreased to 1.89 +/- 0.41 cm2 at follow-up (p = NS). Left atrium diameter decreased from 48 +/- 2.9 mm pre-procedure to 43 +/- 4.8 mm at follow-up (p = 0.0001). P-wave duration decreased from 0.12 +/- 0.01 sec pre-PMV to 0.09 +/- 0.02 sec at follow-up (p = 0.0001). An MVAor = 1.7 cm2 at follow-up was the only independent predictor of a normal P-wave after PMV (p=0.02).ECG changes suggestive of LAE regress in the majority of patients with MS and sinus rhythm that undergo a successful PMV. An MVAor = 1.7 cm2 at late follow-up was found to be an independent predictor of such normalization. more...
- Published
- 2005
8. Epidemiological study of congenital heart defects in children and adolescents. Analysis of 4,538 cases
- Author
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Fábio Henrique Araújo, Nelson Itiro Miyague, Silvia Meyer Cardoso, Frederico Thomaz Ultramari, Igor Rozkowisk, Fabrício Meyer, and Alisson Parrilha Toschi
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Heart Defects, Congenital ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Pediatrics ,Heart disease ,Adolescent ,prevalence ,Tertiary care ,Age Distribution ,Epidemiology ,medicine ,Prevalence ,Humans ,Sex Distribution ,Child ,Tetralogy of Fallot ,Retrospective Studies ,business.industry ,Case-control study ,Infant, Newborn ,Infant ,Retrospective cohort study ,medicine.disease ,congenital heart disease ,lcsh:RC666-701 ,Healthy individuals ,Case-Control Studies ,Child, Preschool ,epidemiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Congenital heart defects in children ,Brazil - Abstract
OBJECTIVE: To analyze the frequency and prevalence of congenital heart defects in a tertiary care center for children with heart diseases. METHODS: We carried out an epidemiological assessment of the first medical visit of 4,538 children in a pediatric hospital from January 1995 to December 1997. All patients with congenital heart defects had their diagnoses confirmed at least on echocardiography. The frequency and prevalence of the anomalies were computed according to the classification of sequential analysis. Age, weight, and sex were compared between the groups of healthy individuals and those with congenital heart defects after distribution according to the age group. RESULTS: Of all the children assessed, 2,017 (44.4%) were diagnosed with congenital heart disease, 201 (4.4%) with acquired heart disease, 52 (1.2%) with arrhythmias, and 2,268 (50%) were healthy children. Congenital heart diseases predominated in neonates and infants, corresponding to 71.5% of the cases. Weight and age were significantly lower in children with congenital heart defects. Ventricular septal defect was the most frequent acyanotic anomaly, and tetralogy of Fallot was the most frequent cyanotic anomaly. CONCLUSION: Children with congenital heart defects are mainly referred during the neonatal period and infancy with impairment in gaining weight. Ventricular septal defect is the most frequent heart defect. more...
- Published
- 2003
9. Effects of mitral stenosis correction surgery on the cardiac rhythm
- Author
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Luciano Leitão, Carlos Augusto Schmidlin, Sérgio Shibata, Maricélia Brommelströet, Fábio Rodrigues Silva, Arleto Zacarias Silva, Leonardo Andrade Mulinari, Ricardo José Choma, Roberto Gomes de Carvalho, Frederico Thomaz Ultramari, and Danton R. da Rocha Loures more...
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Estenose da valva mitral/cirurgia ,Gynecology ,medicine.medical_specialty ,Freqüência cardíaca/fisiologia ,Freqüência cardíaca ,business.industry ,Heart rate ,General Medicine ,Fibrilação atrial/fisiopatologia ,Atrial fibrillation ,Fibrilação atrial ,Estenose da valva mitral ,medicine ,Surgery ,Mitral valve stenosis ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objetivo: Determinar a freqüência de reversão de fibrilação atrial (FA) ao ritmo sinusal (SA) em pacientes com estenose mitral (EM) submetidos a tratamento cirúrgico e identificar prováveis fatores favoráveis ou desfavoráveis a este evento. Casuística e Métodos: Estudo de caso-controle, envolvendo 53 pacientes com EM, sem acometimento de outras valvas, submetidos a correção cirúrgica. A população estudada apresentou as seguintes características: mulheres: 71,7%; idade média: 42,4 anos; classe funcional III: 67,9%; área mitral média: 0,92 cm²; átrio esquerdo médio: 56,0 mm; ritmo antes da operação: SA: 51,0% e FA: 49,0%. Os pacientes foram divididos em dois grupos de acordo com o ritmo apresentado no período pós-operatório tardio: grupo I, formado pelos pacientes que, após a operação, apresentavam ritmo SA e grupo II, constituído por aqueles que, no pós-operatório, estavam em FA. Resultados: Dez (18,9%) pacientes (em relação ao total; 38,5% em relação àqueles com FA) apresentavam FA no período pré-operatório e sofreram reversão para o ritmo SA no pós-operatório e em 2 pacientes (3,8% em relação ao total; 7,4% em relação àqueles em ritmo SA) houve degeneração do ritmo SA para FA. Houve diferença estatisticamente significativa (p < 0,05) entre os dois grupos apenas em relação a variável idade (p = 0,0456). Conclusões: A operação de correção de EM apresenta resultados insatisfatórios em relação à reversão da FA para ritmo SA, sugerindo a necessidade de associação de outro procedimento cirúrgico para restaurar o ritmo normal. Vários estudos tentaram identificar os fatores predisponentes à permanência e ao desenvolvimento de FA após a operação, porém foram obtidos resultados contraditórios. No presente estudo, a única variável que apresentou associação com a FA foi a idade avançada. Objective: To determine the frequency of reversion of atrial fibrillation (AF) to sinus rhythm (SR) following surgical treatment of patients with mitral stenosis (MS) and identify likely favourable or unfavourable factors to this event. Material and Methods: Retrospective case control study, analysing 53 patients with MS, without other valvar diseases, undergoing surgical correction. The baseline characteristics of the studied population were: women: 71.7%; mean age: 42.4 years; functional class III: 67.9%; mean mitral valve area: 0.92 cm²; mean left atrial size: 56.0 mm; rhythm before the surgery: SR: 51.0% and AF: 49.0%. Patients were divided in two groups according to their late postoperative rhythm: group I included the patients with SR after the surgery and group II were formed by those with AF in the postoperative period. Results: Ten (18.9%) patients out of all patients; 38.5% in respect to those with AF presented reversion of AF to SR and 2 of them (3.8% out off all patients; 7.4% out of those with SR) presented degeneration of rhythm from SR to AF. There was statistically significant difference (p < 0.05) between the groups only in respect to variable age (p = 0.0456). Conclusions: The MS correction surgery presents unsatisfactory results in respect to reversion from AF to SR, suggesting the necessity of another associated surgical proceeding to restore the SR. Many studies tried to identify the predisposing factors to the permanence or to the development of AF after the surgery, but they got contradictory results. In the present study, only the variable advanced age presented association with AF. more...
- Published
- 2001
- Full Text
- View/download PDF
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