Biatrial ablation surgical procedures were more effective in controlling atrial fibrillation than procedures limited to the left atrium.

Objective: The aim of this study is to evaluate the initial results of intraoperative radiofrequency ablation using biatrial procedure to treat chronic atrial fibrillation in patients with associated cardiac disease.Methods: Between February 2008 and May 2009, 15 consecutive patients were underwent mitral valve procedure plus modified radiofrequency biatrial ablation of chronic atrial fibrillation. The mean age was 47.73 ± 9.85 years and 60% were male. The mean left atrial diameter was 55.06 ± 7.56 mm.Results: There were no hospital mortality or complications related to radiofrequency ablation. The mean follow-up period was 7 ± 4 months. At the time of hospital discharge 9 (60%) patients were in sinus rhythm. After a mean follow-up period 11 (73.3%) were in sinus rhythm.Conclusion: Intraoperative biatrial radiofrequency ablation is a safe and effective technique for the treatment of chronic atrial fibrillation, with satisfactory midterms outcomes in terms of conversion to sinus rhythm. Bras Cir Cardiovasc 2010; 25(1): 45-50 Rev

119BREDA, JR ET AL -Surgical ablation of atrial fibrillation using radiofrequency Bras Cir Cardiovasc 2008; 23(1): 118-122 Rev

Objective: To evaluate the effect of ventral cardiac denervation on the incidence of atrial fibrillation after coronary artery bypass grafting.Methods: Between September and November 2005, 50 patients from the same institution, without previous diagnosis of atrial arrhythmia, presenting with coronary heart disease with indication for coronary artery bypass grafting were enrolled in a prospective, randomized study. The exclusion criteria were: patients older than 75 years of age, previous history of atrial arrhythmia and associated heart surgeries. Denervation was performed before cardiopulmonary bypass by removing the adipose tissues around the superior vena cava, aorta and pulmonary artery. Patients submitted to denervation were compared with a control group regarding demographic, clinical and operative variables.

Uso tópico de agente antifibrinolítico na redução do sangramento após revascularização cirúrgica do miocárdioTopical use of antifibrinolytic agent to reduce postoperative bleeding after coronary artery bypass surgery Abstract Objective: Antifibrinolytic agents reduce bleeding after cardiac surgery, but there are adverse effects after their systemic use. These effects are avoided by topical application of antifibrinolytic agents in pericardial cavity. We compared the effects of topically applied epsilon-aminocaproic acid (EACA) and placebo on postoperative bleeding and transfusion requirements after coronary artery bypass surgery.Methods: In this single center prospective, randomized, double-blind trial, 53 patients were randomized into two groups to receive EACA (24 g in 250 ml of saline solution) or placebo (250 ml of saline solution) before sternal closure. Groups were compared according the preoperative and intraoperative variables. Postoperative bleeding, transfusion requirements and hematologic parameters were evaluated.Results

Coronary dissection has a significant morbidity and mortality. The ideal management of acute coronary occlusion is the prompt restoration of the vessel patency to limit the extent and duration of ischemia. In the setting of dissection during percutaneous procedure, the usual approach has been emergency aortocoronary bypass surgery. The authors present a case of a patient with left main dissection during percutaneous transluminal coronary angioplasty. This problem was successfully managed with emergent aortocoronary bypass surgery.Descriptors: Angioplasty transluminal percutaneous coronary/adverse effects. Coronary vessels/injuries. Iatronic disease. Catheterization. ResumoA dissecção coronária iatrogênica apresenta alta morbidade e mortalidade. Diante da oclusão aguda do fluxo coronariano, é fundamental a restauração imediata da perviabilidade do vaso para limitar a extensão e duração da isquemia. Nesta situação, pode estar indicada a revascularização cirúrgica do miocárdio de emergência. Os autores apresentam caso de um paciente com dissecção iatrogênica do tronco de coronária esquerda durante angioplastia transluminal percutânea, que foi solucionada pela realização de revascularização completa do miocárdio, com resultado satisfatório.Descritores: Angioplastia coronária transluminal percutânea, efeitos adversos. Vasos coronários/lesões. Doença iatrogênica. Cateterismo. Rev Bras Cir Cardiovasc 2008; 23(2): 268-271 Tratamento operatório da dissecção iatrogênica do tronco de coronária esquerda 269 BREDA, JR ET AL -Operative treatment after iatrogenic left main dissection

The author describes the simultaneous treatment of pectus excavatum and congenital intracardiac defect (atrial septal defect) represented by the interatrial foramen secundum. An 8-year-old boy, with clinical and echocardiography diagnosis of atrial septal defect associated with pectus excavatum was referred to a simultaneous surgical treatment of both abnormalities. The simultaneous surgical treatment of both pectus excavatum and congenital intracardiac defects make it difficult to access the heart. In this case, the simultaneous surgical treatment of atrial septal defect and pectus excavatum was a valuable alternative to surgical repair of both abnormalities, mainly due to its cosmetic outcome.Descriptors: Thorax, abnormalities. Funnel chest, surgery. Heart defects, congenital. Heart septal defects, atrial. ResumoRelatamos tratamento simultâneo de pectus excavatum e defeito congênito intracardíaco representado por comunicação interatrial ostium secundum. Paciente do sexo masculino, 8 anos de idade, com diagnóstico clínico e ecocardiográfico de comunicação interatrial, associada à deformidade da parede torácica tipo pectus excavatum. Foi encaminhado para operação com correção simultânea do defeito congênito intracardíaco associado ao reparo do pectus. O tratamento operatório simultâneo do pectus excavatum e defeitos congênitos intracardíacos torna difícil o acesso ao coração. Foi feita a correção simultânea dessas alterações, com satisfatório resultado, sobretudo estético, para o paciente.Descritores: Tórax, anormalidades. Tórax em funil, cirurgia. Cardiopatias congênitas. Defeitos do septo interatrial. 356BREDA, JR ET AL -Simultaneous repair of congenital heart defect and pectus excavatum Rev Bras Cir Cardiovasc 2007; 22(3): 355-358