We have demonstrated that the short-term and mid-term outcomes of coronary artery surgery alone in patients with a large left ventricle are inferior to coronary artery surgery plus ventricular restoration.

RBCCV 44205-776 O impacto de mudanças nas medidas de prevenção e no tratamento de infecções incisionais em cirurgia de revascularização do miocárdioThe impact of new preventive measures and treatment of surgical site infections after coronary artery bypass graft surgery Abstract Objective: To assess the impact of new preventive measures of surgical site infections after coronary artery bypass graft (CABG) surgery.Method: A retrospective study of 468 patients who underwent CABG surgery with cardiopulmonary bypass was performed. These patients were distributed into two groups: Group A (n=224) and Group B (n=244), respectively before and after a new protocol. The two groups were compared by statistical analysis to determine differences in risk factors, the incidence of sternotomy surgical site infections (superficial and deep), recurrent infections and hospital readmission.Results Resumo Objetivo: Avaliar o impacto de novas medidas de prevenção e tratamento para infecções incisionais em cirurgia de revascularização do miocárdio (RM).Método

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Proporção entre os segmentos do anel da valva tricúspide normal: um parâmetro para realização da anuloplastia valvarProportion among the segments of the normal tricuspid valve annulus: parameter for valve annuloplasty

Proporção entre os segmentos do anel da valva tricúspide normal: um parâmetro para realização da anuloplastia valvar

Objectives: To evaluate the integration of both viability and clinical parameters on the improvement in systolic performance, symptoms and prognosis, with postrevascularization reverse remodeling. Method: One hundred and fifteen patients underwent thallium-201 imaging before myocardial revascularization. Left ventricular ejection fraction, left ventricular end-systolic volume index and. left ventricular end-diastolic volume index were determined before and at each 6 months postrevascularization for 3 years. Results: Patients with ≥ ≥ ≥ ≥ ≥ 4 viable segments evidenced by thallium-201 imaging demonstrated an improvement in the left ventricular ejection fraction of from 34 ± 6 to 44 ± 4%, p<0.001), left ventricular end-systolic volume decreased from 78.3 ± 11 to 57 ± 17 mL/m 2 , p<0.001; left ventricle end-diastolic volume decreased from 113 ± 31 to 91 ± 22 mL/m 2 , p<0.001). Patients with < < < < < 4 viable segments failed to demonstrate an improvement of the left ventricle ejection fraction, 33.4 ± 4 vs. 35.1 ± 5% (p=0.19), and exhibited ongoing left ventricle end-systolic remodeling, 72 ± 23 vs. 73 ± 12 mL/m 2 (p= 0.81) and the left ventricle end-diastolic volume increased from 112 ± 24 to 118 ± 16 mL/m 2 (p=0.34), without improvement in the NYHA functional class and worse long-term prognosis (event; log rank test, p=0.0053). The multivariable analysis demonstrated clinical variables related to the unfavorable evolution showed diabetes, more than one myocardial infarction and a long time interval between myocardial infarction and surgery were associated with worse prognosis. Conclusion: The benefits of myocardium revascularization in patients with viable muscle, as well as an improvement in the left ventricular ejection fraction, provide reverse remodeling, improvement in functional class and favorable long-term prognosis.

The use of the ratio 2.43:1 between the anterior-posterior and septal segments as a parameter in tricuspid valve annuloplasty with a bovine pericardium flexible ring leads to satisfactory results.

O impacto de mudanças nas medidas de prevenção e no tratamento de infecções incisionais em cirurgia de revascularização do miocárdio The impact of new preventive measures and treatment of surgical site infections after coronary artery bypass graft surgery Abstract Objective: To assess the impact of new preventive measures of surgical site infections after coronary artery bypass graft (CABG) surgery. Method: A retrospective study of 468 patients who underwent CABG surgery with cardiopulmonary bypass was performed. These patients were distributed into two groups: Group A (n=224) and Group B (n=244), respectively before and after a new protocol. The two groups were compared by statistical analysis to determine differences in risk factors, the incidence of sternotomy surgical site infections (superficial and deep), recurrent infections and hospital readmission. Results: There was a greater use of internal thoracic artery grafts (p=0.003) and a shorter time of mechanical ventilation (p=0.001) in Group B. Surgical site infections occurred in 44 patients of Group A (19.6%); 33 superficial (14.7%) and 11 deep (4.9%) while in Group B only 13 patients had this complication (5.3%); 10 superficial (4.1%) and 3 deep (1.2%) surgical site infections. Significant improvements were seen in the total number of surgical site infections (p<0.001), of superficial infections (p<0.001) and of deep infections (p=0.037). There were 36.3% and 7.7% of recurrent infections in Groups A and B, respectively (p=0.102). Hospital readmissions due to surgical site infections were 21 in Group A and 3 in Group B (p<0.001). Conclusion: The new preventive measures and treatment for surgical site infections after CABG surgery in this series of patients significantly reduced the incidence of sternotomy surgical site infections and hospital readmissions related to this complication. Descriptors: Infection. Surgical wound infection. Infection control. Cardiac surgical procedures. Myocardial revascularization. Resumo Objetivo: Avaliar o impacto de novas medidas de prevenção e tratamento para infecções incisionais em cirurgia de revascularização do miocárdio (RM). Método: Estudo retrospectivo incluindo 468 pacientes ANTONIALI, F ET AL-The impact of new preventive measures and treatment of surgical site infections after coronary artery bypass graft surgery