Results: The mean time of extracorporeal circulation was 52.5 ± 13.3 min; aortic clamping, 35.6 ± 12.9 min; atrial ablation, 3.05 ± 0.16 min. All the patients were free of atrial fibrillation after the procedure; on hospital discharge, 69.5%; at 6 months, 91.3%; at 12 months, 76.4%; at 18 months, and at 24 months, 68.4%. At 12 months, left atrium mean diameter was 42.1 ± 3.5 mm; left ventricular ejection fraction was 59.2 ± 3.48%; In addition, left atrial contractility was present in 68.8% of the patients. 366GOMES JÚNIOR, JF ET AL -Surgical treatment of chronic atrial fibrillation with conventional electrocautery in mitral valve surgery Bras Cir Cardiovasc 2008; 23(3): 365-371 Rev

Purpose:The development of an experimental model of myocardiopathy induced by Doxorubicin in rats. Methods: 16 wistar male rats were randomized in two groups: Group I (placebo) and Group II (Doxorubicin -5mg/kg). After six months, the animals were subjected to cardiotomy and their hearts were weighted and submitted to transversal cuts, from which fragments for a macro and micro study were obtained. These fragments were studied considering their external and internal diameters and the thickness of the left ventricle (LV). The histological pieces were analyzed for the presence of fibrosis, cytoplasmic vacuolization, necrosis and size of nucleus variation. Data obtained was submitted to statistical analysis with Student's t test. Results: The hearts of the animals in Group II increased 41% in relation to their weight; 33% in the internal diameter and 14% in the external diameter of the LV cavity; and 24% in the thickness of the wall. Fibrosis of the myocardial tissue was observed in 75% of the animals of Group II; all the animals presented miocyte cytoplasmatic vacuolization; myocardial necrosis was present in 75% of the animals; and 87/% presented variation in the size of myocite nuclei. The presence of polymorphonuclear cells was also observed. Conclusion: Doxorubicin was effective in the promotion of macro and microscopic alterations in the cardiac tissue of rats, possibly constituting a model for the experimental study of myocardiopathy. Key words: Cardiomyopathies. Doxorubicin. Rats. RESUMOObjetivo: Desenvolver um modelo experimental de miocardiopatia induzida por doxorrubicina em ratos. Métodos: 16 ratos Wistar machos foram randomizados em 2 grupos: Grupo I (placebo) e Grupo II (doxorrubicina 5mg/kg). Após 6 meses, os animais foram submetidos a cardiotomia e seus corações foram pesados e submetidos a cortes transversais. Estes fragmentos foram estudados considerando seus diâmetros externos e internos e a espessura do ventrículo esquerdo. As peças histológicas foram analisadas quanto à presença de fibrose, vacuolização citoplasmática, necrose e variação do tamanho do núcleo. Os resultados foram submetidos a análise estatística pelo teste t de Student. Resultados: Os corações dos animais do grupo II aumentaram 41% em relação ao peso; 33% no diâmetro interno e 14% no diâmetro externo; e 24% na espessura da parede do VE. Fibrose do tecido miocárdico foi observada em 75% dos animais do grupo II; todos os animais apresentaram vacuolização citoplasmática dos miócitos; Houve necrose miocárdica em 75% dos animais e 87% apresentaram variação no tamanho do núcleo. A presença de células polimorfonucleares também foi observada. Conclusão: A doxorrubicina foi efetiva na promoção de alterações macro e microscópicas no tecido cardíaco de ratos, possivelmente constituindo-se num modelo experimental para estudo da miocardiopatia. Descritores: Cardiomiopatias. Doxorrubicina. Ratos.

208Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2013;28(2):208-16 Pontes JCDV, et al. -Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery RBCCV 44205-1459 DOI: 10.5935/1678 Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery Abstract Objective: This paper demonstrates the initial and pioneering experience implant of the Inovare prosthesis implant through transfemoral or iliac artery route.Methods: Six patients underwent transcatheter aortic valve implantation. The access was femoral or iliac through which the delivery device, a latex balloon catheter with the crimped prosthesis, was inserted. Through the femoral introducer 24 Fr Gore ® DrySeal sheath, an extra stiff guide wire with non-traumatic tip was positioned in the left ventricle by passing through the valve ring. After balloon valvuloplasty, in cases of native valve stenosis, the prosthesis implantation was performed after hypotension induced by tachycardia and controlled by temporary pacemaker. The valve positioning was guided by TEE (transesophageal ecocardiography) and fluoroscopy, aiming to position a third of the length of the prosthesis into the left ventricle cavity.Results: The successful valve implantation was possible in six cases. There was no need of conversion to open surgery due to inability to access or graft migration. There were no intraoperative or hospital deaths. We observed a significant reduction in the mean gradient of 66.84±15.46 mmHg to 19.74±10.61 mm Hg postoperatively (P=0.002), a reduction of 70.46%.Conclusion: Inovare prosthesis, implanted by femoral or iliac artery was feasible, and determined adequate hemodynamic performance in the postoperative follow-up, showing no mortality in this small series.Descriptors: Heart valve diseases. Stents. Heart catheterization. Heart valve prosthesis implantation/methods. Aortic valve/surgery. ORIGINAL ARTICLE 209Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Bras Cir Cardiovasc 2013;28(2):208- Rev INTRODUCTIONDegenerative calcification of normal or congenital bicuspid aortic valve is the leading cause of aortic valve stenosis in adults in developed countries [1][2][3]. Prevalence of severe aortic stenosis increases with age and may affect up to 2% of individuals over 65 years of age [4]. The onset of symptoms constitutes poor prognosis and survival after that is as low as 60% in 1 year and 32% in 5 years [5]. Death in patients with heart failure usually occurs 2 years after the onset of symptoms, and after 3 and 5 years for patients with syncope and angina, respectively [6]. In such cases, surgical intervention alters the natural course of the disease, since surgical mortality, at about 4%, is considered low [7]. However, 33% of patients who are candidates for surgical treatment are not accepted to undergo the procedure, especially due to advanced age and ventricular dysfunction [8]. Other conditions, such as associated comorbidit...

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Substituição valvar mitral com papilopexia cruzada e constrição anular em pacientes com insuficiência cardíacaMitral valve replacement with crossed papillopexy and annular constriction in heart failure patients Abstract Objective: To analyze the short-term and mid-term followups of patients with heart failure and moderate to severe mitral valve insufficiency and who have undergone mitral valve replacement with crossed papillopexy and annular constriction.Methods: Thirteen patients in NYHA functional class III or IV, with a mean age of 54.1 years and with idiopathic etiology, underwent mitral valve replacement with ring constriction and crossed papillopexy. Echocardiograph parameters, functional class and survival actuarial curve were analyzed.Results: There were no deaths during surgery or in the postoperative period. The mean left ventricular diastolic diameter was reduced from 71 ± 8.6 mm to 65.3 ± 8.6 mm (p=0.049) and the mean left ventricular systolic diameter was reduced from .1 ± 8.5 mm to 50.4 ± 11.1 mm (p=0.002). The atrial diameters varied from 49.4 ± 6.4 mm to 44 ± 5.9 mm (p=0.017); the percentage of the left ventricular shortening was 17 ± 4 % to 24 ± 8.3% (p=0.014); the ejection fraction varied statistically and significantly from 34 ± 9% to 45 ± 14% (p=0.008). Eleven (84.6%) patients were in FC I and II. At 1, 6 and 12 months after follow-up surgery, the survival rate was 100%, 82.6%, 71.6%, respectively. This rate was maintained at 7.6% for more than 36 months. Conclusion:The results obtained from patients with heart failure and moderate to severe mitral valve insufficiency and who underwent mitral valve replacement with crossed papillopexy and annular constriction presented evidence of improved heart remodeling and significant improvement in left ventricular performance.