Objective: The aim of this study was to assess the performance of the European System of Cardiac Operation Risk Evaluation (EuroSCORE) model to predict mortality of patients undergoing coronary artery bypass surgery in the Cardiovascular Surgery Division of Santa Casa de São Paulo Medical School.Methods: From May 2005 to November 2006, 100 consecutive patients undergoing coronary artery bypass surgery were retrospectively analyzed. The records of these patients were reviewed in order to retrieve the variables included in the EuroSCORE method. The correlation of predicted and observed mortality was compared. Statistical analysis was performed using the chi-square test for univariate analysis and the Hosmer-Lemeshow test for logistic regression.Results: Hospital mortality was 5%. The EuroSCORE univariate analysis findings were as follows: score 0-2 predicted mortality 0.40%, observed 0.00%; score 3-5 predicted mortality 1.45%, observed 0.00%; score greater than 6 predicted mortality 3.15%, observed 7.94%. In spite of these differences the p-value was 0.213 demonstrating no statistical significance. The p-value for the HosmerLemeshow test was < 0.001 indicating poor calibration of the model for this sample.Conclusion: The EuroSCORE model is a simple, 263CAMPAGNUCCI, VP ET AL -EuroSCORE and the patients undergoing coronary bypass surgery at Santa Casa de São Paulo Aplicamos o teste do qui-quadrado para análise univariada e o teste de Hosmer-Lemeshow para ajuste do modelo de regressão logística.Resultados: A mortalidade hospitalar foi 5,0%. Na análise univariada, para escore 0-2 a mortalidade prevista pelo EuroSCORE foi de 0,40% e a encontrada 0%. Para o escore 3-5, a mortalidade prevista foi de 1,45% e a encontrada 0%. Para escore >6, a mortalidade prevista foi de 3,15% e a encontrada 7,94%. As discrepâncias entre as porcentagens observadas e previstas não foram estatisticamente significantes (p = 0,213

Objectives Cell transplantation is considered a novel approach in the treatment of myocardiopathy. The objective of this study was to evaluate the effects of autologous mononuclear stem cell therapy in doxorubicin-induced dilated myocardiopathy by conducting both functional and histopathologic analysis. Methods Seventy male rats were doxorubicin injected intraperitoneally for 2 weeks. At 1 month, the animals that had demonstrated left ventricular ejection fractions less than 40% were randomly divided into a mononuclear stem cell group and controls. Mononuclear stem cells were isolated. All animals underwent echocardiographic study: baseline, pre-cell therapy, and at 1 month post-cell therapy, and analyzed by the nonparametric Mann-Whitney test. Transplants were performed by subepicardial injections. Standard staining was performed. Results Twenty-three animals were randomly treated: mononuclear stem cell and control groups, with 11 rats completing the study. Cell viability was 85%. Mononuclear stem cells (n=5; 5×106 cells /300 μL medium) and control (n=6; 300 μL medium) were used. The resulting left ventricular ejection fraction in the cell therapy group was not significantly different compared with controls (p=0.54). New vessels were demonstrated in the subepicardial region. Conclusions Autologous mononuclear stem cell therapy was not functionally effective in doxorubicin-induced dilated myocardiopathy in the animal model under study with the experimental conditions, despite occurrence of angiogenic activity.

Aneurismectomia de ventrículo esquerdo com o coração batendo ininterruptamente: resultados imediatosLeft ventricular aneurysmectomy with continuous beating heart: early results AbstractObjective: Operative mortality after left ventricle aneurysmectomy is close to 15%. Specifically for this procedure, forms of myocardial protection have been little discussed. The purpose of this study was to evaluate immediate results of left anterior ventricular aneurysmectomy using the beating heart approach.Method: We performed a retrospective analysis of 34 patients who underwent a left anterior ventricular aneurysmectomy, both with and without revascularization, from January 1997 to May 2005. The series consisted of 20 males and 14 females with a mean age of 52 years-old (range: 28 to 76). All of them were operated on using cardiopulmonary bypass and normothermia; aortic cross-clamping was not used but the open-beating heart technique was. We evaluated the perioperative mortality, thromboembolic events, duration of cardiopulmonary bypass, the length of stay in intensive care unit and the use of invasive ventilatory assistance.Results: There were no perioperative mortalities or thromboembolic events. The cardiopulmonary bypass time was 85 minutes (range: 25-150 minutes). Invasive ventilatory assistance was used on average for 18 hours (range: 8-96 hours) and the mean stay in the intensive unit care was 3.1 days (range: 2-14 days). Conclusion:The beating heart approach constitutes a safe and efficient cardioprotective method for anterior left ventricle aneurysmectomy procedures.Descriptors: Heart aneurysm. Heart arrest, induced. Myocardial ischemia. Treatment outcome. J Cardiovasc Surg 2006; 21(1): 55-61 56 CAMPAGNUCCI, VP ET AL -Left ventricular aneurysmectomy with continuous beating heart: early results Braz INTRODUCTIONIntervention in the acute phase of myocardial infarctions with precocious reperfusion by thromboembolic therapy or angioplasty enables a reduction in mortality due to acute coronary insufficiency. Consequently, there is an increase of patients who present with complications with the evolution of chronic myocardial ischemia [1,2]. These events mainly emerge due to congestive heart failure (CHF) and arrhythmias. There is risk of sudden death in the complex forms of ventricular arrhythmia, but there is a high morbidity seen in patients with CHF. The quality of life of these patients is compromised with limitations and even the inability to do productive activities with frequent hospitalization.Coronary artery bypass grafting or percutaneous surgery to treat ischemic CHF must always be considered and used for patients with coronary injuries who can not be treated by other techniques. However, these alternatives are not always adequate and it is necessary to consider other kinds of intervention, specifically in patients who are refractive to pharmacologic treatment. Heart transplantation is the radical alternative for the most severe forms of CHF; it is not used in a scale proportional to the incidence of the ...

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Abordagem da valva do tronco pulmonar por desvio direito e uso de cânula bicaval: estudo experimental Approach of the pulmonary valve using right heart bypass and bicaval cannula: experimental study Abstract Objective: To reproduce the surgery for correction of pulmonary valve anomalies using right heart bypass and a new bicaval cuffed venous cannula for minimal access surgery.Methods: Fifteen Large-White pigs were used for this study. The standard technique model was established with the first five pigs, the experiment was done with nine animals by sternotomy, and one was submitted to a minimally invasive procedure, but has been excluded of the sample. Bicaval drainage by a single cannula was obtained through the internal jugular vein. The cuffs were inflated to increase blood flow to the machine.