Tratamento cirúrgico da fibrilação atrial crônica com eletrocautério convencional em cirurgia valvar mitral

Júnior, Jandir Ferreira Gomes; Pontes, José Carlos Dorsa Vieira; Gomes, Otoni Moreira; Duarte, João Jackson; Gardenal, Neimar; Dias, Amaury Mont'Serrat Ávila Souza; Benfatti, Ricardo Adala; Silva, Guilherme Viotto Rodrigues da

doi:10.1590/s0102-76382008000300013

Cited by 7 publications

(7 citation statements)

References 25 publications

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“…Gomes et al [ 45 ] , using electrocautery in mitral valve surgery, found that this source of energy reversed arrhythmia in a significant number of patients. In the absence of ultrasound equipment, Brick (personal communication) had the opportunity to use electrocautery in a small number of patients, not recommending its routine use due to charring with the release of small emboli inside the atrium.…”

Section: Discussionmentioning

confidence: 99%

Surgical Ablation of Atrial Fibrillation Using Energy Sources

Brick

Braile

2015

Revista Brasileira De Cirurgia Cardiovascular

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Surgical ablation, concomitant with other operations, is an option for treatment in patients with chronic atrial fibrillation. The aim of this study is to present a literature review on surgical ablation of atrial fibrillation in patients undergoing cardiac surgery, considering energy sources and return to sinus rhythm. A comprehensive survey was performed in the literature on surgical ablation of atrial fibrillation considering energy sources, sample size, study type, outcome (early and late), and return to sinus rhythm. Analyzing studies with immediate results (n=5), the percentage of return to sinus rhythm ranged from 73% to 96%, while those with long-term results (n=20) (from 12 months on) ranged from 62% to 97.7%. In both of them, there was subsequent clinical improvement of patients who underwent ablation, regardless of the energy source used. Surgical ablation of atrial fibrillation is essential for the treatment of this arrhythmia. With current technology, it may be minimally invasive, making it mandatory to perform a procedure in an attempt to revert to sinus rhythm in patients requiring heart surgery.

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Section: Discussionmentioning

confidence: 99%

Surgical Ablation of Atrial Fibrillation Using Energy Sources

Brick

Braile

2015

Revista Brasileira De Cirurgia Cardiovascular

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“…(86) A fonte de energia ideal seria rápida, confiável, com produção de lesão transmural, que não danificasse os tecidos circundantes, sendo passível de usar com CEC, de aplicação minimamente invasiva, por via endocárdica e epicárdica. (105) Gomes et al, (106) utilizando eletrocautério em cirurgia valvar mitral, verificaram que essa fonte de energia reverteu arritmia em número significativo de pacientes. Brick (comunicação pessoal) teve oportunidade, na ausência do equipamento de US, de utilizar eletrocautério em pequeno número de pacientes, não recomendando seu uso rotineiro por provocar carbonização com liberação de pequenos êmbolos dentro do átrio.…”

Section: Discussionunclassified

O Uso De Luteína E Zeaxantina Como Corantes Intraoculares Para Cirurgia Oftalmológica

Martins¹

2022

Avanços Científicos Em Medicina 3

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Foi estudada a segurança e eficácia de formulações intraoculares contendo Luteína e Zeaxantina, isolada ou combinada com Azul Brilhante ou Azul de Trypan em cirurgia de catarata e vitreorretiniana. Soluções-corantes contendo óleo de rícino polietoxilado (Cremophor EL™) como veículo, não apresentam afinidade corante para a Cápsula Anterior, Vítreo, Hialóide Posterior, Membrana Limitante Interna e Membrana Epirretiniana. Adicionalmente, as soluções contendo Cremophor EL™ mostraram-se citotóxicas. Pelo contrário, soluções-corantes contendo álcool polivinílico como veículo mostraram-se eficazes e seguras. Os testes de eficácia em olhos cadavéricos mostraram apenas cinco formulações (sem Cremophor EL™) que coraram o vítreo menos de +++/4. Quanto à Cápsula Anterior e Membrana Limitante Iinterna, apenas a formulação de Luteína e Zeaxantina a 0,5% associada a Azul de Trypan a 0,04%; e a Luteína e Zeaxantina a 0,3% associada a Azul Brilhante a 0,025% atingiram a máxima coloração com os níveis mais baixos de Azul de Trypan e Azul Brilhante. O estudo de toxicidade intravítrea mostrou que nenhuma formulação testada exibe toxicidade “in-vivo” no vítreo e retina. As soluções-corantes Luteína e Zeaxantina a 0,3%-1% associada a Azul Brilhante a 0,025% e Luteína e Zeaxantina a 0,5%-1% associada a Azul de Trypan a 0,04%, ambas em álcool polivinílico, foram as melhores fórmulas em termos de estabilidade, pH e osmolaridade. Estas formulações atingiram os melhores resultados na coloração da Cápsula Anterior, Vítreo e Membrana Limitante Interna de olhos humanos cadavéricos. As soluções-corantes à base de Luteína e Zeaxantina poderão ser uma alternativa segura e eficaz em cirurgia de catarata e vitreorretiniana.

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“…No mortality occurred in our study as well; however, 14 patients required temporary and six patients required permanent pacemakers. In 2008, Gomes Junior et al [23] published a similar study on 33 patients undergoing ablation with electrocautery for AF during MVS. The authors presented parallel results to ours and reported low mortality and morbidity rates.…”

Section: Discussionmentioning

confidence: 99%

The Factors Affecting Rhythm Control for Cryoablation of Atrial Fibrillation in Mitral Valve Surgery

Türker¹,

Erdoğan²,

Doğan³

2019

Braz J Cardiovasc Surg

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ObjectiveTo evaluate the factors impacting on the conversion to sinus rhythm and on the postoperative rhythm findings in the six-month follow-up period of a mitral valve surgery combined with cryoablation Cox-Maze III procedure, in patients with atrial fibrillation.MethodsIn this study, we evaluated 80 patients who underwent structural valve disease surgery in combination with cryoablation. Indications for the surgical procedures were determined in the patients according to the presence of rheumatic or non-rheumatic structural disorders in the mitral valve as evaluated by echocardiography. Cox-Maze III procedure and left atrial appendix closure were applied.ResultsThe results of receiver operating characteristics analysis indicated that the rate of conversion to the sinus rhythm was significantly higher in patients with left atrial diameters ≥ 45.5 mm and with ejection fraction (EF) ≥ 48.5%. However, the statistical differences disappeared in the sixth month. Thromboembolic (TE) events were seen only in three patients in the early period and no more TE events occurred in the six-month follow-up period.ConclusionThe EF and the preoperative left atrial diameter were determined to be the factors impacting on the conversion to sinus rhythm in patients who underwent mitral valve surgery in combination with cryoablation. Mitral valve surgery in combination with ablation for atrial fibrillation does not affect mortality and morbidity in the experienced health centers; however, it remains controversial whether it will provide additional health benefits to the patients compared to those who underwent only mitral valve surgery.

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Tratamento cirúrgico da fibrilação atrial crônica com eletrocautério convencional em cirurgia valvar mitral

Cited by 7 publications

References 25 publications

Surgical Ablation of Atrial Fibrillation Using Energy Sources

Surgical Ablation of Atrial Fibrillation Using Energy Sources

O Uso De Luteína E Zeaxantina Como Corantes Intraoculares Para Cirurgia Oftalmológica

The Factors Affecting Rhythm Control for Cryoablation of Atrial Fibrillation in Mitral Valve Surgery

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