Evolução tardia da operação de Cox para fibrilação atrial em valvopatia mitral

Jatene, Marcelo Biscegli; Sosa, Eduardo; Jatene, Fábio Biscegli; Tarasoutchi, Flávio; Monteiro, Ana Cristina; Salerno, Pedro Rafael; Souza, Luiz Carlos Bento de; Mateos, José Carlos Pachón; Jatene, Adib

doi:10.1590/s0102-76381995000100003

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…Changes have been performed to the "Cox Operation", making it simpler and also propitiating the return of sinusal rhythm [ 18 ] . Studies reporting the success of this technique were published, and it is considered the reference standard for the surgical treatment of AF [ 19 , 20 ] , mainly in patients with mitral valve disease [ 21 ] .…”

Section: Introductionmentioning

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: Introductionmentioning

confidence: 99%

Surgical Ablation of Atrial Fibrillation Using Energy Sources

Brick

Braile

2015

Revista Brasileira De Cirurgia Cardiovascular

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“…Dentre outras complicações encontradas por Jatene et al (53) e Kosakai et al, (115) observa-se o risco de sangramento pela grande quantidade de cortes e suturas. Nesta série, houve apenas um acidente relacionado com ablação, com rotura da parede do átrio esquerdo, resolvido com sutura simples, utilizando fio de polipropileno.…”

Section: Discussionunclassified

“…(48,49) Foram publicados trabalhos relatando o sucesso dessa técnica, considerada padrão de referência para o tratamento operatório da FA, (45,50,51) principalmente em portadores de doença valvar mitral. (52)(53)(54)(55) A ampla dissecção das estruturas cardíacas e a realização de extensas linhas de secção e sutura da parede atrial, porém, aumentavam consideravelmente o tempo operatório, assim como o tempo de circulação extracorpórea (CEC) e de clampeamento aórtico, elevando a morbidade pósoperatória, dificultando a ampla aplicação do procedimento.…”

Section: Introductionunclassified

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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“…The relative complexity and the potential increase of morbidity of the 'maze' surgery [24][25][26] has motivated the procedure to be restricted to the left atrium and only using an ultrasound scalpel [27], or by applying radiofrequency [28], reducing sectioning and the sutures necessary in the atrial walls, keeping, however, the success of the conversion to regular atrial rhythm in 70 to 80% of the patients.…”

Section: Commentsmentioning

confidence: 99%

Nova abordagem técnica e eletrofisiológica para tratamento da fibrilação atrial

Gomes¹,

Gomes²

2004

Rev Bras Cir Cardiovasc

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Introduction: The maze procedure for primary atrial fibrillation treatment, initially proposed by Cox, is somewhat complex, and it increases the morbidity risk compared to isolated mitral valve surgery. Objective: To describe the surgical technique, the concepts of electrophysiology adopted and the preliminary results of a new surgical and electrophysiological approach, including specific atrial circuit blocking as defined by Frame and optimization of the surgical tactic for atrial fibrillation treatment. Method: Eight patients with chronic atrial fibrillation and mitral valve dysfunction, associated in one case with tricuspid valve regurgitation were operated on. The following modifications of the classic Cox procedure were employed: 1-Exclusion of the left atrium appendage by an internal suture closing its left atrial ostium; 2-Exclusion of the right atrium appendage by a purse-string suture used for fixation of the superior vena cava draining cannula; 3-Single atrial incision; 4-Trans-endocardium electrocauterization in the left atrium wall around all pulmonary vein ostia; 5-Substitution of the incisions and sutures in the left atrium by trans-endocardium electrocauterization. Results: The cardiopulmonary bypass time varied from 64 to 133 min (mean 107.5 min) and the cardioplegic time from 40 to 105 min. (mean 76.7 min). At the end of the surgery all patients were in regular atrial rhythm. The postoperative period was uneventful with all patients discharged from hospital showing regular atrial rhythm, without definitive pacemaker implantation. In the six-month postoperative follow up after surgery, six patients were in regular atrial rhythm (75%) with preserved atrial contractions, and two (25%) with clinically controlled atrial fibrillation (NYHA II). Also there were no embolic complications nor thrombotic evidence in the Doppler echocardiography control. Conclusion: It is concluded in this initial series of cases that the electrophysiological approach and the surgical technique employed improved the surgical treatment of the atrial fibrillation making correction of mitral and tricuspid valve injuries possible without additional morbidity.

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Evolução tardia da operação de Cox para fibrilação atrial em valvopatia mitral

Cited by 9 publications

References 19 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

Nova abordagem técnica e eletrofisiológica para tratamento da fibrilação atrial

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