LUIZ FERNANDO CANEO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
LIM/65, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
LIM/65, Hospital das Clínicas, Faculdade de Medicina - Líder
6 resultados
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- Adherence to the cardiac surgery checklist decreased mortality at a teaching hospital: A retrospective cohort study(2022) MEJIA, Omar Asdrubal Vilca; MENDONCA, Frederico Carlos Cordeiro de; SAMPAIO, Lucimar Aparecida Barrense Nogueira; GALAS, Filomena Regina Barbosa Gomes; PONTES, Mauricio Franklin; CANEO, Luiz Fernando; DALLAN, Luis Roberto Palma; LISBOA, Luiz Augusto Ferreira; FERREIRA, Joao Fernando Monteiro; DALLAN, Luis Alberto de Oliveira; JATENE, Fabio BiscegliObjective: To evaluate the impact of adherence to the cardiac surgical checklist on mortality at the teaching hospital. Methods: A retrospective cohort study after the implementation of the cardiac surgical safety checklist in a reference hospital in Latin America. All patients undergoing coronary artery bypass surgery and/or heart valve surgery from 2013 to 2019 were analyzed. After the implementation of the project InCor-Checklist ???Five steps to safe cardiac surgery??? in 2015, the correlation between adherence and completeness of this instrument with surgical mortality was assessed. The EuroSCORE II was used as a reference to assess the risk of expected mortality for patients. Cross-sectional questionnaires were during the implementation of the InCor-Checklist. To perform the correlation, Pearson???s coefficient was calculated using R software. Results: Since 2013, data from 8139 patients have been analyzed. The average annual mortality was 5.98%. In 2015, the instrument was used in only 58% of patients; in contrast, it was used in 100% of patients in 2019. There was a decrease in surgical mortality from 8.22% to 3.13% for the same group of procedures. The results indicate that the greater the checklist use, the lower the surgical mortality (r = 88.9%). In addition, the greater the InCor-Checklist completeness, the lower the surgical mortality (r = 94.1%). Conclusion: In the formation of the surgical patient safety culture, the implementation and adherence to the InCorChecklist ???Five steps to safe cardiac surgery??? was associated with decreased mortality after cardiac surgery.
- Risk factors for death or mechanical ventilation time after bidirectional cavopulmonary anastomosis in a developing country(2022) JONAS, Marina C.; CARMONA, Fabio; CANEO, Luiz F.; TURQUETTO, Aida L. R.; JATENE, Marcelo B.; MANSO, Paulo H.Background: Glenn procedure is performed for patients with cyanotic CHD and univentricular physiology and has a survival rate above 90%. Aim: To evaluate the risk factors associated with a poor outcome after Glenn procedure. Methods: The data for this retrospective analysis were collected from a regional Brazilian registry of congenital heart surgeries (ASSIST initiative) from 2014 to 2019. Data from 97 patients who underwent the Glenn procedure were considered. The primary outcomes were prolonged mechanical ventilation (>24 hours post-operatively) or in-hospital death, alone and combined. Results: The overall in-hospital mortality was 13.4% (n = 13). Prolonged mechanical ventilation occurred in 52% (n = 51) of the patients. Our analysis found that risk factors for death or prolonged post-operative mechanical ventilation were cardiopulmonary bypass duration and post-operative lactate, whereas weight-for-age z-score and age at surgery were risk factors for prolonged mechanical ventilation. Cardiopulmonary bypass duration increased (adjusted odds ratio: 1.02; 95 % CI: 1.01, 1.03) and age at surgery decreased (adjusted odds ratio: 0.96; 95 % CI: 0.93, 0.99) the odds of the combined outcome. Conclusions: Age at surgery, post-operative lactate, and low-weight-for-age z-score are associated with prolonged mechanical ventilation and death following the Glenn procedure.
- Impact of the First Wave of the COVID-19 Pandemic on Cardiovascular Surgery in Brazil: Analysis of a Tertiary Reference Center(2022) LISBOA, Luiz Augusto; MEJIA, Omar Asdrubal Vilca; ARITA, Elisandra Trevisan; GUERREIRO, Gustavo Pampolha; SILVEIRA, Lucas Molinari Veloso Da; BRANDAO, Carlos Manuel De Almeida; DIAS, Ricardo Ribeiro; DALLAN, Luis Roberto Palma; MIANA, Leonardo; CANEO, Luiz F.; JATENE, Marcelo Biscegli; DALLAN, Luis Alberto Oliveira; JATENE, Fabio Biscegli
- Initial experience with del Nido cardioplegia solution at a Pediatric and Congenital Cardiac Surgery Program in Brazil(2022) CANEO, Luiz Fernando; MATTE, Gregory S.; TURQUETTO, Aida Luiza R.; PEGOLLO, Luana Marques de Carvalho; MIGLIOLI, Maria Clara Amato; SOUZA, Gisele T. de; AMATO, Luciana Patrick; MIANA, Leonardo A.; MASSOTI, Maria Raquel B.; PENHA, Juliano G.; TANAMATI, Carla; JATENE, Marcelo B.; JATENE, Fabio B.Objective: The aim of this study was to evaluate outcome measures between our standard multidose cardioplegia protocol and a del Nido cardioplegia protocol in congenital heart surgery patients. Methods: Retrospective single-center study including 250 consecutive patients that received del Nido cardioplegia (DN group) with a mandatory reperfusion period of 30% of cross clamp time and 250 patients that received a modified St. Thomas' solution (ST group). Groups were matched by age, weight, gender, and Risk Adjustment for Congenital Heart Surgery (RACHS-1) scores. Preoperative hematocrit and oxygen saturation were also recorded. Outcomes analyzed were the vasoactive inotropic score (VIS), lactate, ventilation time, ventricular dysfunction with low cardiac output syndrome (LCOS), intensive care unit (ICU) length of stay (LOS), hospital LOS, bypass and aortic cross-clamp times, and in-hospital mortality. Results: Both groups were comparable demographically. Statistically significant differences (p <= 0.05) were noted for cardiac dysfunction with LCOS, hematocrit at end of surgery (p = 0.0038), VIS on ICU admission and at end of surgery (p = 0.0111), and ICU LOS (p = 0.00118) with patients in the DN group having more desirable values for those parameters. Other outcome measures did not reach statistical significance. Conclusion: In our congenital cardiac surgery population, del Nido cardioplegia strategy was associated with less ventricular dysfunction with LCOS, a lower VIS and decreased ICU LOS compared with patients that received our standard myocardial protection using a modified St. Thomas' solution. Despite the limitation of this study, including its retrospective nature and cohort size, these data supported our transition to incorporate del Nido cardioplegia solution with a mandatory reperfusion period as the preferred myocardial protection method in our program.
- Experimental and Clinical Performance of Long-Term Cannulas for Mechanical Circulatory Assistance(2022) OYAMA, H. T. T.; BACHT, S.; MAZZETTO, M.; CANEO, L. F.; JATENE, M. B.; JATENE, F. B.; CESTARI, I. A.Mechanical circulatory assistance with left ventricle assist devices (VADs) can be used for hemodynamic stabilization in patients waiting for heart transplantation. In this application the VAD is connected to the heart with the use of special cannulas. The purpose of this work is to present in the performance of long-term cannulas designed for pediatric patients undergoing circulatory assistance. Pressure drop of cannulas with different sizes were tested using a mock loop of the pediatric arterial circulation. Considering a flow range of 0.52-1.25 L/min the pressure drops obtained was 9.43 to 22.1 mm Hg, respectively. Good clinical results were obtained with cannulas associated with a centrifugal pump or DAV for a period of approximately 4-64 days, with no thrombus formation on the tips of the cannulas or bleeding. The implantation of cannulas proved to be technically feasible and their removal was easy to perform in cases of ventricular recovery or transition to a long-term assistance device.
- A New Dawn for Brazilian Pediatric Cardiac Surgery Is on the Way - Issues Around and Outside the Operating Room(2022) CANEO, Luiz Fernando; MIANA, Leonardo Augusto; GARROS, Daniel; NEIROTTI, RodolfoIn some developing countries, congenital heart disease still stands out among the leading causes of death in the first year of life. Therefore, there is a great need to develop programs designed to improve outcomes in the diagnosis and surgical treatment of congenital heart disease in these nations, where children have always been and still are severely underserved. The Brazilian Public Health Care System demands universal access to treatment as a constitutional right. Therefore, an underfunded Pediatric Cardiac Surgery program is unacceptable since it will cost lives and increase the infant mortality rate. Additionally, poor funding decreases providers' interest, impedes technological advances and multidisciplinary engagement, and reduces access to comprehensive care. Unfortunately, in most developing countries, Pediatric Cardiac Surgery progress is still the result of isolated personal efforts, dedication, and individual resilience. This article aims to present the current state of Brazilian pediatric cardiac surgery and discuss the structural and human limitations in developing a quality care system for children with congenital heart disease. Considering such constraints, quality improvement programs via International collaboration with centers of excellence, based on proper data collection and outcomes analysis, have been introduced in the country. Such initiatives should bring a new dawn to Brazilian Pediatric Cardiac Surgery.