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
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- ECMO: Improving our Results by Chasing the Rabbits(2015) CANEO, Luiz Fernando; NEIROTTI, Rodolfo A.As Marcelo Giugale published in the Financial Times, Latin America, on the whole, has not excelled at innovation - doing the same things in a new and better way or at doing new things. It has been slow to acquire, adopt and adapt technologies by this time available in other places[1]. Although extracorporeal membrane oxygenation (ECMO) is not a new technology, its use in Latin America is not widespread as needed. Furthermore, we still have a number centers doing ECMO, not reporting their cases, lacking a structured training program and not registered with the extracorporeal life support organization (ELSO). With this scenario, and accepting that ECMO is the first step in any circulatory support program, it is difficult to anticipate the incorporation of new and more complex devices as the technologically advanced world is currently doing. However, the good news is that with the support of experts from USA, Europe and Canada the results in Latin America ELSO'S centers are improving by following its guidelines for training, and using a standard educational process. There is no doubt that we can learn a great deal from the high velocity organizations - the rabbits - whom everyone chases but never catches, that manage to stay ahead because of their endurance, responsiveness, and their velocity in self-correction([2]).
- Uma reflexão sobre o desempenho da cirurgia cardíaca pediátrica no Estado de São Paulo(2012) CANEO, Luiz Fernando; JATENE, Marcelo Biscegli; YATSUDA, Nelson; GOMES, Walter J.
- The Importance of the Proper Definition of Adulthood: What is and What is Not Included in a Scientific Publication(2017) CANEO, Luiz Fernando; NEIROTTI, Rodolfo
- The debt to the nation's health: the case of the congenital(2013) GOMES, Walter J.; NOGUEIRA, Aldemir Jose da Silva; JATENE, Fabio Biscegli; MENDONCA, Jose Teles de; NETO, Jose Wanderley; MULINARI, Leonardo Andrade; CANEO, Luiz Fernando; JATENE, Marcelo Biscegli; CASCUDO, Marcelo Matos; PINTO JUNIOR, Valdester Cavalcante
- Post-cardiotomy ECMO in pediatric and congenital heart surgery: impact of team training and equipment in the results(2015) MIANA, Leonardo Augusto; CANEO, Luiz Fernando; TANAMATI, Carla; PENHA, Juliano Gomes; GUIMARAES, Vanessa Alves; MIURA, Nana; GALAS, Filomena Regina Barbosa Gomes; JATENE, Marcelo BiscegliIntroduction: Post-cardiotomy myocardial dysfunction requiring mechanical circulatory support occurs in about 0.5% of cases. In our environment, the use of extracorporeal membrane oxygenation has been increasing in recent years. Objective: To evaluate the impact of investment in professional training and improvement of equipment in the rate of weaning from extracorporeal membrane oxygenation and survival. Methods: A retrospective study. Fifty-six pediatric and/or congenital heart patients underwent post-cardiotomy extracorporeal membrane oxygenation at our institution between November 1999 and July 2014. We divided this period into two phases: phase I, 36 cases (before the structuring of the extra-corporeal membrane oxygenation program) and phase II, 20 cases (after the extracorporeal membrane oxygenation program implementation) with investment in training and equipment). Were considered as primary outcomes: extracorporeal membrane oxygenation weaning and survival to hospital discharge. The results in both phases were compared using Chi-square test. To identify the impact of the different variables we used binary logistic regression analysis. Results: Groups were comparable. In phase I, 9 patients (25%) were weaned from extracorporeal membrane oxygenation, but only 2 (5.5%) were discharged. In phase II, extracorporeal membrane oxygenation was used in 20 patients, weaning was possible in 17 (85%), with 9 (45%) hospital discharges (P<0.01). When the impact of several variables on discharge and weaning of extracorporeal membrane oxygenation was analyzed, we observe that phase II was an independent predictor of better results (P<0.001) and need for left cavities drainage was associated with worse survival (P=0.045). Conclusion: The investment in professional training and improvement of equipment significantly increased extracorporeal membrane oxygenation results.
- Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian Hospital(2014) MIANA, Leonardo Augusto; AZEKA, Estela; CANEO, Luiz Fernando; TURQUETTO, Ada Luisa; TANAMATI, Carla; PENHA, Juliano Gomes; CAUDURO, Alexandre; JATENE, Marcelo BiscegliIntroduction: Cardiac transplantation remains the gold standard for end-stage cardiomyopathies and congenital heart defects in pediatric patients. Objective: This study aims to report on 20 years of experience since the first case and evaluate our results. Methods: We conducted a retrospective analysis of the database and outpatient follow-up. Between October 1992 and April 2012, 109 patients underwent 114 transplants. 51.8% of them being female. The age of patients ranged from 12 days to 21 years with a mean of 8.8 +/- 5.7 years and a median of 5.2 years. The underlying diagnosis was dilated cardiomyopathy in 61.5%, congenital heart disease in 26.6% and restrictive cardiomyopathy in 11.9%. All patients above 17 years old had congenital heart disease. Results: Survival rate at 30 days, 1, 5, 10, 15, and 20 years were 90.4%, 81.3%, 70.9%, 60.5%, 44.4% and 26.7%, respectively. Mean cold ischemic time was 187.9 minutes and it did not correlate with mortality (P>0.05). Infectious complications and rejection episodes were the most common complications P<0.0001), occurring, respectively, in 66% and 57.4% of the survivors after 10 years. There was no incidence of graft vascular disease and lymphoproliferative disease at year one, but they affected, respectively, 7.4% and 11% of patients within 10 years. Conclusion: Twenty-year pediatric heart transplant results at our institution were quite satisfactory and complication rates were acceptable.
- In-Vitro Evaluation of Two Types of Neonatal Oxygenators in Handling Gaseous Microemboli and Maintaining Optimal Hemodynamic Stability During Cardiopulmonary Bypass(2016) MARUPUDI, Neelima; WANG, Shigang; CANEO, Luiz Fernando; JATENE, Fabio Biscegli; KUNSELMAN, Allen R.; UNDAR, AkifObjective: Usually only FDA-approved oxygenators are subject of studies by the international scientific community. The objective of this study is to evaluate two types of neonatal membrane oxygenators in terms of transmembrane pressure gradient, hemodynamic energy transmission and gaseous microemboli capture in simulated cardiopulmonary bypass systems. Methods: We investigated the Braile Infant 1500 (Braile Biomedica, Sao Jose do Rio Preto, Brazil), an oxygenator commonly used in Brazilian operating rooms, and compared it to the Dideco Kids D100 (Sorin Group, Arvada, CO, USA), that is an FDA-approved and widely used model in the USA. Cardiopulmonary bypass circuits were primed with lactated Ringer's solution and packed red blood cells (Hematocrit 40%). Trials were conducted at flow rates of 500 ml/min and 700 ml/ min at 35 degrees C and 25 degrees C. Real-time pressure and flow data were recorded using a custom-based data acquisition system. For gaseous microemboli testing, 5cc of air were manually injected into the venous line. Gaseous microemboli were recorded using the Emboli Detection and Classification Quantifier. Results: Braile Infant 1500 had a lower pressure drop (P< 0.01) and a higher total hemodynamic energy delivered to the pseudopatient (P< 0.01). However, there was a higher raw number of gaseous microemboli seen prior to oxygenator at lower temperatures with the Braile oxygenator compared to the Kids D100 (P< 0.01). Conclusion: Braile Infant 1500 oxygenator had a better hemodynamic performance compared to the Dideco Kids D100 oxygenator. Braile had more gaseous microemboli detected at the pre-oxygenator site under hypothermia, but delivered a smaller percentage of air emboli to the pseudopatient than the Dideco oxygenator.
- Cirurgia cardiovascular pediátrica: aquilo devemos preservar, o que devemos melhorar e o que devemos transformar(2012) CANEO, Luiz Fernando