MARCELO BISCEGLI JATENE

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Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina - Líder

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Agora exibindo 1 - 10 de 11
  • conferenceObject
    Stenting the Right Ventricular Outflow Tract as a Palliative Procedure in Patients with Tetralogy of Fallot
    (2014) PEDRA, Carlos; COSTA, Rodrigo; RIBEIRO, Marcelo; NASCIMENTO, Wanda; PEDRA, Simone; FURLANETTO, Glaucio; JATENE, Marcelo; ELIAS, Patricia; SANTANA, Virginia; FONTES, Valmir
  • article 3 Citação(ões) na Scopus
    Heart Transplantation in Pediatric Population and in Adults With Congenital Heart Disease: Long-term Follow-up, Critical Clinical Analysis, and Perspective for the Future
    (2014) AZEKA, E.; JATENE, M.; GALAS, F. R. B.; TANAMATI, C.; PENHA, J.; BENVENUTI, L.; MIURA, N.; JUNIOR, J. O. C.
    Background. Heart transplantation is a treatment option for children as well as for adults with congenital heart disease. Objective. To report the experience of a tertiary center with heart transplant program in pediatric population and in adults with congenital heart disease. Patients and Methods. The study consisted of the evaluation of pediatric as well as adult patients undergoing heart transplantation for congenital heart disease. We evaluated the following indication and complications such as renal dialysis, graft vascular disease, tumors and survival. Results. From October 1992 to November 2013, 134 patients had transplantation, and there were 139 transplantations and 5 retransplantations. The immunosuppression regimen is based on calcineurin inhibitors and cytostatic drugs. The type of heart disease indicated for transplantation was cardiomyopathies in 70% and congenital heart disease in 30%. Of these 134 patients, 85 patients were alive. Actuarial survival is 77.4%, 69.6%, 59.3% at 1, 5, and 10 years after transplantation. Three patients underwent renal transplantation, 1 patient is in renal dialysis, and 8.2% of patients had post-transplant lymphoproliferative disease. Two patients had retransplantation for graft vascular disease; 1 of them required a simultaneous kidney transplant and died 30 days after the procedure and 1 patient is clinically well 2 years after retransplantation. Conclusion. Heart transplantation in children and in adults with congenital heart disease is a promising therapeutic option and enables long-term survival for these patients.
  • article 12 Citação(ões) na Scopus
    Cardiopatias Congênitas como um Sinal de Alerta para o Diagnóstico da Deleção do 22q11.2
    (2014) GRASSI, Marcilia S.; JACOB, Cristina M. A.; KULIKOWSKI, Leslie D.; PASTORINO, Antonio C.; DUTRA, Roberta L.; MIURA, Nana; JATENE, Marcelo B.; PEGLER, Stephanie P.; KIM, Chong A.; CARNEIRO-SAMPAIO, Magda
    Background: To alert for the diagnosis of the 22q11.2 deletion syndrome (22q11.2DS) in patients with congenital heart disease (CHD). Objective: To describe the main CHDs, as well as phenotypic, metabolic and immunological findings in a series of 60 patients diagnosed with 22q11.2DS. Methods: The study included 60 patients with 22q11.2DS evaluated between 2007 and 2013 (M: F = 1.3, age range 14 days to 20 years and 3 months) at a pediatric reference center for primary immunodeficiencies. The diagnosis was established by detection of the 22q11.2 microdeletion using FISH (n = 18) and/or MLPA (n = 42), in association with clinical and laboratory information. Associated CHDs, progression of phenotypic facial features, hypocalcemia and immunological changes were analyzed. Results: CHDs were detected in 77% of the patients and the most frequent type was tetralogy of Fallot (38.3%). Surgical correction of CHD was performed in 34 patients. Craniofacial dysmorphisms were detected in 41 patients: elongated face (60%) and/or elongated nose (53.3%), narrow palpebral fissure (50%), dysplastic, overfolded ears (48.3%), thin lips (41.6%), elongated fingers (38.3%) and short stature (36.6%). Hypocalcemia was detected in 64.2% and decreased parathyroid hormone (PTH) level in 25.9%. Decrease in total lymphocytes, CD4 and CD8 counts were present in 40%, 53.3% and 33.3%, respectively. Hypogammaglobulinemia was detected in one patient and decreased concentrations of immunoglobulin M (IgM) in two other patients. Conclusion: Suspicion for 22q11.2DS should be raised in all patients with CHD associated with hypocalcemia and/or facial dysmorphisms, considering that many of these changes may evolve with age. The 22q11.2 microdeletion should be confirmed by molecular testing in all patients.
  • bookPart
    Breve história da cirurgia cardiovascular no Brasil e no mundo
    (2014) LIGUORI, Gabriel Romero; KANAS, Alexandre Fligelman; IUAMOTO, Leandro Ryuchi; MARQUES, Laís Costa; VELOSO, Patrícia Maquinêz; JATENE, Marcelo Biscegli
  • article 11 Citação(ões) na Scopus
    I DIRETRIZ DE INSUFICIÊNCIA CARDÍACA (IC) E TRANSPLANTE CARDÍACO, NO FETO, NA CRIANÇA E EM ADULTOS COM CARDIOPATIA CONGÊNITA, DA SOCIEDADE BRASILEIRA DE CARDIOLOGIA
    (2014) AZEKA, E.; JATENE, M. B.; JATENE, I. B.; HOROWITZ, E. S. K.; BRANCO, K. C.; SOUZA NETO, J. D.; MIURA, N.; MATTOS, S.; AFIUNE, J. Y.; TANAKA, A. C.; SANTOS, C. C. L.; GUIMARAES, I. C. B.; MANSO, P. H.; PELLIZARI, R. C. R. S.; SANTOS, M. V. C.; THOMAZ, A. M.; CRISTOFANI, L. M.; RIBEIRO, A. C. L.; KULIKOWSKI, L. D.; SAMPAIO, M. C.; PEREIRA, A. C.; SOARES, A. M.; SOARES JUNIOR, J.; OH, G. H. Y.; MOREIRA, V; MOTA, C. C. C.; AFIUNE, C. M. C.; PEDRA, C.; PEDRA, S.; PEDROSA, A.; GUIMARAES, V; CANEO, L. F.; FERREIRO, C. R.; CAVALHEIRO FILHO, C.; STEFANELLO, B.; NEGRAO, C. E.; TURQUETTO, A. L. R.; MESQUITA, S. M. F.; MAEDA, W. T.; ZORZANELLI, L.; PANAJOTOPOLOS, N.; SIQUEIRA, A. W. S.; GALAS, F. R. B.; HAJJAR, L. A.; BENVENUTI, L. A.; VINCENZI, P.; ODONE, V; LOPES, M. H.; V, T. M. Strabelli; FRANCHI, S. M.; TAKEUTI, A. D.; DUARTE, M. F.; LEON, R. G. P.; HERMIDA, R. P. M.; SORPRESO, I. C. E.; SOARES JUNIOR, J. M.; MELO, N. R.; BARACAT, E. C.; BORTOLOTTO, M. R. F. L.; SCANAVACCA, M.; SHIMODA, M. S.; FORONDA, G.; ROMANO, B. W.; SILVA, D. B.; OMURA, M. M.; BARBEIRO, C. P. M.; VINHOLE, A. R. G.; PALOMO, J. S. H.; GONCALVES, M. A. B.; REIS, I. C. F.; OLIVEIRA, L. G.; RIBEIRO, C. C.; ISOSAKI, M.; VIEIRA, L. P.; FELTRIM, M. I. Z.; MANOEL, L. A.; ABUD, K. C. O.; PASCHOTTO, D. R.; NEVES, I. L. I.; SENAHA, L. E.; GARCIA, A. C. C. N.; CIPRIANO, S. L.; SANTOS, V. C.; FERRAZ, A. S.; MOREIRA, A. E. L. C.; PAULO, A. R. S. A. De; DUQUE, A. M. P. C.; TRINDADE, E.; BACAL, F.; AULER JUNIOR, J. O. C.; ALMEIDA, D. R.
  • bookPart
    Cardiopatias congênitas
    (2014) LIGUORI, Gabriel Romero; KANAS, Alexandre Fligelman; MARQUES, Laís Costa; AKERMAN, Denise; CAMARGO, Thaís Fernandes de; JATENE, Marcelo Biscegli
  • article 5 Citação(ões) na Scopus
    Clinical recommendations for postoperative care after heart transplantation in children: 21 years of a single-center experience
    (2014) AZEKA, Estela; JATENE, Marcelo Biscegli; TANAKA, Ana Cristina; GALAS, Filomena Regina; HAJJAR, Ludhmilla Abrahao; MIURA, Nana; AULER JUNIOR, Jose Otavio Costa
    Heart transplantation is an option for children with complex congenital heart disease and cardiomyopathies. A patient's quality of life and long-term survival depend on successful management of the surgical complications and adverse side effects of immunosuppression. The purpose of this review was to summarize the practical management of postoperative care in this patient population and to make recommendations for the future.
  • article 69 Citação(ões) na Scopus
    Hemostatic effects of fibrinogen concentrate compared with cryoprecipitate in children after cardiac surgery: A randomized pilot trial
    (2014) GALAS, Filomena R. B. G.; ALMEIDA, Juliano P. de; FUKUSHIMA, Julia T.; VINCENT, Jean Louis; OSAWA, Eduardo A.; ZEFERINO, Suely; CAMARA, Ligia; GUIMARAES, Vanessa A.; JATENE, Marcelo B.; HAJJAR, Ludhmila A.
    Objectives: Acute acquired hypofibrinogenemia in children undergoing cardiac surgery is a major concern because it often results in perioperative bleeding and high rates of allogeneic blood transfusion. Fibrinogen concentrate has been proposed as an alternative to cryoprecipitate (the gold standard therapy), with minimal infectious and immunologic risks. Our objective was to investigate the efficacy and safety of fibrinogen concentrate in children undergoing cardiac surgery. Methods: In this randomized pilot study, patients were allocated to receive fibrinogen concentrate (60 mg/kg) or cryoprecipitate (10 mL/kg) if bleeding was associated with fibrinogen levels <1 g/dL after cardiopulmonary bypass weaning. The primary outcome was postoperative blood losses during the 48 hours after surgery. Results: A total of 63 patients were included in the study, 30 in the fibrinogen concentrate group and 33 in the cryoprecipitate group. The median 48-hour blood loss was not significantly different between the 2 groups (320 mL [interquartile range, 157-750] vs 410 mL [interquartile range, 215-510], respectively; P = .672). After treatment, plasma fibrinogen concentration increased similarly following administration of both products. There were no differences in allogeneic blood transfusion after intervention treatment. Conclusions: A large trial comparing fibrinogen concentrate and cryoprecipitate in the management of children with acute acquired hypofibrinogenemia during heart surgery is feasible. The preliminary results of our study showed that the use of fibrinogen concentrate was as efficient and safe as cryoprecipitate in the management of bleeding children undergoing cardiac surgery.
  • article 7 Citação(ões) na Scopus
    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 Biscegli
    Introduction: 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.
  • article 6 Citação(ões) na Scopus
    Comparative trial of the use of antiplatelet and oral anticoagulant in thrombosis prophylaxis in patients undergoing total cavopulmonary operation with extracardiac conduit: echocardiographic, tomographic, scintigraphic, clinical and laboratory analysis
    (2014) PESSOTTI, Cristiane Felix Ximenes; JATENE, Marcelo Biscegli; JATENE, Ieda Biscegli; OLIVEIRA, Patricia Marques; SUCCI, Fabiana Moreira Passos; MOREIRA, Valeria de Melo; LOPES, Rafael Willain; PEDRA, Simone Rolim Fernandes Fontes
    Objective: To compare the efficacy of aspirin and warfarin for prophylaxis of thrombosis in patients undergoing total cavopulmonary anastomosis. Evaluate whether coagulation factors (VII, VIII and protein C), clinical data, fenestration or hemodynamic factors, interfere with postoperative thrombosis. Methods: A prospective, randomized study of 30 patients, randomized into Group I (Warfarin) and Group II (AAS), underwent total cavopulmonary shunt with extracardiac conduit, between 2008 and 2011, with follow-up by clinical visits to evaluate side effects and adhesion. Performed transesophageal echocardiography in post operatory time, 3, 6,12 and 24 months; angiotomography at 6, 12 and 24 months to evaluate changes in the internal tube wall or thrombi and pulmonary scintigraphy to evaluate possible PTE. Results: Two deaths in group I; 33.3% of patients had thrombus (46.7% in Group II). The previous occurrence of thrombus and low levels of coagulation protein C were the only factors that influenced the time free of thrombus (P=0.035 and 0.047). Angio-tomographic evaluation: 35.7% in group II presented material accumulation greater than 2 mm (P=0.082). Scintigraphy: two patients had PTE in group II. Five patients had difficulty to comply with the treatment, 4 in group I with INR ranging from 1 to 6.4. Conclusion: The previous occurrence of thrombus is a risk [GRAPHICS] factor for thrombosis in the postoperative period. Patients using AAS tend to deposit material in the tube wall. The small sample size did not allow to conclude which is the most effective drug in the prevention of thrombosis in this population.