VERA DEMARCHI AIELLO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
- PEDIATRIC HEART TRANSPLANTATION PROGRAM: SINGLE CENTER EXPERIENCE OF 20 YEARS(2013) AZEKA, Estela; GALAS, Filomena; TANAMATI, Carla; PENHA, Juliano; FERNANDES, Marcos; SENAHA, Luciano; XAVIER, Johnny; DELGADO, Ana Beatriz Romani; KAJITA, Luiz; AIELLO, Vera; BENVENUTI, Luiz; MIURA, Nana; AULER JUNIOR, Jose Otavio Costa; JATENE, MarceloOBJECTIVE: Heart transplantation has been the treatment of choice for children with refractory to conventional therapy. To report the experience with heart transplantation in a single center. MATERIAL AND METHODS: To report the single center experience of hearttransplantation. Data analysis was demographic characteristics, clinical outcome and survival Kaplan Meier curve. RESULTS: From October 30, 1992 to October 2nd, 2012, 120 transplants were performed and 115 patients were submitted to heart transplantation at Heart Institute (InCor) University of Sao Paulo Medical School, Sao Paulo, Brazil. The causes of indication for transplantation were: cardiomyopathies (76%) and congenital heart disease (24%). Five patients were submitted to re-transplantation. Three of them were re-transplanted on the early postoperative period with high mortality (66.6%). One patient was submitted to simultaneous re-transplantation and kidney transplantation after 13.9 yrs of follow-up and one of patient was successful re-transplanted after 10 yr of follow-up. The post-operative immunosuppression regimen was double immunosuppression and polyclonal anti-thymocyte serum induction therapy. The actuarial survival was 80%, 71%, and 61% at 1, 5, and 10 yr, respectively. CONCLUSION: Heart transplantation has been a promising option for children. The use of double immunosuppression with polyclonal anti-thymocyte serum induction therapy combined with surveillance of acute rejection with non-invasive tests may provide favorable clinical outcome.
conferenceObject Mechanical Esophageal Displacement for Esophageal Safety of Mechanical Esophageal Displacement for Esophageal Thermal Injury Prevention During Atrial Fibrillation Ablation in Swine(2019) PEREIRA, Renner; PISANI, Cristiano F.; AIELLO, Vera; CESTARI, Idagene A.; MOURA, Daniel; CHOKR, Muhieddine; HARDY, Carina; SISSY, Melo; SCANAVACCA, Mauricio; HACHUL, DeniseconferenceObject CLINICAL CHALLENGES AFTER PEDIATRIC HEART TRANSPLANTATION: 20 YEARS OF EXPERIENCE(2013) AZEKA, Estela; AULER, Jose Otavio; GALAS, Filomena; TANAMATI, Carla; PENHA, Juliano; KAJITA, Luiz; AIELLO, Vera; BENVENUTI, Luiz; JATENE, MarceloPURPOSE: Heart transplantation has been the treatment of choice for children with refractory to conventional therapy. Objective: to report the clinical experience with heart transplantation in a single center. METHOD: To report the single center experience of heart transplantation. Data analysis was demographic characteristics, clinical outcome and survival Kaplan Meier curve. RESULTS: From October 30, 1992 to October 2nd, 2012, 120 transplants were performed and 115 patients were submitted to heart transplantation at Heart Institute (InCor) University of Sao Paulo Medical School, Sao Paulo, Brazil. The causes of indication for transplantation were: cardiomyopathies (76%) and congenital heart disease (24%). Five patients were submitted to re-transplantation. Three of them were re-transplanted on the early postoperative period with high mortality (66.6%). One patient was submitted to simultaneous re-transplantation and kidney transplantation after 13.9 years of follow-up and one of patient was successful re-transplanted after 10 year of follow-up. The post-operative immunosuppression regimen was double immunosuppression and polyclonal anti-thymocyte serum induction therapy. The actuarial survival was 80%, 71%, and 61% at 1, 5, and 10 yr, respectively. CONCLUSION: Heart transplantation has been a promising option for children. The use of double immunosuppression with polyclonal anti-thymocyte serum induction therapy combined with surveillance of acute rejection with non-invasive tests may provide favorable clinical outcome.- Catheter Ablation of Focal Atrial Tachycardia with Early Activation Close to the His-Bundle from the Non Coronary Aortic Cusp(2021) CHOKR, Muhieddine; MOURA, Lucas G. de; SOUSA, Italo Bruno dos Santos; PISANI, Cristiano Faria; HARDY, Carina Abigail; MELO, Sissy Lara de; PONTE FILHO, Arnobio Dias da; COSTA, Ieda Prata; TAVORA, Ronaldo Vasconcelos; SACILOTTO, Luciana; WU, Tan Chen; DARRIEUX, Francisco Carlos da Costa; HACHUL, Denise Tessariol; AIELLO, Vera; SCANAVACCA, MauricioBackground: Atrial tachycardia (AT) ablation with earliest activation site close to the His-Bundle is a challenge due to the risk of complete AV block by its proximity to His-Purkinje system (HPS). An alternative to minimize this risk is to position the catheter on the non-coronary cusp (NCC), which is anatomically contiguous to the para-Hisian region. Objectives: The aim of this study was to perform a literature review and evaluate the electrophysiological characteristics, safety, and success rate of catheter-based radiofrequency (RF) delivery in the NCC for the treatment of para-Hisian AT in a case series. Methods: This study performed a retrospective evaluation of ten patients (Age: 36 +/- 10 y-o) who had been referred for SVT ablation and presented a diagnosis of para-Hisian focal AT confirmed by classical electrophysiological maneuvers. For statistical analysis, a p-value of <0.05 was considered statistically significant. Results: The earliest atrial activation at the His position was 28 +/- 12ms from the P wave and at the NCC was 3 +/- 2ms earlier than His position, without evidence of His potential in all patients. RF was applied on the NCC (4-mm-tip catheter; 30W, 55 degrees C), and the tachycardia was interrupted in 5 +/- 3s with no increase in the PR interval or evidence of junctional rhythm. Electrophysiological tests did not reinduce tachycardia in 9/10 of patients. There were no complications in all procedures. During the 30 +/- 12 months follow-up, no patient presented tachycardia recurrence. Conclusion: The percutaneous treatment of para-Hisian AT through the NCC is an effective and safe strategy, which represents an interesting option for the treatment of this complex arrhythmia.
- CONGENITAL HEART DISEASE IN ADOLESCENT AND ADULTS: INDICATION FOR HEART TRANSPLANTATION AND CLINICAL OUTCOME(2013) FARHAT, Juliana; JATENE, Marcelo; FERNANDES, Marcos; SENAHA, Luciano; DELGADO, Ana Beatriz Romani; TANAMATI, Carla; AIELLO, Vera; BENVENUTI, Luiz; PENHA, Juliano; VALDO, Melinade Oliveira; BRITO, Pedro Thiago; AZEKA, EstelaOBJECTIVE: The aim of the study was to evaluate the patients who were submitted to heart transplantation due to congenital heart disease. MATERIAL AND METHODS: It was considered a retrospective analysis of the medical records of the patients who were submitted to heart transplantation at Heart Institute (InCor) University of Sao Paulo Medical School from 2002 through 2012. RESULTS: From 2002 through 2012, 115 patients have undergone heart transplantation at Heart Institute (InCor) University of Sao Paulo Medical School. Of those, 29 (25.2%) had congenital heart diseases, having one of them submitted to re-transplantation 9 yrs after transplantation. The mean age was 8.56 yrs old (range of 0.11–26.06). The assessed congenital heart diseases were: double outlet (three patients), hypoplastic heart syndrome (two patients), pulmonary atresia (two patients), ventricular septal defect (one patient), Ebstein anomaly (two patients),Uhl anomaly (one patient), congenital heart block (three patients), tetralogy of Fallot (one patient), av canal (one patient), complex congenital heart disease (12 patients). Twenty patients had submitted to cardiac surgery before transplantation. The mean ischemia time was 170.8 min. Thirteen patients (44.8%) died (due to surgical complications, heart failure due to acute rejection and multiple organ insufficiency). Mean follow-up period of 4.7 yrs. CONCLUSION: Heart transplantation is an indication for patients with congenital heart disease and allowed long term survival for this population.
- Safety of an esophageal deviator for atrial fibrillation catheter ablation(2023) PEREIRA, Renner; PISANI, Cristiano; AIELLO, Vera; CESTARI, Idagene; OYAMA, Helena; SANTOS, Osmar; OTUBO, Jorge; MOURA, Daniel; SCANAVACCA, MauricioBACKGROUND Esophageal thermal injury is a complication of atrial fibrillation (AF) ablation, and it can be avoided by esophageal deviation during left atrial posterior wall radiofrequency catheter ablation.OBJECTIVE This study aimed to evaluate the safety of a nitinol-based mechanical esophageal displacement device (MEDD) and its performance.METHODS This preclinical safety study was conducted on 20 pigs, with 10 undergoing radiofrequency AF ablation using the MEDD and 10 serving as a control group under anticoagulation but without radiofrequency application. Esophageal traumatic injuries were classified from 0 to 4 and were grouped as absent (grade 0), minor (grade 1 or 2), moderate (grade 3), or major risk lesions (grade 4) by anatomopathological study. Grades 1 and 2 were considered accept-able. Fluoroscopy was used to measure displacement.RESULTS Five (25%) pigs developed traumatic lesions, 4 with grade 1 and 1 with grade 2 (2-mm superficial ulcer). There was no difference in lesion occurrence between the radiofrequency and control groups (30% and 20%, respectively; P = .43). Under rightward displacement, the right edge moved 23.9 (interquartile range [IQR] 21.3- 26.3) mm and the left edge moved 16.3 (IQR 13.8-18.4) mm (P , .001) from baseline. Under leftward displacement, the right edge moved 13.5 (IQR 10.9-15.3) mm and the left edge moved 16.5 (IQR 12.3-18.5) mm (P = .07). A perforation to the pharyngeal diverticulum occurred in 1 pig, related to an accidental extubation.CONCLUSION In pigs, the MEDD demonstrated safety in relation to esophageal tissue, and successful deviation. Esophageal traumatic injuries were acceptable, but improper manipulation led to pharyngeal lesion.
conferenceObject CAN HIGH POWER LASER ON SWINE MITRAL VALVE CHORDAE TENDINEAE IMPROVE MITRAL REGURGITATION? INSIGHTS FOR A NEW SURGICAL ERY TECHNIQUE(2013) PINTO, Nathali; POMERANTZEFF, Pablo; DEANA, Alessandro; CORREA, Paulo; ZEZELL, Denise; AIELLO, Vera; LOPES, Luciana; MARCOS, Rodrigo; MARTINS, Rodrigo; CHAVANTES, Maria Cristina- SIMULTANEOUS RENAL TRANSPLANTATION AND HEART RE-TRANSPLANTATION: SINGLE CENTER EXPERIENCE(2013) DELGADO, Ana Beatriz Romani; JATENE, Marcelo; DAVID-NETO, Elias; FERNANDES, Marcos; MOURA, Mariana Tiemi Minede; GALAS, Filomena Regina; HAJJAR, Ludhmilla; PENHA, Juliano; TANAMATI, Carla; RISO, Arlindo; BENVENUTI, Luiz Alberto; AIELLO, Vera; AULER JUNIOR, Jose Otavio Costa; NAHAS, William; AZEKA, EstelaOBJECTIVES: To report a simultaneous renal transplantation and heart re-transplantation in pediatric population at single center. MATERIAL AND METHODS: To report the prevalence and the clinical outcome of kidney transplantation and heart re-transplantation at Heart Institute (Incor) University of Sao Paulo Medical School. RESULTS: From October 1992 to October 2012, 115 patients were submitted to heart transplantation and 120 transplants were performed. One of 115 patients was submitted to kidney and heart re-transplantation at our institution. A 17 yrs old adolescent was submitted to hear transplantation at age of 4 yrs old. The indication for heart transplantation was dilated cardiomyopathy. He developed graft vascular disease 6 yrs after transplant and renal failure due to calcineurin inhibitors 10 yrs later the transplantation. He was admitted at Emergency room and needed vasoative drug infusion. He was listed to simultaneous kidney and heart re-transplantation. He was submitted to procedure and the ischemic time for the heart was 180 min. The donor was male and the cause of brain death was trauma. He developed severe coagulopathy. The patient died after 13 yrs of the first heart transplantation and 31 days after the second transplant due to multiple organ failure. CONCLUSION: Simultaneous kidney and heart re-transplantation can be performed although being complex procedure.
- RESTRICTIVE SYNDROME AND HYPERTROPHIC CARDIOMIOPATHY AS INDICATION FOR HEART TRANSPLANTATION: CLINICAL OUTCOME IN A SINGLE CENTER(2013) TANAKA, Ana Cristina; MIURA, Nana; THOMAZ, Ana Maria; FERNANDES, Marcos; VALE, Natalia Freitas de Deus; AIELLO, Vera; BENVENUTI, Luiz; TAVARES, Glaucia; NOMURA, Cesar; JATENE, Marcelo; AZEKA, EstelaOBJECTIVES: The purpose of this study was to evaluate the prevalence and outcome of restrictive syndrome in a cohort of pediatric heart transplantation. MATERIAL AND METHODS: To evaluate the prevalence and clinical outcome of children with restrictive syndrome and hypertrophic cardiomiopathy submitted to heart transplantation. RESULTS: From October 1992 to 2012, 115 patients were submitted to heart transplantation. One hundred and twenty transplants were performed at Heart Institute (InCor) University of Sao Paulo Medical School. Seventeen (14.7%) of these patients had restrictive syndrome and have undergone to heart transplantation. The mean age was 10.4 yrs. Survival was 76.4%. Follow up period ranged from 26 days to 6.6 yrs. CONCLUSION: Restrictive syndrome and hypertrophic cardiomyopathy can be an indication for heart transplantation with a favorable outcome.
- Estudo da dose excipiente: fármaco com avaliação da hiperplasia neointimal por tomografia de coerência óptica e histopatologia em artérias coronárias porcinas após o emprego do balão eluidor de sirolimus(2012) TAKIMURA, Celso Kiyochi; GALON, Micheli Zanotti; SOJITRA, Prakash; DOSHI, Manish; AIELLO, Vera; GUTIERREZ, Paulo Sampaio; CARVALHO, Juliana; FERREIRA, Suzane Kiss; CHAVES, Marcio Jose Figueira; LAURINDO, Francisco Rafael Martins; LEMOS, Pedro AlvesBACKGROUND: Magic TouchTM is a sirolimus based nano carrier balloon. We aimed at finding the excipient:drug ratio with the highest capacity to inhibit neointimal proliferation 28 days after the use of this balloon after bare metal stenting in porcine coronary arteries. METHODS: Fourteen domestic pigs with coronary bare metal stenting followed by dilation (60 seconds) using balloons with an excipient:sirolimus ratio of 1:1, 0.5:1, 0.25:1, 1:0 or a control balloon were evaluated. After 28 days neointimal hyperplasia was assessed by optical coherence tomography and histopathology. RESULTS: Percent neointimal hyperplasia (%) assessed by optical coherence tomography and histomorphometry was 32.2 and 35.1, 28.1 and 33.4, 17.3 and 20.9, 28.6 and 30.2, and 37.9 and 42.3 in the groups with 0.25:1, 0.5:1, 1:1, 1:0 excipient:sirolimus ratios and control balloon, respectively (P = 0.03 for excipient:sirolimus 1:1 versus control balloon). The neointimal interstrut thickness (mm) was 0.23, 0.30, 0.16, 0.24 and 0.30 in the groups with 0.25:1, 0.5:1, 1:1, 1:0 excipient:sirolimus ratios and control balloon, respectively (P < 0.01 for excipient:sirolimus 1:1 versus control balloon). The scores of inflammation, injury and fibrin deposition were low and there was no significant difference among groups. CONCLUSIONS: There was a stepwise increase in inhibitory efficacy of neointimal proliferation as the excipient concentration increased; the lowest efficacy was observed with the 0.25:1 excipient:sirolimus formulation and the most intensive inhibition was observed with the 1:1 excipient:sirolimus formulation. The 1:1 excipient:sirolimus formulation significantly reduced neointimal proliferation when compared to the control group, with low inflammation and injury scores.