VERA DEMARCHI AIELLO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- 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 RESTRICTIVE AND HYPERTROPHIC CARDIOMYOPATHIES AS INDICATION FOR HEART TRANSPLANTATION: CLINICAL OUTCOME IN A SINGLE CENTER(2013) TANAKA, Ana Cristina; MIURA, Nana; THOMAZ, Ana Maria; AIELLO, Vera Demarchi; BENEVENUTI, Luiz; TAVARES, Glaucia; NOMURA, Cesar; JATENE, Marcelo Biscegli; AZEKA, EstelaPURPOSE: The purpose of this study was evaluate the prevalence and outcome of restrictive and hypertrophic cardiomyopathies in a cohort of pediatric heart transplantation. METHOD: To evaluate the prevalence and clinical outcome of children with restrictive and hypertrophic cardiomyopathies submitted heart transplantation. RESULTS: From october 1992 to 2012, 115 patients were submitted heart transplantation. 120 transplants were performed at Heart Institute (InCor) University São Paulo Medical School. Seventeen (14,7%) of these patients hat restrictive cardiomyopathy/hypertrophic cardiomyopathy and have undergone to heart transplantation. The mean age was 10,4 years. Survival was 76,4%. Follow-up period ranged from 26 days to 6,6 years. CONCLUSION: Restrictive and hypertrophic cardiomyopathies can be an indication for heart transplantation a favorable outcome.conferenceObject 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.- Case Report: The Challenge for Diagnosis of Myocarditis and Transplant Rejection After COVID Infection in a Heart-Transplanted Adolescent(2023) PEGADO, Helio Milani; SIQUEIRA, Adailson; NAVARAJASEGARAN, Joshua; BENVENUTI, Luiz Alberto; CASTRO, Claudia Regina Pinheiro; ARRIETA, Santiago Raul; GUTIERREZ, Paulo Sampaio; DOLHNIKOFF, Marisa; AIELLO, Vera Demarchi; JATENE, Marcelo Biscegli; AZEKA, EstelaPatients who have undergone organ transplantation are immunosuppressed hosts, leaving them at a higher risk of infections. SARS-COV-2 has been shown to affect heart-transplanted patients. In this case report, we present the case of a 14-year-old heart transplant recipient who developed signs and symptoms of heart failure, along with fatigue, after a COVID-19 infection. An endomyocardial biopsy was performed to diagnose rejection and to evaluate whether this was myocarditis due to SARS-COV-2. The biopsy showed intense acute cellular rejection (3R) and antibody rejection PAMR1 H+ but was negative for the SARS-CoV-2 virus. The patient received organ rejection therapy with high-dose methylprednisolone and human immunoglobulin. After treatment, her heart function recovered, with biopsy investigations showing a lower level of cellular rejection (1R).
conferenceObject SIBLINGS WITH RESTRICTIVE SYNDROME AND HYPERTROPHIC CARDIOMYOPATHY: A RARE CASE OF SUCCESSFUL HEART TRANSPLANTATION(2013) AZEKA, Estela; KAWASAKA, Ana Laura B. C.; TANAKA, Ana Cristina S.; PEREIRA, Alexandre C.; AIELLO, Vera D.; JATENE, Marcelo B.PURPOSE: To report the cases of siblings with restrictive syndrome who underwent heart transplantation and whose hearts had histological characteristics of hypertrophic cardiomyopathy (HCM). METHOD: Case1) A 7 year-old boy with recurrent pneumonias and cardiomegaly. Echocardiography showed features of restrictive cardiomyopathy. No pericardial commitment was found. Due to refractory congestive heart failure he was listed and successfully transplanted at the age 14. The analysis of the explanted heart revealed diffuse myocite disarray, with no septal asymmetry or subaortic obstruction. He is currently in clinical follow up for 5 years. Case 2) A 10 year-old female with exertion dyspnea, cyanosis and vomits. Due to the family history, she was referred for investigation. Restrictive cardiomyopathy was diagnosed. She was listed for heart transplant and successfully transplanted at the age of 13. The analysis of the explanted heart showed mild thickening of ventricular walls with no asymmetries or subaortic obstruction and several areas of myocyte disarray and fibrosis. She is currently in clinical follow up for 2 years. Blood samples of our patients were tested for mutations in genes MYH7, MYBPC and Troponin I (most frequently related to HCM in Brazil), but no alterations were found. CONCLUSION: HCM is a genetic condition related to mutations in genes that encode components of the sarcomere. It can rarely present with features of restrictive syndrome. Heart transplant is the therapeutic option for refractory congestive heart failure, before the evolution to pulmonary hypertension, with good clinical outcome.- 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.
- 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.