VERA DEMARCHI AIELLO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
14 resultados
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Agora exibindo 1 - 10 de 14
- Nomenclature for Pediatric and Congenital Cardiac Care: Unification of Clinical and Administrative Nomenclature - The 2021 International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Revision of the International Classification of Diseases (ICD-11)(2021) JACOBS, Jeffrey P.; FRANKLIN, Rodney C. G.; BELAND, Marie J.; SPICER, Diane E.; COLAN, Steven D.; III, Henry L. Walters; BAILLIARD, Frederique; HOUYEL, Lucile; LOUIS, James D. St.; LOPEZ, Leo; AIELLO, Vera D.; GAYNOR, J. William; KROGMANN, Otto N.; KUROSAWA, Hiromi; MARUSZEWSKI, Bohdan J.; STELLIN, Giovanni; WEINBERG, Paul Morris; JACOBS, Marshall Lewis; BORIS, Jeffrey R.; COHEN, Meryl S.; EVERETT, Allen D.; GIROUD, Jorge M.; GULESERIAN, Kristine J.; HUGHES, Marina L.; JURASZEK, Amy L.; SESLAR, Stephen P.; SHEPARD, Charles W.; SRIVASTAVA, Shubhika; COOK, Andrew C.; CRUCEAN, Adrian; HERNANDEZ, Lazaro E.; LOOMBA, Rohit S.; ROGERS, Lindsay S.; SANDERS, Stephen P.; SAVLA, Jill J.; TIERNEY, Elif Seda Selamet; TRETTER, Justin T.; WANG, Lianyi; ELLIOTT, Martin J.; MAVROUDIS, Constantine; TCHERVENKOV, Christo I.Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code (IPCCC) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases (ICD-11). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC. The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature . This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature. The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC, as IPCCC continues to evolve.
- Parameters associated with outcome in pediatric patients with congenital heart disease and pulmonary hypertension subjected to combined vasodilator and surgical treatments(2019) THOMAZ, Ana Maria; KAJITA, Luiz J.; AIELLO, Vera D.; ZORZANELLI, Leina; GALAS, Filomena Regina B. G.; MACHADO, Cleide G.; BARBERO-MARCIAL, Miguel; JATENE, Marcelo B.; RABINOVITCH, Marlene; LOPES, Antonio AugustoManagement of pediatric pulmonary hypertension associated with congenital heart disease (PHT-CHD) is challenging. Some patients have persistently elevated pulmonary artery pressure (PAP) after cardiac surgery, an undesired condition that is difficult to predict. We investigated the value of clinical, hemodynamic, and histopathological data in predicting the outcome in a prospective cohort. Patients with PHT-CHD received sildenafil orally pre- and postoperatively for six months and then were subjected to a catheter study. Thirty-three patients were enrolled (age range = 4.6-37.0 months). Pulmonary vascular resistance (PVR) was 4.9 (range = 3.9-7.2) Wood units x m(2) (median with IQR). Twenty-two patients had a >= 20% decrease in PVR and pulmonary-to-systemic vascular resistance ratio (PVR/SVR) in response to inhaled nitric oxide (NO). The response was directly related to the degree of medial hypertrophy of pulmonary arterioles (P < 0.05) (morphometric analysis, intraoperative lung biopsy). Subsequently, five of the non-responders had a >= 30% increase in pulmonary blood flow in response to sildenafil (3.0 [2.0-4.0] mg/kg/day). Six months after surgery, PAP and PVR were significantly lower (P < 0.001 vs. baseline), even in seven patients with Heath-Edwards grade III/IV pulmonary vascular lesions (P = 0.018), but still abnormal in 12 individuals (>25 mmHg and >3.0 U x m(2), respectively). A preoperative PVR/SVR of >= 24% during NO inhalation and a wall thickness of arteries accompanying respiratory bronchioli of >= 4.7 (Z score) were identified, respectively, as risk and protection factors for abnormal postoperative hemodynamics (hazard ratio [95% CI] = 1.09 [1.01-1.18], P = 0.036; and 0.69 [0.49-0.98], P = 0.040, respectively). Thus, in PHT-CHD patients receiving oral sildenafil pre- and post-surgical repair of cardiac lesions, mid-term postoperative outcome is predictable to some extent.
- Ultrahigh resolution spectral-domain optical coherence tomography using the 1000-1600 nm spectral band(2022) BERNSTEIN, L. I. A. N. E.; RAMIER, A. N. T. O. I. N. E.; WU, J. I. A. M. I. N.; AIELLO, V. E. R. A. D.; BELAND, M. A. R. I. E. J.; LIN, C. H. A. R. L. E. S. P.; YUN, SEOK-HYUNUltrahigh resolution optical coherence tomography (UHR-OCT) can image micro-scopic features that are not visible with the standard OCT resolution of 5-15 mu m. In previous studies, high-speed UHR-OCT has been accomplished within the visible (VIS) and near-infrared (NIR-I) spectral ranges, specifically within 550-950 nm. Here, we present a spectral domain UHR-OCT system operating in a short-wavelength infrared (SWIR) range from 1000 to 1600 nm using a supercontinuum light source and an InGaAs-based spectrometer. We obtained an axial resolution of 2.6 mu m in air, the highest ever recorded in the SWIR window to our knowledge, with deeper penetration into tissues than VIS or NIR-I light. We demonstrate imaging of conduction fibers of the left bundle branch in freshly excised porcine hearts. These results suggest a potential for deep-penetration, ultrahigh resolution OCT in intraoperative applications. (c) 2022 Optica Publishing Group under the terms of the Optica Open Access Publishing Agreement
- Percutaneous Transatrial Access to the Pericardial Space for Epicardial Mapping and Ablation(2011) SCANAVACCA, Mauricio I.; VENANCIO, Ana Claudia; PISANI, Cristiano F.; LARA, Sissy; HACHUL, Denise; DARRIEUX, Francisco; HARDY, Carina; PAOLA, Edna; AIELLO, Vera D.; MAHAPATRA, Srijoy; SOSA, EduardoBackground-Puncture of the atrial appendage may provide access to the pericardial space. The aim of this study was to evaluate the feasibility of epicardial mapping and ablation through an endocardial transatrial access in a swine model. Methods and Results-An 8-F Mullins sheath was used to perforate the right (n=16) or left (n=1) atrial appendage in 17 pigs (median weight, 27.5 kg; first and third quartiles [Q1, Q3], 25.2, 30.0 kg). A 7-F ablation catheter was introduced into the pericardial space to perform epicardial mapping and deliver radiofrequency pulses on the atria. The pericardial space was entered in all 17 animals. In 15 (88%) animals, there was no hemodynamic instability (mean blood pressure monitoring, initial median, 80 mm Hg; Q1, Q3, 70, 86 mm Hg; final median, 88 mm Hg; Q1, Q3, 80, 96 mm Hg; P=0.426). In these 15, a mild hemorrhagic pericardial effusion was identified and aspirated (median, 20 mL; Q1, Q3, 15, 30 mL) during the procedure, and postmortem gross analysis revealed that the atrial perforation was closed in these animals. In 2 (12%) of the 17 animals, there was major pericardial bleeding with hemodynamic collapse. On gross examination, it was found that pericardial space was accessed through right ventricular perforation in 1 animal and the tricuspid annulus in the other. After the initial study, we used an occlusion device in 3 other animals to attempt to seal the puncture (2 at the right atrial appendage and 1 at the right ventricle). These 3 animals had no significant pericardial bleeding. Conclusions-Transatrial endovascular right atrial appendage puncture may provide a potential alternative route for pericardial access. Further studies are needed to evaluate its safety with longer and more-complex procedures before being applied in clinical settings. (Circ Arrhythm Electrophysiol. 2011;4:331-336.)
- Report from The International Society for Nomenclature of Paediatric and Congenital Heart Disease: cardiovascular catheterisation for congenital and paediatric cardiac disease (Part 2-Nomenclature of complications associated with interventional cardiology)(2011) BERGERSEN, Lisa; GIROUD, Jorge Manuel; JACOBS, Jeffrey Phillip; FRANKLIN, Rodney Cyril George; BELAND, Marie Josee; KROGMANN, Otto Nils; AIELLO, Vera Demarchi; COLAN, Steven D.; ELLIOTT, Martin J.; GAYNOR, J. William; KUROSAWA, Hiromi; MARUSZEWSKI, Bohdan; STELLIN, Giovanni; TCHERVENKOV, Christo I.; III, Henry Lane Walters; WEINBERG, Paul; EVERETT, Allen DaleInterventional cardiology for paediatric and congenital cardiac disease is a relatively young and rapidly evolving field. As the profession begins to establish multi-institutional databases, a universal system of nomenclature is necessary for the field of interventional cardiology for paediatric and congenital cardiac disease. The purpose of this paper is to present the results of the efforts of The International Society for Nomenclature of Paediatric and Congenital Heart Disease to establish a system of nomenclature for cardiovascular catheterisation for congenital and paediatric cardiac disease, focusing both on procedural nomenclature and the nomenclature of complications associated with interventional cardiology. This system of nomenclature for cardiovascular catheterisation for congenital and paediatric cardiac disease is a component of The International Paediatric and Congenital Cardiac Code. This manuscript is the second part of the two-part series. Part 1 covered the procedural nomenclature associated with interventional cardiology as treatment for paediatric and congenital cardiac disease. Part 2 will cover the nomenclature of complications associated with interventional cardiology as treatment for paediatric and congenital cardiac disease.
- Expert Consensus Statement: Anatomy, Imaging, and Nomenclature of Congenital Aortic Root Malformations(2023) TRETTER, Justin T.; SPICER, Diane E.; FRANKLIN, Rodney C. G.; BELAND, Marie J.; AIELLO, Vera D.; COOK, Andrew C.; CRUCEAN, Adrian; LOOMBA, Rohit S.; YOO, Shi-Joon; QUINTESSENZA, James A.; TCHERVENKOV, Christo I.; JACOBS, Jeffrey P.; NAJM, Hani K.; ANDERSON, Robert H.Over the past 2 decades, several categorizations have been proposed for the abnormalities of the aortic root. These schemes have mostly been devoid of input from specialists of congenital cardiac disease. The aim of this review is to provide a classification, from the perspective of these specialists, based on an understanding of normal and abnormal morphogenesis and anatomy, with emphasis placed on the features of clinical and surgical relevance. We contend that the description of the congenitally malformed aortic root is simplified when approached in a fashion that recognizes the normal root to be made up of 3 leaflets, supported by their own sinuses, with the sinuses themselves separated by the interleaflet triangles. The malformed root, usually found in the setting of 3 sinuses, can also be found with 2 sinuses, and very rarely with 4 sinuses. This permits description of trisinuate, bisinuate, and quadrisinuate variants, respectively. This feature then provides the basis for classification of the anatomical and functional number of leaflets present. By offering standardized terms and definitions, we submit that our classification will be suitable for those working in all cardiac specialties, whether pediatric or adult. It is of equal value in the settings of acquired or congenital cardiac disease. Our recommendations will serve to amend and/or add to the existing International Paediatric and Congenital Cardiac Code, along with the Eleventh iteration of the International Classification of Diseases provided by the World Health Organization.
- Report from The International Society for Nomenclature of Paediatric and Congenital Heart Disease: cardiovascular catheterisation for congenital and paediatric cardiac disease (Part 1-Procedural nomenclature)(2011) BERGERSEN, Lisa; EVERETT, Allen Dale; GIROUD, Jorge Manuel; MARTIN, Gerard R.; FRANKLIN, Rodney Cyril George; BELAND, Marie Josee; KROGMANN, Otto Nils; AIELLO, Vera Demarchi; COLAN, Steven D.; ELLIOTT, Martin J.; GAYNOR, J. William; KUROSAWA, Hiromi; MARUSZEWSKI, Bohdan; STELLIN, Giovanni; TCHERVENKOV, Christo I.; III, Henry Lane Walters; WEINBERG, Paul; JACOBS, Jeffrey PhillipInterventional cardiology for paediatric and congenital cardiac disease is a relatively young and rapidly evolving field. As the profession begins to establish multi-institutional databases, a universal system of nomenclature is necessary for the field of interventional cardiology for paediatric and congenital cardiac disease. The purpose of this paper is to present the results of the efforts of The International Society for Nomenclature of Paediatric and Congenital Heart Disease to establish a system of nomenclature for cardiovascular catheterisation for congenital and paediatric cardiac disease, focusing both on procedural nomenclature and on the nomenclature of complications associated with interventional cardiology. This system of nomenclature for cardiovascular catheterisation for congenital and paediatric cardiac disease is a component of The International Paediatric and Congenital Cardiac Code. This manuscript is the first part of a two-part series. Part 1 will cover the procedural nomenclature associated with interventional cardiology as treatment for paediatric and congenital cardiac disease. This procedural nomenclature of The International Paediatric and Congenital Cardiac Code will be used in the IMPACT Registry (TM) (IMproving Pediatric and Adult Congenital Treatment) of the National Cardiovascular Data Registry (R) of The American College of Cardiology. Part 2 will cover the nomenclature of complications associated with interventional cardiology as treatment for paediatric and congenital cardiac disease.
- Repair of congenital heart disease with associated pulmonary hypertension in children: what are the minimal investigative procedures? Consensus statement from the Congenital Heart Disease and Pediatric Task Forces, Pulmonary Vascular Research Institute (PVRI)(2014) LOPES, Antonio Augusto; BARST, Robyn J.; HAWORTH, Sheila Glennis; RABINOVITCH, Marlene; DABBAGH, Maha Al; CERRO, Maria Jesus del; IVY, Dunbar; KASHOUR, Tarek; KUMAR, Krishna; HARIKRISHNAN, S.; D'ALTO, Michele; THOMAZ, Ana Maria; ZORZANELLI, Leina; AIELLO, Vera D.; MOCUMBI, Ana Olga; SANTANA, Maria Virginia T.; GALAL, Ahmed Nasser; BANJAR, Hanaa; TAMIMI, Omar; HEATH, Alexandra; FLORES, Patricia C.; DIAZ, Gabriel; SANDOVAL, Julio; KOTHARI, Shyam; MOLEDINA, Shahin; GONCALVES, Rilvani C.; BARRETO, Alessandra C.; BINOTTO, Maria Angelica; MAIA, Margarida; HABSHAN, Fahad Al; ADATIA, IanStandardization of the diagnostic routine for children with congenital heart disease associated with pulmonary arterial hypertension (PAH-CHD) is crucial, in particular since inappropriate assignment to repair of the cardiac lesions (e. g., surgical repair in patients with elevated pulmonary vascular resistance) may be detrimental and associated with poor outcomes. Thus, members of the Congenital Heart Disease and Pediatric Task Forces of the Pulmonary Vascular Research Institute decided to conduct a survey aimed at collecting expert opinion from different institutions in several countries, covering many aspects of the management of PAH-CHD, from clinical recognition to noninvasive and invasive diagnostic procedures and immediate postoperative support. In privileged communities, the vast majority of children with congenital cardiac shunts are now treated early in life, on the basis of noninvasive diagnostic evaluation, and have an uneventful postoperative course, with no residual PAH. However, a small percentage of patients (older at presentation, with extracardiac syndromes or absence of clinical features of increased pulmonary blood flow, thus suggesting elevated pulmonary vascular resistance) remain at a higher risk of complications and unfavorable outcomes. These patients need a more sophisticated diagnostic approach, including invasive procedures. The authors emphasize that decision making regarding operability is based not only on cardiac catheterization data but also on the complete diagnostic picture, which includes the clinical history, physical examination, and all aspects of noninvasive evaluation.
- Nomenclature for Pediatric and Congenital Cardiac Care: Unification of Clinical and Administrative Nomenclature - The 2021 International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Revision of the International Classification of Diseases (ICD-11)(2021) JACOBS, Jeffrey P.; FRANKLIN, Rodney C. G.; BELAND, Marie J.; SPICER, Diane E.; COLAN, Steven D.; WALTERS, Henry L.; BAILLIARD, Frederique; HOUYEL, Lucile; LOUIS, James D. St; LOPEZ, Leo; AIELLO, Vera D.; GAYNOR, J. William; KROGMANN, Otto N.; KUROSAWA, Hiromi; MARUSZEWSKI, Bohdan J.; STELLIN, Giovanni; WEINBERG, Paul Morris; JACOBS, Marshall Lewis; BORIS, Jeffrey R.; COHEN, Meryl S.; EVERETT, Allen D.; GIROUD, Jorge M.; GULESERIAN, Kristine J.; HUGHES, Marina L.; JURASZEK, Amy L.; SESLAR, Stephen P.; SHEPARD, Charles W.; SRIVASTAVA, Shubhika; COOK, Andrew C.; CRUCEAN, Adrian; HERNANDEZ, Lazaro E.; LOOMBA, Rohit S.; ROGERS, Lindsay S.; SANDERS, Stephen P.; SAVLA, Jill J.; TIERNEY, Elif Seda Selamet; TRETTER, Justin T.; WANG, Lianyi; ELLIOTT, Martin J.; MAVROUDIS, Constantine; I, Christo TchervenkovSubstantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code (IPCCC) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases (ICD-11). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC. The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature . This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature. The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC, as IPCCC continues to evolve.
- The independence of the infundibular building blocks in the setting of double-outlet right ventricle(2017) AIELLO, Vera D.; SPICER, Diane E.; ANDERSON, Robert H.; BROWN, Nigel A.; MOHUN, Timothy J.It has long been contentious as to whether the presence of bilateral infundibulums, or conuses, is a prerequisite for the diagnosis of double-outlet right ventricle. As the use of such a criterion would abrogate the so-called ""morphological method"", which correctly states that one variable entity should not be defined on the basis of another entity that is itself variable, it is now accepted that double outlet can exist in the setting of fibrous continuity between the leaflets of the atrioventricular and arterial valves. Although this debate has now been resolved, there are other contentious areas still requiring clarification in the setting of hearts unified because of the presence of this particular ventriculo-arterial connection - for example, it is questionable whether the channel between the ventricles should be described as a ""ventricular septal defect"", whereas it is equally arguable that the mere presence of fibrous continuity between the leaflets of the arterial valves does not necessarily place the channel in a doubly committed location. In this review, we describe a series of autopsied hearts in which the anatomical features serve to illuminate these various topics. We then discuss recent findings regarding cardiac development that point to the individuality of the building blocks of the ventricular outflow tracts, specifically the outlet septum, the inner heart curvature, or ventriculo-infundibular fold, and the septomarginal trabeculation, or septal band.