MARIA RAQUEL BRIGONI MASSOTI
Índice h a partir de 2011
2
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/65, Hospital das Clínicas, Faculdade de Medicina
LIM/65, Hospital das Clínicas, Faculdade de Medicina
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- EuroSCORE II and the importance of a local model, InsCor and the future SP-SCORE(2014) LISBOA, Luiz Augusto Ferreira; MEJIA, Omar Asdrubal Vilca; MOREIRA, Luiz Felipe Pinho; DALLAN, Luis Alberto Oliveira; POMERANTZEFF, Pablo Maria Alberto; DALLAN, Luis Roberto Palma; MASSOTI, Maria Raquel B.; JATENE, Fabio B.Introduction: The most widely used model for predicting mortality in cardiac surgery was recently remodeled, but the doubts regarding its methodology and development have been reported. Objective: The aim of this study was to evaluate the performance of the EuroSCORE II to predict mortality in patients undergoing coronary artery bypass grafts or valve surgery at our institution. Methods: One thousand consecutive patients operated on coronary artery bypass grafts or valve surgery, between October 2008 and July 2009, were analyzed. The outcome of interest was in-hospital mortality. Calibration was performed by correlation between observed and expected mortality by Hosmer Lemeshow. Discrimination was calculated by the area under the ROC curve. The performance of the EuroSCORE II was compared with the EuroSCORE and InsCor (local model). Results: In calibration, the Hosmer Lemeshow test was inappropriate for the EuroSCORE II (P=0.0003) and good for the EuroSCORE (P=0.593) and InsCor (P=0.184). However, the discrimination, the area under the ROC curve for EuroSCORE II was 0.81 [95% CI (0.76 to 0.85), P<0.001], for the EuroSCORE was 0.81 [95% CI (0.77 to 0.86), P<0.001] and for InsCor was 0.79 [95% CI (0.74-0.83), P<0.001] showing up properly for all. Conclusion: The EuroSCORE II became more complex and resemblance to the international literature poorly calibrated to predict mortality in patients undergoing coronary artery bypass grafts or valve surgery at our institution. These data emphasize the importance of the local model.
- Surgical Correction of Ascending Aortic Aneurysm Without Coronary Dilatation After Kawasaki Disease in a 3-Year-Old Child(2022) SANTOS, Romullo M.; MASSOTI, Maria Raquel B.; CORONEL, Monica Raquel Gonzalez; MAIA, Frederico Faria; MIANA, Leonardo Augusto; JATENE, Marcelo BiscegliKawasaki disease (KD) is an inflammatory condition that may affect genetically predisposed individuals in pediatric ages after infectious/ environmental triggering. An infrequent finding associated with KD is ascending aortic aneurysm during or after the acute phase of the disease. In this Multimedia presentation, we describe a three-year-old girl submitted to surgical treatment.
bookPart Dissecção aguda de aorta(2015) MASSOTI, Maria Raquel; DIAS, Ricardo Ribeiro- Heart Retransplantation for Coronary Allograft Vasculopathy in Children: 25 Years of Single -Center Experience(2020) AZEKA, Estela; WALKER, Thomas; SIQUEIRA, Adailson Wagner da Silva; PENHA, Juliano; MIANA, Leonardo; CANEO, Luiz Fernando; MASSOTI, Maria Raquel; TANAMATI, Carla; MIURA, Nana; JATENE, Marcelo Biscegli
bookPart Dissecção aguda de aorta(2015) MASSOTI, Maria Raquel; DIAS, Ricardo RibeirobookPart Dissecção aguda de aorta(2018) MASSOTI, Maria Raquel; DUNCAN, José Augusto; DIAS, Ricardo RibeirobookPart Dissecção aguda de aorta(2018) MASSOTI, Maria Raquel; DUNCAN, José Augusto; DIAS, Ricardo Ribeiro- Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation(2018) MIANA, Leonardo A.; SILVA, Guilherme Viotto Rodrigues da; CANEO, Luiz Fernando; TURQUETTO, Aida Luisa; TANAMATI, Carla; FORONDA, Gustavo; MASSOTI, Maria Raquel; PENHA, Juliano G.; AZEKA, Estela; GALAS, Filomena R. B. G.; JATENE, Fabio B.; JATENE, Marcelo B.Introduction: Donor shortage and organ allocation is the main problem in pediatric heart transplant. Mechanical circulatory support is known to increase waiting list survival, but it is not routinely used in pediatric programs in Latin America. Methods: All patients listed for heart transplant and supported by a mechanical circulatory support between January 2012 and March 2016 were included in this retrospective single-center study. The endpoints were mechanical circulatory support time, complications, heart transplant survival and discharge from the hospital. Results: Twenty-nine patients from our waiting list were assessed. Twelve (45%) patients were initially supported by extracorporeal membrane oxygenation (ECMO) and a centrifugal pump was implanted in 17 (55%) patients. Five patients initially supported by ECMO were bridged to another device. One was bridged to a centrifugal pump and four were bridged to Berlin Heart Excor (R). Among the 29 supported patients, 18 (62%) managed to have a heart transplant. Thirty-day survival period after heart transplant was 56% (10 patients). Median support duration was 12 days (interquartile range [IQR] 4-26 days) per run and the waiting time for heart transplant was 9.5 days (IQR 2.5-25 days). Acute kidney injury was identified as a mortality predictor (OR=22.6 [CI=1.04-494.6]; P=0.04). Conclusion: Mechanical circulatory support was able to bridge most INTERMACS 1 and 2 pediatric patients to transplant with an acceptable complication rate. Acute renal failure increased mortality after mechanical circulatory support in our experience.
- Initial experience with del Nido cardioplegia solution at a Pediatric and Congenital Cardiac Surgery Program in Brazil(2022) CANEO, Luiz Fernando; MATTE, Gregory S.; TURQUETTO, Aida Luiza R.; PEGOLLO, Luana Marques de Carvalho; MIGLIOLI, Maria Clara Amato; SOUZA, Gisele T. de; AMATO, Luciana Patrick; MIANA, Leonardo A.; MASSOTI, Maria Raquel B.; PENHA, Juliano G.; TANAMATI, Carla; JATENE, Marcelo B.; JATENE, Fabio B.Objective: The aim of this study was to evaluate outcome measures between our standard multidose cardioplegia protocol and a del Nido cardioplegia protocol in congenital heart surgery patients. Methods: Retrospective single-center study including 250 consecutive patients that received del Nido cardioplegia (DN group) with a mandatory reperfusion period of 30% of cross clamp time and 250 patients that received a modified St. Thomas' solution (ST group). Groups were matched by age, weight, gender, and Risk Adjustment for Congenital Heart Surgery (RACHS-1) scores. Preoperative hematocrit and oxygen saturation were also recorded. Outcomes analyzed were the vasoactive inotropic score (VIS), lactate, ventilation time, ventricular dysfunction with low cardiac output syndrome (LCOS), intensive care unit (ICU) length of stay (LOS), hospital LOS, bypass and aortic cross-clamp times, and in-hospital mortality. Results: Both groups were comparable demographically. Statistically significant differences (p <= 0.05) were noted for cardiac dysfunction with LCOS, hematocrit at end of surgery (p = 0.0038), VIS on ICU admission and at end of surgery (p = 0.0111), and ICU LOS (p = 0.00118) with patients in the DN group having more desirable values for those parameters. Other outcome measures did not reach statistical significance. Conclusion: In our congenital cardiac surgery population, del Nido cardioplegia strategy was associated with less ventricular dysfunction with LCOS, a lower VIS and decreased ICU LOS compared with patients that received our standard myocardial protection using a modified St. Thomas' solution. Despite the limitation of this study, including its retrospective nature and cohort size, these data supported our transition to incorporate del Nido cardioplegia solution with a mandatory reperfusion period as the preferred myocardial protection method in our program.
- Heart Transplantation in Children and Adults With Congenital Heart Disease: 3 Decades of Evolution(2023) AZEKA, Estela; SIQUEIRA, Adailson Wagner Da Silva; TANAKA, Ana Cristina; MASSOTI, Maria Raquel Brigoni; MIANA, Leonardo; ZORZANELLI, Leina; GUIMARAES, Vanessa; PENHA, Juliano; CANEO, Luiz Fernando; TANAMATI, Carla; MIURA, Nana; JATENE, Marcelo BiscegliHeart transplantation is the treatment of choice for children and adults with congenital heart disease. We report the heart transplant single-center experience. The number of transplantations has increased over the last 3 decades. The Kaplan-Meier survival curves in the first, second, and third decades at 5 and 10 years were 69% and 59%, 62% and 52%, and 66% and 60%, respectively.