FERNANDO LUIZ DE MELO BERNARDI
Índice h a partir de 2011
6
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- Recent Developments and Current Status of Transcatheter Aortic Valve Replacement Practice in Latin America - the WRITTEN LATAM Study(2022) BERNARDI, Fernando Luiz de Melo; RIBEIRO, Henrique Barbosa; NOMBELA-FRANCO, Luis; CERRATO, Enrico; MALUENDA, Gabriel; NAZIF, Tamim; LEMOS, Pedro Alves; SZTEJFMAN, Matias; LAMELAS, Pablo; ECHEVERRI, Dario; LOPES, Marcelo Antonio Cartaxo Queiroga; BRITO, Fabio Sandoli de; ABIZAID, Alexandre A.; MANGIONE, Jose A.; ELTCHANINOFF, Helene; SONDERGAARD, Lars; RODES-CABAU, JosepBackground: Transcatheter aortic valve replacement (TAVR) is a worldwide adopted procedure with rapidly evolving practices. Regional and temporal variations are expected to be found. Objective: To compare TAVR practice in Latin America with that around the world and to assess its changes in Latin America from 2015 to 2020. Methods: A survey was applied to global TAVR centers between March and September 2015, and again to Latin-American centers between July 2019 and January 2020. The survey consisted of questions addressing: i) center's general information; ii) pre-TAVR evaluation; iii) procedural techniques; iv) post-TAVR management; v) follow-up. Answers from the 2015 survey of Latin-American centers (LATAM15) were compared with those of other centers around the world (WORLD15) and with the 2020 updated Latin-American survey (LATAM20). A 5% level of significance was adopted for statistical analysis. Results: 250 centers participated in the 2015 survey (LATAM15=29; WORLD15=221) and 46 in the LATAM20. Combined centers experience accounted for 73 707 procedures, with WORLD15 centers performing, on average, 6- and 3-times more procedures than LATAM15 and LATAM20 centers, respectively. LATAM centers performed less minimalistic TAVR than WORLD15 centers, but there was a significant increase in less invasive procedures after 5 years in Latin-American centers. For postprocedural care, a lower period of telemetry and maintenance of temporary pacing wire, along with less utilization of dual antiplatelet therapy was observed in LATAM20 centers. Conclusion: Despite still having a much lower volume of procedures, many aspects of TAVR practice in Latin-American centers have evolved in recent years, following the trend observed in developed country centers.
- Incidence, Predictor, and Clinical Outcomes of Multiple Resheathing With Self-Expanding Valves During Transcatheter Aortic Valve Replacement(2021) BERNARDI, Fernando L. M.; RODES-CABAU, Josep; TIRADO-CONTE, Gabriela; SANTOS, Ignacio J. Amat; PLACHTZIK, Claudia; CURA, Fernando; SZTEJFMAN, Matias; MANGIONE, Fernanda M.; TUMELEIRO, Rogerio; ESTEVES, Vinicius Borges Cardozo; MELO, Eduardo Franca Pessoa de; CHAUVET, Alejandro Alcocer; FUCHS, Felipe; SARMENTO-LEITE, Rogerio; MARTINS, Estevao Carvalho de Campos; NOMBELA-FRANCO, Luis; DELGADO-ARANA, Jose Raul; BOCKSCH, Wolfgang; LAMELAS, Pablo; GIULIANI, Carlos; CAMPANHA-BORGES, Diego Carter; MANGIONE, Jose A.; JR, Fabio Sandoli de Brito; ABIZAID, Alexandre C.; RIBEIRO, Henrique B.Background No study has evaluated the impact of the additional manipulation demanded by multiple resheathing (MR) in patients undergoing transcatheter aortic valve replacement with repositionable self-expanding valves. Methods and Results This study included a real-world, multicenter registry involving 16 centers from Canada, Germany, Latin America, and Spain. All consecutive patients who underwent transcatheter aortic valve replacement with the Evolut R, Evolut PRO, and Portico valves were included. Patients were divided according to the number of resheathing: no resheathing, single resheathing (SR), and MR. The primary end point was device success. Secondary outcomes included procedural complications, early safety events, and 1-year mortality. In 1026 patients, the proportion who required SR and MR was 23.9% and 9.3%, respectively. MR was predicted by the use of Portico and moderate/severe aortic regurgitation at baseline (both with P<0.01). Patients undergoing MR had less device success (no resheathing=89.9%, SR=89.8%, and MR=80%; P=0.01), driven by more need for a second prosthesis and device embolization. At 30 days, there were no differences in safety events. At 1 year, more deaths occurred with MR (no resheathing=10.5%, SR=8.0%, and MR=18.8%; P=0.014). After adjusting for baseline differences and center experience by annual volume, MR associated with less device success (odds ratio, 0.42; P=0.003) and increased 1-year mortality (hazard ratio, 2.06; P=0.01). When including only the Evolut R/PRO cases (N=837), MR continued to have less device success (P<0.001) and a trend toward increased mortality (P=0.05). Conclusions Repositioning a self-expanding valve is used in a third of patients, being multiple in approximate to 10%. MR, but not SR, was associated with more device failure and higher 1-year mortality, regardless of the type of valve implanted.
conferenceObject INCIDENCE, PREDICTOR AND CLINICAL OUTCOMES OF MULTIPLE RESHEATHING WITH SELF-EXPANDING VALVES DURING TRANSCATHETER AORTIC VALVE REPLACEMENT(2021) BERNARDI, Fernando; RODES-CABAU, Josep; TIRADO-CONTE, Gabriela; SANTOS, Ignacio Amat; PLACHTZIK, Claudia; CURA, Fernando; SZTEJFMAN, Matias; MANGIONE, Fernanda; TUMELEIRO, Rogerio; ESTEVES, Vinicius; MELLO, Eduardo Pessoa de; CHAUVET, Alejandro; FUCHS, Felipe; SARMENTO-LEITE, Rogerio; MARTINS, Estevao; NOMBELA-FRANCO, Luis; DELGADO-ARANA, Jose Raul; BOCKSCH, Wolfgang; LAMELAS, Pablo; GIULIANI, Carlos; CRISTOVAO, Salvador; CAMPANHA-BORGES, Diego Carter; BRITO JR., Fabio Sandoli de; ABIZAID, Alexandre; RIBEIRO, Henrique