FERNANDO LUIZ DE MELO BERNARDI

Índice h a partir de 2011
6
ORCID
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina

Filtros

Limpar filtros

Configurações

Colaboração internacional: Alemanha ×

Resultados de Busca

Agora exibindo 1 - 2 de 2
  • article 7 Citação(ões) na Scopus
    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.
  • article 38 Citação(ões) na Scopus
    Direct Transcatheter Heart Valve Implantation Versus Implantation With Balloon Predilatation Insights From the Brazilian Transcatheter Aortic Valve Replacement Registry
    (2016) BERNARDI, Fernando L. M.; RIBEIRO, Henrique B.; CARVALHO, Luiz A.; SARMENTO-LEITE, Rogerio; MANGIONE, Jose A.; LEMOS, Pedro A.; ABIZAID, Alexandre; GRUBE, Eberhard; RODES-CABAU, Josep; BRITO JR., Fabio S. de
    Background-Direct transcatheter aortic valve replacement (TAVR) is regarded as having potential advantages over TAVR with balloon aortic valve predilatation (BAVP) in reducing procedural complications, but there are few data to support this approach. Methods and Results-Patients included in the Brazilian TAVR registry with CoreValve and Sapien-XT prosthesis were compared according to the implantation technique, with or without BAVP. Clinical and echocardiographic data were analyzed in overall population and after propensity score matching. A total of 761 consecutive patients (BAVP=372; direct-TAVR=389) were included. Direct-TAVR was possible in 99% of patients, whereas device success was similar between groups (BAVP=81.2% versus direct-TAVR=78.1%; P=0.3). No differences in clinical outcomes at 30 days and 1 year were observed, including all-cause mortality (7.6% versus 10%; P=0.25 and 18.1% versus 24.5%; P=0.07, respectively) and stroke (2.8% versus 3.8%; P=0.85 and 5.5% versus 6.8%; P=0.56, respectively). Nonetheless, TAVR with BAVP was associated with a higher rate of new onset persistent left bundle branch block with the CoreValve (47.7% versus 35.1%; P=0.01 at 1 year). Mean gradient and incidence of moderate/severe aortic regurgitation were similar in both groups at 1 year (11% versus 13.3%; P=0.57 and 9.8 +/- 5.5 versus 8.7 +/- 4.3; P=0.09, respectively). After propensity score matching analysis, all-cause mortality and stroke remained similar. By multivariable analysis, BAVP and the use of CoreValve were independent predictors of new onset persistent left bundle branch block. Conclusions-The 2 TAVR strategies, with or without BAVP, provided similar clinical and echocardiographic outcomes over a midterm follow-up although BAVP was associated with a higher rate of new onset persistent left bundle branch block, particularly in patients receiving a CoreValve.