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
- Surgical cutdown versus percutaneous access in transfemoral transcatheter aortic valve implantation: Insights from the Brazilian TAVI registry(2015) BERNARDI, Fernando L. M.; GOMES, Wilton F.; BRITO JR., Fabio S. de; MANGIONE, Jose A.; SARMENTO-LEITE, Rogerio; SIQUEIRA, Dimitry; CARVALHO, Luiz A.; TUMELERO, Rogerio; GUERIOS, Enio E.; LEMOS, Pedro A.ObjectiveTo compare the 1-year outcomes of complete percutaneous approach versus surgical vascular approach for transfemoral transcatheter aortic valve implantation (TAVI), among real-world patients from the multi-center Brazilian TAVI registry. BackgroundVascular access still remains a major challenge for TAVI via transfemoral approach. Vascular access through complete percutaneous approaches or through open surgical vascular techniques seems to be acutely similar. However, the long-term outcomes of both techniques remain poorly described. MethodsThe study population comprised all patients treated via transfemoral route in the Brazilian TAVI registry, a real-world, nation-based, multi-center study. Patients were divided according to the initial vascular access approach (percutaneous vs. surgical) and clinically followed-up for 1 year. The primary endpoint was the incidence of combined adverse events all-cause mortality, life-threatening bleeding, and/or major vascular complication at 1 year. ResultsA total of 402 patients from 18 centers comprised the study population (percutaneous approach in 182 patients; surgical cutdown approach 220 patients). The incidence of combined adverse events was not different in the percutaneous and the surgical groups at 30 days (17.6% vs. 16.3%; P=0.8) and at 1 year (primary endpoint) (30.9% vs. 28.8%; P=0.8). Also, the study groups overall were comparable regarding the incidence of each individual safety adverse events at 30 days and at 1 year. ConclusionTotal percutaneous techniques or surgical cutdown and closure may provide similar safety and effectiveness during the first year of follow-up in patients undergoing transfemoral TAVI. (c) 2015 Wiley Periodicals, Inc.
conferenceObject Transcatheter aortic valve implantation in degenerated aortic bioprosthesis: an analysis from the Brazilian TAVI Registry(2015) BERNARDI, Guilherme; BERNARDI, Fernando L. de Melo; PRATES, Paulo R.; LEMOS, Pedro A.; SIQUEIRA, Dimytri A.; MANGIONE, Jose A.; DOURADO, Adriano; CARVALHO, Luiz Antonio; THIAGO, Luiz Eduardo Sao; LIMA, Valter; ANDREA, Julio; BRITO JR., Fabio; SARMENTO-LEITE, Rogerio Rogerio- Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? Analysis of 568 Patients(2015) TRUFFA, Marcio A. M.; ALVES, Gustavo M. P.; BERNARDI, Fernando; ESTEVES FILHO, Antonio; RIBEIRO, Expedito; GALON, Micheli Z.; SPADARO, Andre; KAJITA, Luiz J.; ARRIETA, Raul; LEMOS, Pedro A.Background: Advantages and disadvantages of ad hoc percutaneous coronary intervention have been described. However little is known about the radiation exposure of that procedure as compared with the staged intervention. Objective: To compare the radiation dose of the ad hoc percutaneous coronary intervention with that of the staged procedure. Methods: The dose-area product and total Kerma were measured, and the doses of the diagnostic and therapeutic procedures were added. In addition, total fluoroscopic time and number of acquisitions were evaluated. Results: A total of 568 consecutive patients were treated with ad hoc percutaneous coronary intervention (n = 320) or staged percutaneous coronary intervention (n = 248). On admission, the ad hoc group had less hypertension (74.1% vs 81.9%; p = 0.035), dyslipidemia (57.8% vs. 67.7%; p = 0.02) and three-vessel disease (38.8% vs. 50.4%; p = 0.015). The ad hoc group was exposed to significantly lower radiation doses, even after baseline characteristic adjustment between both groups. The ad hoc group was exposed to a total dose-area product of 119.7 +/- 70.7 Gycm(2), while the staged group, to 139.2 +/- 75.3 Gycm(2) (p < 0.001). Conclusion: Ad hoc percutaneous coronary intervention reduced radiation exposure as compared with diagnostic and therapeutic procedures performed at two separate times.