ANTONIO SERGIO DE SANTIS ANDRADE LOPES

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina

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Autor e Coautores FMUSP-HC Normalizados: GUILHERME SOBREIRA SPINA ×

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Agora exibindo 1 - 10 de 24
  • conferenceObject
    Predictors of contractile reserve on dobutamine stress echocardiography in patients with classical low-flow, low-gradient aortic stenosis
    (2019) ROSA, V. Emer Egypto; RIBEIRO, H. B.; SAMAPIO, R. O.; MORAIS, T. C.; ROSA, M. E. E.; SANTIS, A. S. A. L. De; FERNANDES, J. R. C.; SPINA, G. S.; VIEIRA, M. L. C.; POMERANTZEFF, P. M. A.; ROCHITTE, C. E.; MATHIAS JR., W.; TARASOUTCHI, F.
  • article 1 Citação(ões) na Scopus
    Transcatheter Valve-in-Valve Procedures for Bioprosthetic Valve Dysfunction in Patients With Rheumatic vs. Non-Rheumatic Valvular Heart Disease
    (2021) LOPES, Mariana Pezzute; ROSA, Vitor Emer Egypto; PALMA, Jose Honorio; VIEIRA, Marcelo Luiz Campos; FERNANDES, Joao Ricardo Cordeiro; SANTIS, Antonio de; SPINA, Guilherme Sobreira; FONSECA, Rafael de Jesus; MARCHI, Mauricio F. de Sa; ABIZAID, Alexandre; BRITO, Fabio Sandoli de; TARASOUTCHI, Flavio; SAMPAIO, Roney Orismar; RIBEIRO, Henrique Barbosa
    Background: Bioprosthetic heart valve has limited durability and lower long-term performance especially in rheumatic heart disease (RHD) patients that are often subject to multiple redo operations. Minimally invasive procedures, such as transcatheter valve-in-valve (ViV) implantation, may offer an attractive alternative, although data is lacking. The aim of this study was to evaluate the baseline characteristics and clinical outcomes in rheumatic vs. non-rheumatic patients undergoing ViV procedures for severe bioprosthetic valve dysfunction. Methods: Single center, prospective study, including consecutive patients undergoing transcatheter ViV implantation in aortic, mitral and tricuspid position, from May 2015 to September 2020. RHD was defined according to clinical history, previous echocardiographic and surgical findings. Results: Among 106 patients included, 69 had rheumatic etiology and 37 were non-rheumatic. Rheumatic patients had higher incidence of female sex (73.9 vs. 43.2%, respectively; p = 0.004), atrial fibrillation (82.6 vs. 45.9%, respectively; p < 0.001), and 2 or more prior surgeries (68.1 vs. 32.4%, respectively; p = 0.001). Although, device success was similar between groups (75.4 vs. 89.2% in rheumatic vs. non-rheumatic, respectively; p = 0.148), there was a trend toward higher 30-day mortality rates in the rheumatic patients (21.7 vs. 5.4%, respectively; p = 0.057). Still, at median followup of 20.7 [5.1-30.4] months, cumulative mortality was similar between both groups (p = 0.779). Conclusion: Transcatheter ViV implantation is an acceptable alternative to redo operations in the treatment of patients with RHD and severe bioprosthetic valve dysfunction. Despite similar device success rates, rheumatic patients present higher 30 day mortality rates with good mid-term clinical outcomes. Future studies with a larger number of patients and follow-up are still warranted, to firmly conclude on the role transcatheter ViV procedures in the RHD population.
  • conferenceObject
    Long-term prognostic impact of pulmonary vascular resistance in patients with rheumatic mitral stenosis undergoing percutaneous mitral balloon valvuloplasty
    (2022) NAZZETTA, D. Cian; SOUSA, L. C. G. De; ROSA, V. E. E.; TESSARI, F. C.; PESSOA, R. S.; LIPARI, L. F. V. P.; FERNANDES, J. R. C.; LOPES, M. P.; SANTIS, A. S. A. L. De; SPINA, G. S.; PIRES, L. J. N. T.; SAMPAIO, R. O.; TARASOUTCHI, F.
  • conferenceObject
    Short- and Long-term Outcomes After Surgical Aortic Valve Replacement in Patients With Classical Low-flow, Low-gradient Aortic Stenosis
    (2019) ROSA, Vitor E.; RIBEIRO, Henrique B.; SAMPAIO, Roney O.; MORAIS, Thamara C.; ROSA, Marcela E.; SANTIS, Antonio S. De; FERNANDES, Joao Ricardo C.; SPINA, Guilherme S.; VIEIRA, Marcelo L.; POMERANTZEFF, Pablo M.; ROCHITTE, Carlos E.; MATHIAS JR., Wilson; TARASOUTCHI, Flavio
  • conferenceObject
    Predictors of Mortality in Prosthetic Valve Endocarditis
    (2016) SANTIS, Antonio S.; SPINA, Guilherme; ROSA, Vitor; ACCORSI, Tarso; FERNANDES, Joao Ricardo; SAMPAIO, Roney; PIRES, Lucas; PAIXAO, Milena; TARASOUTCHI, Flavio
  • conferenceObject
    EuroSCORE II, BNP, C-Reactive Protein, Creatinine and Delayed Myocardial Enhancement Imaging are Predictors of 1-Year Mortality in Patients with Low-Flow and Low-Gradient True Severe Aortic Stenosis with Low Ejection Fraction
    (2016) ROSA, Vitor E.; SAMPAIO, Roney O.; PAIXAO, Milena R.; FERNANDES, Joao Ricardo C.; ACCORSI, Tarso A.; SANTIS, Antonio S. de; SPINA, Guilherme S.; VIEIRA, Marcelo L.; MORAIS, Thamara C.; BELLO, Juliana H.; MATHIAS JR., Wilson; ROCHITTE, Carlos E.; BRANDAO, Carlos Manuel A.; TARASOUTCHI, Flavio
  • conferenceObject
    Rheumatic myocarditis: a poorly recognized etiology of left ventricular dysfunction in valvular heart disease patients
    (2021) ROSA, V. Emer Egypto; LOPES, M. P.; SPINA, G. S.; SOARES JR., J.; SALAZAR, D.; ROMERO, C. E.; LOTTEMBERG, M. P.; SANTIS, A. De; PIRES, L. J. N. T.; GONCALVES, L. F. T.; FERNANDES, J. R. C.; SAMPAIO, R. O.; TARASOUTCHI, F.
  • conferenceObject
    Topographic pattern of valve calcification: a new determinant of disease severity in aortic valve stenosis
    (2017) SANTIS, A. De; TARASOUTCHI, F. T.; ARAUJO FILHO, J. A. B.; KATZ, M.; VIEIRA, M. C.; NOMURA, C. H.; SPINA, G. S.; SAMPAIO, R. O.; BROWN, J.; EDELMAN, E. R.; ROSA, V. E. E.; FERNANDES, J. R. C.; LEMOS, P. A.
  • article 8 Citação(ões) na Scopus
    Miocardite Clinicamente Manifesta em Surto Agudo de Febre Reumatica
    (2014) XAVIER JR., Jose L.; SOEIRO, Alexandre de Matos; LOPES, Antonio S. S. A.; SPINA, Guilherme S.; SERRANO JR., Carlos V.; OLIVEIRA JR., Mucio T.
  • article 7 Citação(ões) na Scopus
    Heart Transplant in Patients with Predominantly Rheumatic Valvular Heart Disease
    (2015) ROSA, Vitor E. E.; LOPES, Antonio S. S. A.; ACCORSI, Tarso A. D.; FERNANDES, Joao Ricardo C.; SPINA, Guilherme S.; SAMPAIO, Roney O.; BACAL, Fernando; TARASOUTCHI, Flavio
    Background and aim of the study: International records indicate that only 2.6% of patients with heart transplants have valvular heart disease. The study aim was to evaluate the epidemiological and clinical profile of patients with valvular heart disease undergoing heart transplantation. Methods: Between 1985 and 2013, a total of 569 heart transplants was performed at the authors' institution. Twenty patients (13 men, seven women; mean age 39.5 +/- 15.2 years) underwent heart transplant due to structural (primary) valvular disease. Analyses were made of the patients' clinical profile, laboratory data, echocardiographic and histopathological data, and mortality and rejection. Results: Of the patients, 18 (90%) had a rheumatic etiology, with 85% having undergone previous valve surgery (45% had one or more operations), and 95% with a normal functioning valve prosthesis at the time of transplantation. Atrial fibrillation was present in seven patients (35%), while nine (45%) were in NYHA functional class IV and eight (40%) in class III. The indication for cardiac transplantation was refractory heart failure in seven patients (35%) and persistent NYHA class III/IV in ten (50%). The mean left ventricular ejection fraction (LVEF) was 26.6 +/- 7.9%. The one-year mortality was 20%. Histological examination of the recipients' hearts showed five (27.7%) to have reactivated rheumatic myocarditis without prior diagnosis at the time of transplantation. Univariate analysis showed that age, gender, LVEF, rheumatic activity and rejection were not associated with mortality at one year. Conclusion: Among the present patient cohort, rheumatic heart disease was the leading cause of heart transplantation, and a significant proportion of these patients had reactivated myocarditis diagnosed in the histological analyses. Thus, it appears valid to investigate the existence of rheumatic activity, especially in valvular cardiomyopathy with severe systolic dysfunction before transplantation.