FERNANDA CASTIGLIONI TESSARI

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico

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  • article 0 Citação(ões) na Scopus
    Risk prediction in patients with classical low-flow, low-gradient aortic stenosis undergoing surgical intervention
    (2023) TESSARI, Fernanda Castiglioni; LOPES, Maria Antonieta Albanez A. de M.; CAMPOS, Carlos M. M.; ROSA, Vitor Emer Egypto; SAMPAIO, Roney Orismar; SOARES, Frederico Jose Mendes Mendonca; LOPES, Rener Romulo Souza; NAZZETTA, Daniella Cian; JR, Fabio Sandoli de Brito; RIBEIRO, Henrique Barbosa; VIEIRA, Marcelo L. C.; JR, Wilson Mathias; FERNANDES, Joao Ricardo Cordeiro; LOPES, Mariana Pezzute; ROCHITTE, Carlos E. E.; POMERANTZEFF, Pablo M. A.; ABIZAID, Alexandre; TARASOUTCHI, Flavio
    IntroductionClassical low-flow, low-gradient aortic stenosis (LFLG-AS) is an advanced stage of aortic stenosis, which has a poor prognosis with medical treatment and a high operative mortality after surgical aortic valve replacement (SAVR). There is currently a paucity of information regarding the current prognosis of classical LFLG-AS patients undergoing SAVR and the lack of a reliable risk assessment tool for this particular subset of AS patients. The present study aims to assess mortality predictors in a population of classical LFLG-AS patients undergoing SAVR.MethodsThis is a prospective study including 41 consecutive classical LFLG-AS patients (aortic valve area & LE;1.0 cm(2), mean transaortic gradient <40 mmHg, left ventricular ejection fraction <50%). All patients underwent dobutamine stress echocardiography (DSE), 3D echocardiography, and T1 mapping cardiac magnetic resonance (CMR). Patients with pseudo-severe aortic stenosis were excluded. Patients were divided into groups according to the median value of the mean transaortic gradient (& LE;25 and >25 mmHg). All-cause, intraprocedural, 30-day, and 1-year mortality rates were evaluated.ResultsAll of the patients had degenerative aortic stenosis, with a median age of 66 (60-73) years; most of the patients were men (83%). The median EuroSCORE II was 2.19% (1.5%-4.78%), and the median STS was 2.19% (1.6%-3.99%). On DSE, 73.2% had flow reserve (FR), i.e., an increase in stroke volume & GE;20% during DSE, with no significant differences between groups. On CMR, late gadolinium enhancement mass was lower in the group with mean transaortic gradient >25 mmHg [2.0 (0.0-8.9) g vs. 8.5 (2.3-15.0) g; p = 0.034), and myocardium extracellular volume (ECV) and indexed ECV were similar between groups. The 30-day and 1-year mortality rates were 14.6% and 43.8%, respectively. The median follow-up was 4.1 (0.3-5.1) years. By multivariate analysis adjusted for FR, only the mean transaortic gradient was an independent predictor of mortality (hazard ratio: 0.923, 95% confidence interval: 0.864-0.986, p = 0.019). A mean transaortic gradient & LE;25 mmHg was associated with higher all-cause mortality rates (log-rank p = 0.038), while there was no difference in mortality regarding FR status (log-rank p = 0.114).ConclusionsIn patients with classical LFLG-AS undergoing SAVR, the mean transaortic gradient was the only independent mortality predictor in patients with LFLG-AS, especially if & LE;25 mmHg. The absence of left ventricular FR had no prognostic impact on long-term outcomes.
  • 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
    LEFT VENTRICULAR PSEUDOANEURYSM AS A COMPLICATION OF MITRAL VALVE REPLACEMENT SURGERY
    (2022) SOARES, Fernanda; ALMEIDA, Camila; ACCORSI, Tarso Augusto; TARASOUTCHI, Flavio; LIPARI, Layara Fernanda; PEREIRA, Thiago; TESSARI, Fernanda; SIQUEIRA, Bernardo; OLIVEIRA, Renan; CUNHA, Matheus Luan
  • conferenceObject
    Degenerative or rheumatic: after all, what is the most prevalent etiology of mitral regurgitation in developing countries?
    (2023) LIPARI, L. F. Vicente Pereira; FERNANDES, J. R. C.; ZIOTTI, S. V.; NAZZETTA, D. C.; TESSARI, F. C.; PESSOA, R. S.; HAUSSAUER JR., H. V.; ROSA, V. E. E.; PIRES, L. J. N. T.; ACCORSI, T. A. D.; LOPES, M. P.; SANTIS, A. S. De; SPINA, G. S.; SAMPAIO, R. O.; TARASOUTCHI, F.
  • bookPart
    Tamponamento cardíaco
    (2023) MAGALHãES, Francisco Monteiro de Almeida; TESSARI, Fernanda Castiglioni; ROSA, Vitor Emer Egypto