WALKIRIA SAMUEL AVILA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
35 resultados
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conferenceObject GOING AGAINST THE ODDS - A CASE OF SUCCESS IN A PREGNANT PATIENT WITH COMPLEX CONGENITAL HEART DISEASE(2021) KORMANN-MOREIRA, Mylena Cristina; MARTINS, Ana Vitoria Vitoreti; LEMOUCHE, Stephanie Ondracek; SANTANA, Marcela Devido; TANAKA, Ana Cristina Sayuri; ZORZANELLI, Leina; THOMAZ, Ana Maria; IKARI, Nana Miura; AVILA, Walkiria SamuelbookPart Cardiopata gestante(2018) LEAL, Tatiana de Carvalho Andreuci Torres; ASANO, Gabriela Cruz Gouveia; AVILA, Walkiria SamuelbookPart Cardiopata gestante(2015) LEAL, Tatiana de Carvalho Andreucci Torres; AVILA, Walkiria SamuelconferenceObject Pregnancy in women with complex congenital heart disease. A constant challenge. Data from InCor Registry(2018) SAMUEL, W. Avila; ROSSI, E. G. R. Giusti; RIBEIRO, V. M. R. Martins; MIURA, N. M.; BURGARELLI, C. B. T. Testa; HAJJAR, L. D. Abrahao- Position Statement on Women's Cardiovascular Health-2022(2022) OLIVEIRA, Glaucia Maria Moraes de; ALMEIDA, Maria Cristina Costa de; MARQUES-SANTOS, Celi; COSTA, Maria Elizabeth Navegantes Caetano; CARVALHO, Regina Coeli Marques de; FREIRE, Claudia Maria Vilas; MAGALHAES, Lucelia Batista Neves Cunha; HAJJAR, Ludhmila Abrahao; RIVERA, Maria Alayde Mendonca; CASTRO, Marildes Luiza de; AVILA, Walkiria Samuel; LUCENA, Alexandre Jorge Gomes de; BRANDAO, Andrea Araujo; MACEDO, Ariane Vieira Scarlatelli; LANTIERI, Carla Janice Baister; POLANCZYK, Carisi Anne; ALBUQUERQUE, Carlos Japhet da Matta; BORN, Daniel; FALCHETO, Eduardo Belisario; BRAGANCA, Erika Olivier Vilela; BRAGA, Fabiana Goulart Marcondes; COLOMBO, Fernanda M. Consolim; JATENE, Ieda Biscegli; COSTA, Isabela Bispo Santos da Silva; RIVERA, Ivan Romero; SCHOLZ, Jaqueline Ribeiro; MELO FILHO, Jose Xavier de; SANTOS, Magaly Arrais dos; BARBOSA, Marcia de Melo; IZAR, Maria Cristina de Oliveira; AZEVEDO, Maria Fatima; MOURA, Maria Sanali; CAMPOS, Milena dos Santos Barros; SOUZA, Olga Ferreira de; MEDEIROS, Orlando Otavio de; SILVA, Sheyla Cristina Tonheiro Ferro da; RIZK, Stephanie Itala; RODRIGUES, Thais de Carvalho Vieira; SALIM, Thais Rocha; LEMKE, Viviana de Mello Guzzo; ALEXANDRE, Elisabeth Regina Giunco
bookPart Cardiopatia na gravidez: Condutas práticas para o clínico(2017) GODOY, Lucas Colombo; ABUD, Isabela Cristina Kirnew; AVILA, Walkiria Samuel- Pregnancy in Women with Complex Congenital Heart Disease. A Constant Challenge(2019) AVILA, Walkiria Samuel; RIBEIRO, Veronica Martins; ROSSI, Eduardo Giusti; BINOTTO, Maria Angelica; BORTOLOTTO, Maria Rita; TESTA, Carolina; FRANCISCO, Rossana; HAJJAR, Ludhmilla Abraao; MIURA, NanaBackground: The improvement in surgical techniques has contributed to an increasing number of childbearing women with complex congenital heart disease (CCC). However, adequate counseling about pregnancy in this situation is uncertain, due to a wide variety of residual cardiac lesions. Objectives: To evaluate fetal and maternal outcomes in pregnant women with CCC and to analyze the predictive variables of prognosis. Methods: During 10 years we followed 435 consecutive pregnancies in patients (pts) with congenital heart disease. Among of them, we selected 42 pregnancies in 40 (mean age of 25.5 +/- 4.5 years) pts with CCC, who had been advised against pregnancy. The distribution of underlying cardiac lesions were: D-Transposition of the great arteries, pulmonary atresia, tricuspid atresia, single ventricle, double-outlet ventricle and truncus arteriosus. The surgical procedures performed before gestation were: Fontan, Jatene, Rastelli, Senning, Mustard and other surgical techniques, including Blalock, Taussing, and Glenn. Eight (20,0%) pts did not have previous surgery. Nineteen 19 (47.5%) pts had hypoxemia. The clinical follow-up protocol included oxygen saturation recording, hemoglobin and hematocrit values; medication adjustment to pregnancy, anticoagulation use, when necessary, and hospitalization from 28 weeks, in severe cases. The statistical significance level considered was p < 0.05. Results: Only seventeen (40.5%) pregnancies had maternal and fetal uneventful courses. There were 13 (30.9%) maternal complications, two (4.7%) maternal deaths due to hemorrhage pos-partum and severe pre-eclampsia, both of them in women with hypoxemia. There were 7 (16.6%) stillbirths and 17 (40.5%) premature babies. Congenital heart disease was identified in two (4.1%) infants. Maternal and fetal complications were higher (p < 0.05) in women with hypoxemia. Conclusions: Pregnancy in women with CCC was associated to high maternal and offspring risks. Hypoxemia was a predictive variable of poor maternal and fetal outcomes. Women with CCC should be advised against pregnancy, even when treated in specialized care centers.
bookPart Doença cardíaca durante a gravidez(2016) ÁVILA, Walkiria Samuel- Patient Management with Metallic Valve Prosthesis during Pregnancy and Postpartum Period(2015) GARCEZ, Juliane Dantas Seabra; ROSA, Vitor Emer Egypto; LOPES, Antonio Sergio de Santis Andrade; ACCORSI, Tarso Augusto Duenhas; FERNANDES, Joao Ricardo Cordeiro; POMERANTZEFF, Pablo Maria; AVILA, Walkiria Samuel; TARASOUTCHI, FlavioProsthetic thrombosis is a rare complication, but it has high mortality and morbidity. Young women of childbearing age that have prosthetic heart valves are at increased risk of thrombosis during pregnancy due to changes in coagulation factors. Anticoagulation with adequate control and frequent follow-up if pregnancy occurs must be performed in order to prevent complications related to anticoagulant use. Surgery remains the treatment of choice for prosthetic heart valve thrombosis in most clinical conditions. Patients with metallic prosthetic valves have an estimated 5% risk of thrombosis during pregnancy and maternal mortality of 1.5% related to the event. Anticoagulation with vitamin K antagonists during pregnancy is related to varying degrees of complications at each stage of the pregnancy and postpartum periods. Warfarin sodium crosses the placental barrier and when used in the first trimester of pregnancy is a teratogenic agent, causing 1-3% of malformations characterized by fetal warfarin syndrome and also constitutes a major cause of miscarriage in 10-30% of cases. In the third trimester and at delivery, the use of warfarin is associated with maternal and neonatal bleeding in approximately 5 to 15% of cases, respectively. On the other hand, inadequate anticoagulation, including the suspension of the oral anticoagulants aiming at fetal protection, carries a maternal risk of about 25% of metallic prosthesis thrombosis, particularly in the mitral valve. This fact is also due to the state of maternal hypercoagulability with activation of coagulation factors V, VI, VII, IX, X, platelet activity and fibrinogen synthesis, and decrease in protein S levels. The Registry of Pregnancy and Cardiac Disease (ROPAC), assessing 212 pregnant women with metal prosthesis, showed that prosthesis thrombosis occurred in 10 (4.7%) patients and maternal hemorrhage in 23.1%, concluding that only 58% of patients with metallic prosthesis had a complication-free pregnancy(1-7).
bookPart Valvopatias na gravidez(2016) SAMPAIO, Roney Orismar; PAIXãO, Milena Ribeiro; AVILA, Walkiria Samuel