NANA MIURA IKARI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- Mechanical Circulatory Assistance in Children: Clinical Outcome(2023) CORBI, Maria Julia De Aro Braz; JATENE, Marcelo Biscegli; SIQUEIRA, Adailson Wagner Da Silva; GRAU, Claudia Regina Pinheiro Castro; TAVARES, Glaucia Maria Penha; IKARI, Nana Miura; AZEKA, EstelaBackground. In countries where organ donation is scarce, mortality in the pediatric heart transplant waiting list is high, and ventricular assist devices (VADs) are therapeutic alternatives in these situations. Berlin Heart EXCOR is currently 1 of the few VADs specific for children.Methods. This retrospective study includes pediatric patients who underwent Berlin Heart EXCOR placement in a Brazilian hospital between 2012 and 2021. Clinical and laboratory data at the time of VAD implantation and the occurrence of complications and outcomes (success as a bridge to transplant or death) were analyzed.Results. Eight patients, from 8 months to 15 years, were included: 6 with cardiomyopathy and 2 with congenital heart disease. Six were on Intermacs 1 and 2 on Intermacs 2. The most common complications observed were stroke and right ventricular dysfunction. Six were transplanted, and 2 died. Those submitted to transplant had a higher mean weight than those who died, with no statistically significant difference. The underlying disease had no impact on the outcome. The group undergoing transplant had lower brain natriuretic peptide and lactate values, but no laboratory variable showed a statistically significant difference in the outcome. Conclusion. A VAD is an invasive treatment with potentially serious adverse effects and is still poorly available in Brazil. However, as a bridge to transplant, it is a useful treatment for children in progressive clinical decline. In this study, we did not observe any clinical or laboratory factor at the time of VAD implantation that implied better outcomes.
- Implementation of a High-Risk Outpatient Clinic for Children with Complex Congenital Heart Disease in a Reference Service in Brazil(2023) FORONDA, Gustavo; MELO, Vanessa Ferreira Amorim de; GRAU, Claudia Regina Pinheiro de Castro; PIVA, Ingrid Magatti; TAVARES, Glaucia Maria Penha; TANAKA, Ana Cristina Sayuri; MIURA, NanaBackground: Children with congenital heart disease (CHD), even after surgical approaches, and especially those who undergo staged procedures in the first months of life, remain vulnerable to readmissions and complications, requiring very close monitoring and differentiated intervention strategies. Methods: Descriptive and exploratory study, of the experience report type, which presents the process of building the high -risk outpatient clinic for complex congenital heart diseases (AAR) at the Instituto do Coracao (InCor). Results: Report of the path taken to structure the AAR, demonstrating the organization, interface with the multidisciplinary team, admission and discharge criteria, training, and patient profile. In these five years of care, 275 patients were treated, 59.65% with biventricular interstage physiology, followed by univentricular interstage physiology (34.55%), residual defects after surgical procedures (3.63%), tumors with risk of mechanical obstruction ( 1.45%) and patients with an intrauterine approach (0.72%). The significant number of critical patients who were successfully discharged from hospital (44.72%), the low mortality rate due to sudden deaths at home and the high adherence to follow-up corroborate the impact of this specialized assistance. Conclusions: Despite the limitations of the study, this experience report showed that with few resources, there is the possibility of organizing an AAR with differentiated care, with the objective of early detection and treatment of residual injuries, identification of early interventions, education of parents for follow-up of their children, resulting in individualized treatment, promoting a better quality of life for this population.