MONICA SAMUEL AVILA GRINBERG
Projetos de Pesquisa
Unidades Organizacionais
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
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação, Hospital das Clínicas, Faculdade de Medicina
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- Survival of Heart Transplant Patients with Chagas' Disease Under Different Antiproliferative Immunosuppressive Regimens(2023) FURQUIM, Silas Ramos; GALBIATI, Luana Campoli; AVILA, Monica S.; MARCONDES-BRAGA, Fabiana G.; FUKUSHIMA, Julia; MANGINI, Sandrigo; SEGURO, Luis Fernando Bernal da Costa; CAMPOS, Iascara Wozniak de; STRABELLI, Tania Mara Varejao; BARONE, Fernanda; PAULO, Audrey Rose da Silveira Amancio de; OHE, Luciana Akutsu; GALANTE, Mariana Cappelletti; GAIOTTO, Fabio Antonio; BACAL, FernandoBackground: Chagas' disease (CD) is an important cause of heart transplantation (HT). The main obstacle is Chagas' disease reactivation (CDR), usually associated to high doses of immunosuppressants. Previous studies have suggested an association of mycophenolate mofetil with increased CDR. However, mortality predictors are unknown.Objectives: To identify mortality risk factors in heart transplant patients with CD and the impact of antiproliferative regimen on survival.Methods: Retrospective study with CD patients who underwent HT between January 2004 and September 2020, under immunosuppression protocol that prioritized azathioprine and change to mycophenolate mofetil in case of rejection. We performed univariate regression to identify mortality predictors; and compared survival, rejection and evidence of CDR between who received azathioprine, mycophenolate mofetil and those who changed from azathioprine to mycophenolate mofetil after discharge (""Change"" group). A p-value < 0.05 was considered statistically significant. Results: Eighty-five patients were included, 54.1% men, median age 49 (39-57) years, and 91.8% were given priority in waiting list. Nineteen (22.4%) used azathioprine, 37 (43.5%) mycophenolate mofetil and 29 (34.1%) switched therapy; survival was not different between groups, 2.9 (1.6-5.0) x 2.9 (1.8-4.8) x 4.2 (2.0-5.0) years, respectively; p=0.4. There was no difference in rejection (42%, 73% and 59% respectively; p=0.08) or in CDR (T. cruzi positive by endomyocardial biopsy 5% x 11% x 7%; p=0.7; benznidazole use 58% x 65% x 69%; p=0.8; positive PCR for T. cruzi 20% x 68% x 42% respectively; p=0.1) rates.Conclusions: This retrospective study did not show difference in survival in heart transplant patients with CD receiving different antiproliferative regimens. Mycophenolate mofetil was not associated with statistically higher rates of CDR or graft rejection in this cohort. New randomized clinical trials are necessary to address this issue.
- Diretriz de Assistência Circulatória Mecânica da Sociedade Brasileira de Cardiologia(2016) AYUB-FERREIRA, Silvia Moreira; SOUZA NETO, Joao David de; ALMEIDA, Dirceu Rodrigues; BISELLI, Bruno; AVILA, Monica Samuel; COLAFRANCESCHI, Alexandre Siciliano; STEFANELLO, Bianca; CARVALHO, Braulio Matias de; POLANCZYK, Carisi Anne; GALANTINI, Danilo Ribeiro; BOCCHI, Edimar Alcides; CHAMLIAN, Eduardo Gregorio; HOJAIJ, Elaine Marques; GAIOTTO, Fabio Antonio; PINTON, Fabio Augusto; JATENE, Fabio Biscegli; RAMIRES, Felix Jose Alvarez; ATIK, Fernando Antibas; FIGUEIRA, Fernando; BACAL, Fernando; GALAS, Filomena Regina Barbosa Gomes; BRITO, Flavio de Souza; CONCEICAO-SOUZA, Germano Emilio; RIBEIRO, Gustavo Calado de Aguiar; PINHEIRO JUNIOR, Jairo Alves; SOUZA, Januario Manoel de; ROSSI NETO, Joao Manoel; LIMA, Jose Lindemberg da Costa; MEJIA, Juan Cosquillo; FERNANDES, Juliana Rolim; BAUMWORCEL, Leonardo; MOURA, Lidia Ana Zytynski; HAJJAR, Ludhmila Abrahao; BECK-DA-SILVA, Luis; ROHDE, Luis Eduardo Paim; SEGURO, Luis Fernando Bernal da Costa; PINHEIRO, Mabel Leite; PARK, Marcelo; FERNANDES, Marcelo Ramalho; MONTERA, Marcelo Westerlund; ALVES, Marco Stephan Lofrano; WANDERLEY JUNIOR, Mauro Rogerio de Barros; HOSSNE, Nelson; FERNANDES, Paulo Manuel Pego; LEMOS, Pedro; SCHNEIDEWIND, Rafael Otto; UCHOA, Ricardo Barreira; HONORATO, Ronaldo; MANGINI, Sandrigo; FALCAO, Sandra Nivea dos Reis Saraiva; LOPES, Sergio Augusto Veiga; STRABELLI, Tania Mara Varejao; GUIMARAES, Tereza Cristina Felippe; CAMPANILI, Ticiane Carolina Goncalves Faustino; ISSA, Victor Sarli
- 3rd Brazilian Directive on Cardiac Transplantation(2018) BACAL, Lemando; MARCONDES-BRAGA, Fabiana C.; ROHDE, Luis Eduardo Paim; XAVIER JUNIOR, Jose Leudo; BRITO, Flavio de Souza; MOURA, Lidia Ana Zytynski; COLAFRANCESCHI, Alexandre Siciliano; LAVAGNOLI, Carlos Fernando Ramos; GELAPE, Claudio Leo; ALMEIDA, Dirceu Rodrigues; GAIOTTO, Fabio Antonio; ATIK, Fernando Antibas; FIGUEIRA, Fernando Augusto M. S.; SOUZA, Germano Emilio Conceicao; RODRIGUES, Helcio; CAMPOS, Iascara Wozniak; SOUZA NETO, Joao David de; ROSSI NETO, Joao Manoel; GASPARETTO, Juliano; GOLDRAICH, Livia Adams; BENVENUTI, Luiz Alberto; SEGURO, Luis Fernando B. C.; ULHOA JUNIOR, Marcelo Boteiho; V, Maria da Consolacao Moreira; AVILA, Monica Samuel; CARNEIRO, Rodrigo; MANGINI, Sandrigo; FERREIRA, Silvia Moreira Ayub; STRABELLI, Tania Mara
article 3rd Brazilian Directive on Cardiac Transplantation (vol 111, pg 230, 2018)(2019) BACAL, Fernando; MARCONDES-BRAGA, Fabiana G.; ROHDE, Luis Eduardo Paim; JUNIOR, Jose Leudo Xavier; BRITO, Flavio de Souza; MOURA, Lidia Ana Zytynski; COLAFRANCESCHI, Alexandre Siciliano; LAVAGNOLI, Carlos Fernando Ramos; GELAPE, Claudio Leo; ALMEIDA, Dirceu Rodrigues; GAIOTTO, Fabio Antonio; ATIK, Fernando Antibas; FIGUEIRA, Fernando Augusto M. S.; SOUZA, Germano Emilio Conceicao; RODRIGUES, Helcio; CAMPOS, Iacara Wozniak; NETO, Joao David de Souza; NETO, Joao Manoel Rossi; GASPARETTO, Juliano; GOLDRAICH, Livia Adams; BENVENUTI, Luiz Alberto; SEGURO, Luis Fernando B. C.; JUNIOR, Marcelo Botelho Ulhoa; MOREIRA, Maria da Consolacao V.; AVILA, Monica Samuel; CARNEIRO, Rodrigo; MANGINI, Sandrigo; FERREIRA, Silvia Moreira Ayub; STRABELLI, Tania Mara- A modified heterotopic heart transplant technique to bridge patients with ""fixed"" pulmonary hypertension: A case report(2022) GAIOTTO, Fabio Antonio; BACAL, Fernando; STEFFEN, Samuel Padovan; MARCONDES-BRAGA, Fabiana Goulart; SEGURO, Luis Fenando Bernal da Costa; MANGINI, Sandrigo; CAMPOS, Iascara Wozniak de; AVILA, Monica Samuel; KALIL FILHO, Roberto; JATENE, Fabio Biscegli
- COVID-19 complicating perioperative management of LVAD implantation: A case report and systematic review(2021) BELFORT, Deborah de Sa Pereira; BISELLI, Bruno; AVILA, Monica Samuel; LIRA, Maria Tereza Sampaio de Sousa; GALAS, Filomena Regina Barbosa Gomes; STEFFEN, Samuel Padovani; GAIOTTO, Fabio Antonio; JATENE, Fabio Biscegli; BOCCHI, Edimar Alcides; FERREIRA, Silvia Moreira AyubThe coronavirus 2019 disease (COVID-19) affected 125 million people worldwide and caused 2.7 million deaths. Some comorbidities are associated with worse prognosis and left ventricular assist device (LVAD) recipients are probably part of this high-risk population. We report a 31-year-old male patient who developed COVID-19 during LVAD implantation. His postoperative period was complicated by severe pneumonia and mechanical ventilation (MV) leading to right ventricular failure (RVF) and inotrope necessity. He experienced multiple complications, but eventually recovered. We present a systematic review of LVAD recipients and COVID-19. Among 14 patients, the mean age was 62.7 years, 78.5% were male. A total of 5 patients (35.7%) required MV and 3 patients (21.4%) died. A total of 2 patients (14.2%) had thromboembolic events. This case and systematic review suggest LVAD recipients are at particular risk of unfavorable outcomes and they may be more susceptible to RVF in the setting of COVID-19, particularly during perioperative period.
- Dispositivo de Assistência Ventricular Esquerda Seguido de Transplante Cardíaco(2015) BISELLI, Bruno; AYUB-FERREIRA, Silvia Moreira; AVILA, Monica Samuel; GAIOTTO, Fabio Antonio; JATENE, Fabio Biscegli; BOCCHI, Edimar Alcides