FABIO SANDOLI DE BRITO JUNIOR

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

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  • conferenceObject
    Atrial Fibrillation in Patients Undergoing Transcatheter Aortic Valve Implantation Is Associated With Increased Mortality
    (2021) NIEUWKERK, Astrid van; BLANCO, Roberto; TCHETCHE, Didier; BRITO JR., Fabio; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; DOMINGUEZ, Juan Francisco Oteo; DUMONTEIL, Nicolas; ABIZAID, Alexandre; BAAN, Jan; SARTORI, Samantha; D'ERRIGO, Paola; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; GHATTAS, Angie; PAGNESI, Matteo; DANGAS, George; MEHRAN, Roxana; DELEWI, Ronak
  • conferenceObject
    Patients With Previous Cerebrovascular Events Undergoing Transcatheter Aortic Valve Implantation Have More Periprocedural Strokes
    (2023) NIEUWKERK, Astrid van; AARTS, Hugo; HEMELRIJK, Kimberley; CARRILLO, Cristobal A. Urbano; TCHETCHE, Didier; BRITO JR., Fabio; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; GARCIA-BLAS, Sergio; DUMONTEIL, Nicolas; ABIZAID, Alexandre; SARTORI, Samantha; D'ERRIGO, Paola; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; PAGNESI, Matteo; DANGAS, George; MEHRAN, Roxana; DELEWI, Ronak
  • conferenceObject
    Balloon-Expandable or Self-Expandable Valves in Valve-in-Valve Transcatheter Aortic Valve Implantation?
    (2021) NIEUWKERK, Astrid Van; FERNANDEZ-NOFRERIAS, Eduard; TCHETCHE, Didier; BRITO JR., Fabio; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; TELLO, Vicente Mainar; DUMONTEIL, Nicolas; BAAN, Jan; ABIZAID, Alexandre; SARTORI, Samantha; D'ERRIGO, Paola; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; PAGNESI, Matteo; GHATTAS, Angie; DANGAS, George; MEHRAN, Roxana; DELEWI, Ronak
  • article 69 Citação(ões) na Scopus
    Sex Differences in Transfemoral Transcatheter Aortic Valve Replacement
    (2019) VLASTRA, Wieneke; CHANDRASEKHAR, Jaya; BLANCO, Bruno Garcia Del; TCHETCHE, Didier; BRITO, Fabio S. de; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; BAAN, Jan; TIJSSEN, Jan G. P.; MORENO, Raul; DUMONTEIL, Nicolas; TARASOUTCHI, Flavio; SARTORI, Samantha; D'ERRIGO, Paola; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; PAGNESI, Matteo; BERENGUER, Alberto; MODINE, Thomas; DANGAS, George; MEHRAN, Roxana; PIEK, Jan J.; DELEWI, Ronak
    BACKGROUND Transfemoral aortic valve replacement (TAVR) is a guideline-recommended treatment option for patients with severe aortic valve stenosis. Women and men present with different baseline characteristics, which may influence procedural outcomes. OBJECTIVES This study sought to evaluate differences between women and men undergoing transfemoral TAVR across the globe during the last decade. METHODS The CENTER (Cerebrovascular EveNts in patients undergoing TranscathetER aortic valve implantation with balloon-expandable valves versus self-expandable valves)-collaboration was a global patient level dataset of patients undergoing transfemoral TAVR (N = 12,381) from 2007 to 2018. In this retrospective analysis, the study examined differences in baseline patient characteristics, 30-day stroke and mortality, and in-hospital outcomes between female and male patients. The study also assessed for temporal changes in outcomes and predictors for mortality per sex. RESULTS We included 58% (n = 7,120) female and 42% (n = 5,261) male patients. Women had higher prevalence of hypertension and glomerular filtration rate <30 ml/min/1.73 m(2) but lower prevalence of all other traditional cardiovascular comorbidities. Both sexes had similar rates of 30-day stroke (2.3% vs. 2.5%; p = 0.53) and mortality (5.9% vs. 5.5%; p = 0.17). In contrast, women had a 50% higher risk of life-threatening or major bleeding (6.7% vs. 4.4%; p < 0.01). Over the study period, mortality rates decreased to a greater extent in men than in women (60% vs. 50% reduction; both p < 0.001), with no reductions in stroke rates over time. CONCLUSIONS In this global collaboration, women and men had similar rates of 30-day mortality and stroke. However, women had higher rates of procedural life-threatening or major bleeding after TAVR. Between 2007 and 2018, mortality rates decreased to a greater extent in men than in women. (C) 2019 Published by Elsevier on behalf of the American College of Cardiology Foundation.
  • conferenceObject
    Outcomes of Patients With High Gradient and Low-Flow LowGradient Aortic Valve Stenosis Undergoing Transcatheter Aortic Valve Implantation: Results From the CENTER2 Collaboration
    (2023) HEMELRIJK, Kimberley; NIEUWKERK, Astrid van; GHEORGHE, Livia Luciana; TCHETCHE, Didier; BRITO JR., Fabio; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; DUMONTEIL, Nicolas; SARMENTO-LEITE, Rogerio; SARTORI, Samantha; D'ERRIGO, Paola; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; PAGNESI, Matteo; ASMARATS, Lluis; DANGAS, George; MEHRAN, Roxana; DELEWI, Ronak
  • conferenceObject
    Diabetes Mellitus in Transfemoral Transcatheter Aortic Valve Implantation: A Propensity Matched Analysis
    (2022) NIEUWKERK, Astrid van; BLANCO, Roberto; TCHETCHE, Didier; BRITO JR., Fabio; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; DOMINGUEZ, Juan Francisco Oteo; DUMONTEIL, Nicolas; ABIZAID, Alexandre; SARTORI, Samantha; D'ERRIGO, Paola; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; PAGNESI, Matteo; DANGAS, George; MEHRAN, Roxana; DELEWI, Ronak
  • article 8 Citação(ões) na Scopus
    Infective Endocarditis Caused by Staphylococcus aureus After Transcatheter Aortic Valve Replacement
    (2022) VAL, David del; ABDEL-WAHAB, Mohamed; MANGNER, Norman; DURAND, Eric; IHLEMANN, Nikolaj; URENA, Marina; PELLEGRINI, Costanza; GIANNINI, Francesco; GASIOR, Tomasz; WOJAKOWSKI, Wojtek; LANDT, Martin; AUFFRET, Vincent; SINNING, Jan Malte; CHEEMA, Asim N.; NOMBELA-FRANCO, Luis; CHAMANDI, Chekrallah; CAMPELO-PARADA, Francisco; MUNOZ-GARCIA, Erika; HERRMANN, Howard C.; TESTA, Luca; WON-KEUN, K.; CASTILLO, Juan Carlos; ALPERI, Alberto; TCHETCHE, Didier; BARTORELLI, Antonio L.; KAPADIA, Samir; STORTECKY, Stefan; AMAT-SANTOS, Ignacio; WIJEYSUNDERA, Harindra C.; LISKO, John; GUTIERREZ-IBANES, Enrique; SERRA, Vicenc; SALIDO, Luisa; ALKHODAIR, Abdullah; VENDRAMIN, Igor; CHAKRAVARTY, Tarun; LERAKIS, Stamatios; VILALTA, Victoria; REGUEIRO, Ander; ROMAGUERA, Rafael; KAPPERT, Utz; BARBANTI, Marco; MASSON, Jean-Bernard; MAES, Frederic; FIORINA, Claudia; MICELI, Antonio; KODALI, Susheel; RIBEIRO, Henrique B.; MANGIONE, Jose Armando; JR, Fabio Sandoli de Brito; DATO, Guglielmo Mario Actis; ROSATO, Francesco; FERREIRA, Maria-Cristina; LIMA, Valter Corriea de; COLAFRANCESCHI, Alexandre Siciliano; ABIZAID, Alexandre; MARINO, Marcos Antonio; ESTEVES, Vinicius; ANDREA, Julio; GODINHO, Roger R.; ALFONSO, Fernando; ELTCHANINOFF, Helene; SONDERGAARD, Lars; HIMBERT, Dominique; HUSSER, Oliver; LATIB, Azeem; BRETON, Herve Le; SERVOZ, Clement; PASCUAL, Isaac; SIDDIQUI, Saif; OLIVARES, Paolo; HERNANDEZ-ANTOLIN, Rosana; WEBB, John G.; SPONGA, Sandro; MAKKAR, Raj; KINI, Annapoorna S.; BOUKHRIS, Marouane; GERVAIS, Philippe; LINKE, Axel; CRUSIUS, Lisa; HOLZHEY, David; RODES-CABAU, Josep
    Background: Staphylococcus aureus (SA) has been extensively studied as causative microorganism of surgical prosthetic-valve infective endocarditis (IE). However, scarce evidence exists on SA IE after transcatheter aortic valve replacement (TAVR). Methods: Data were obtained from the Infectious Endocarditis After TAVR International Registry, including patients with definite IE after TAVR from 59 centres in 11 countries. Patients were divided into 2 groups according to microbiologic etiology: non-SA IE vs SA IE. Results: SA IE was identified in 141 patients out of 573 (24.6%), methicillin-sensitive SA in most cases (115/141, 81.6%). Self-expanding valves were more common than balloon-expandable valves in patients presenting with early SA IE. Major bleeding and sepsis complicating TAVR, neurologic symptoms or systemic embolism at admission, and IE with cardiac device involvement (other than the TAVR prosthesis) were associated with SA IE (P < 0.05 for all). Among patients with IE after TAVR, the likelihood of SA IE increased from 19% in the absence of those risk factors to 84.6% if > 3 risk factors were present. In-hospital (47.8% vs 26.9%; P < 0.001) and 2-year (71.5% vs 49.6%; P < 0.001) mortality rates were higher among patients with SA IE vs non-SA IE. Surgery at the time of index SA IE episode was associated with lower mortality at follow-up compared with medical therapy alone (adjusted hazard ratio 0.46, 95% CI 0.22-0.96; P = 0.038). Conclusions: SA IE represented approximately 25% of IE cases after TAVR and was associated with very high in-hospital and late mortality. The presence of some features determined a higher likelihood of SA IE and could help to orientate early antibiotic regimen selection. Surgery at index SA IE was associated with improved outcomes, and its role should be evaluated in future studies.
  • article 11 Citação(ões) na Scopus
    Outcomes in Valve-in-Valve Transcatheter Aortic Valve Implantation
    (2022) NIEUWKERK, Astrid C. van; SANTOS, Raquel B.; FERNANDEZ-NOFRERIAS, Eduard; TCHETCHE, Didier; JR, Fabio S. de Brito; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; MAINAR, Vicente; DUMONTEIL, Nicolas; BAAN, Jan; ABIZAID, Alexandre; SARTORI, Samantha; D'ERRIGO, Paola; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; PAGNESI, Matteo; LARRAYA, Garikoitz Lasa; GHATTAS, Angie; DANGAS, George; MEHRAN, Roxana; DELEWI, Ronak
    The use of valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) is increasing, but studies evaluating clinical outcomes in these patients are scarce. Also, there are limited data to guide the choice of valve type in ViV-TAVI. Therefore, this CENTER-study evaluated clinical outcomes in patients with ViV-TAVI compared to patients with native valve TAVI (NV-TAVI). In addition, we compared outcomes in patients with ViV-TAVI treated with self-expandable versus balloon-expandable valves. A total of 256 patients with ViV-TAVI and 11333 patients with NV-TAVI were matched 1:2 using propensity score matching, resulting in 256 patients with ViV-TAVI and 512 patients with NV-TAVI. Mean age was 81 +/- 7 years, 58% were female, and the Society of Thoracic Surgeons Predicted Risk of Mortality was 6.3% (4.0% to 12.8%). Mortality rates were comparable between ViV-TAVI and NV-TAVI patients at 30 days (4.1% vs 5.9%, p = 0.30) and 1 year (14.2% vs 17.3%, p = 0.34). Stroke rates were also similar at 30 days (2.8% vs 1.8%, p = 0.38) and 1 year (4.9% vs 4.3%, p = 0.74). Permanent pacemakers were less frequently implanted in patients with ViV-TAVI (8.8% vs 15.0%, relative risk 0.59, 95% confidence interval [CI] 0.37 to 0.92, p = 0.02). Patients with ViV-TAVI were treated with self-expandable valves (n = 162) and balloon-expandable valves (n = 94). Thirty-day major bleeding was less frequent in patients with self-expandable valves (3% vs 13%, odds ratio 5.12, 95% CI 1.42 to 18.52, p = 0.01). Thirty-day mortality was numerically lower in patients with self-expandable valves (3% vs 7%, odds ratio 3.35, 95% CI 0.77 to 14.51, p = 0.11). In conclusion, ViV-TAVI seems a safe and effective treatment for failing bioprosthetic valves with low mortality and stroke rates comparable to NV-TAVI for both valve types. (C) 2022 The Author(s).
  • article 31 Citação(ões) na Scopus
    Transfemoral TAVR in Nonagenarians From the CENTER Collaboration
    (2019) VLASTRA, Wieneke; CHANDRASEKHAR, Jaya; VENDRIK, Jeroen; GUTIERREZ-IBANES, Enrique; TCHETCHE, Didier; BRITO JR., Fabio S. de; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; BAAN, Jan; TIJSSEN, Jan G. P.; PAN, Manuel; DUMONTEIL, Nicolas; MANGIONE, Jose A.; SARTORI, Samantha; D'ERRIGO, Paola; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; PAGNESI, Matteo; GILA, Joaquin Sanchez; MODINE, Thomas; DANGAS, George; MEHRAN, Roxana; PIEK, Jan J.; DELEWI, Ronak
    OBJECTIVES This study aimed to compare differences in patient characteristics and clinical outcomes of nonagenarians undergoing transcatheter aortic valve replacement (TAVR) versus patients younger than 90 years of age and to test the predictive accuracy of the logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation), the EuroSCORE II, and the STS-PROM (Society of Thoracic Surgeons Predicted Risk of Mortality) for mortality after TAVR in nonagenarians. BACKGROUND The prevalence of severe aortic valve stenosis is increasing due to the rising life expectancy. However, there are limited data evaluating outcomes in patients older than 90 years of age. Moreover, the predictive accuracy of risk scores for mortality has not been evaluated in nonagenarian patients undergoing transfemoral TAVR. METHODS The CENTER (Cerebrovascular EveNts in Patients Undergoing TranscathetER Aortic Valve Implantation) collaboration (N = 12,381) is an international collaboration consisting of 3 national registries, 6 local or multicenter registries, and 1 prospective clinical study, selected through a systematic online search. The primary endpoint of this study was the difference in 30-day all-cause mortality and stroke after TAVR in nonagenarians versus patients younger than 90 years of age. Secondary endpoints included differences in baseline characteristics, in-hospital outcomes, and the differences in predictive accuracy of the logistic EuroSCORE, the EuroSCORE II, and STS-PROM. RESULTS A total of 882 nonagenarians and 11,499 patients younger than 90 years of age undergoing transfemoral TAVR between 2007 and 2018 were included. Nonagenarians had considerably fewer comorbidities than their counterparts. Nevertheless, rates of 30-day mortality (9.9% vs. 5.4%; relative risk [RR]: 1.8; 95% confidence interval [CI]: 1.4 to 2.3; p = 0.001), in-hospital stroke (3.0% vs. 1.9%; RR: 1.5; 95% CI: 1.0 to 2.3; p = 0.04), major or life-threatening bleeding (8.1% vs. 5.5%; RR: 1.6; 95% CI: 1.1 to 2.2; p = 0.004), and new-onset atrial fibrillation (7.9% vs. 5.2%; RR: 1.6; 95% CI: 1.1 to 2.2; p = 0.01) were higher in nonagenarians. The STS-PROM adequately estimated mortality in nonagenarians, with an observed-expected mortality ratio of 1.0. CONCLUSIONS In this large, global, patient-level analysis, mortality after transfemoral TAVR was 2-fold higher in nonagenarians compared with patients younger than 90 years of age, despite the lower prevalence of baseline comorbidities. Moreover, nonagenarians had a higher risk of in-hospital stroke, major or life-threatening bleeding, and new-onset atrial fibrillation. The STS-PROM was the only surgical risk score that accurately predicted the risk of mortality in nonagenarians. (J Am Coll Cardiol Intv 2019; 12: 911-20) (c) 2019 by the American College of Cardiology Foundation.
  • article 71 Citação(ões) na Scopus
    Predictors, Incidence, and Outcomes of Patients Undergoing Transfemoral Transcatheter Aortic Valve Implantation Complicated by Stroke From the CENTER-Collaboration
    (2019) VLASTRA, Wieneke; JIMENEZ-QUEVEDO, Pilar; TCHETCHE, Didier; CHANDRASEKHAR, Jaya; BRITO JR., Fabio S. de; BARBANTI, Marco; KORNOWSKI, Ran; LATIB, Azeem; D'ONOFRIO, Augusto; RIBICHINI, Flavio; BAAN, Jan; TIJSSEN, Jan G. P.; HERNANDEZ, Jose M. De la Torre; DUMONTEIL, Nicolas; SARMENTO-LEITE, Rogerio; SARTORI, Samantha; ROSATO, S.; TARANTINI, Giuseppe; LUNARDI, Mattia; ORVIN, Katia; PAGNESI, Matteo; HERNANDEZ-ANTOLIN, Rosana; MODINE, Thomas; DANGAS, George; MEHRAN, Roxana; PIEK, Jan J.; DELEWI, Ronak
    BACKGROUND: Stroke remains one of the most devastating complications of transcatheter aortic valve implantation (TAVI). The aim of this study was to identify the incidence, timing, temporal trends, and predictors of stroke after TAVI and evaluate the outcomes of patients with stroke. METHODS AND RESULTS: The CENTER-Collaboration is an international collaboration consisting of 3 national registries and 7 local registries or prospective clinical trials, selected through a systematic review. Accordingly, a total of 10 982 patients undergoing transfemoral TAVI between 2007 and 2018 were included in the current patient-level pooled analyses. A total of 261 patients (2.4%) experienced stroke during the first month after TAVI. The median time between TAVI and stroke was 1 day (interquartile range, 0-6 days). The stroke rate was comparable in procedures performed in the early years of TAVI (2007-2012) to those in the more recent years of TAVI (2013-2018; both 2.4%; P=1.0). Independent predictors of stroke at 30 days were a history of cerebrovascular events (odds ratio, 2.2; 95% CI, 1.4-3.6; P=0.0012) and a glomerular filtration rate of <30 mL/min per 1.73 m(2) (odds ratio, 1.7; 95% CI, 1.0-2.8; P=0.05). Stroke occurring within the first 30 days after TAVI was associated with a 6-fold increase of 30-day mortality (odds ratio, 6.0; 95% CI, 4.4-8.1; P<0.001). Moreover, patients with stroke more frequently had documented new-onset atrial fibrillation (16% versus 3%; P<0.001) and major or life-threatening bleedings (12% versus 7%; P=0.002) at 30-day follow-up. CONCLUSIONS: In this large, global, patient-level analysis, the incidence of stroke after transfemoral TAVI was 2.4%. Prior cerebrovascular events and a low glomerular filtration rate independently predicted the occurrence of stroke after TAVI. The occurrence of stroke after TAVI was associated with a strikingly 6-fold increase of 30-day mortality; additionally, there was a 5-fold higher rate of new-onset atrial fibrillation in patients with stroke.