FABIO SANDOLI DE BRITO JUNIOR

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

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  • conferenceObject
    The External Validity of Prediction Models for Contrast-Induced Nephropathy After TAVI: Insights From the Brazilian TAVI Registry.
    (2018) ROSA, Vitor E. E.; CAMPOS, Carlos M.; BACELAR, Antonio; ABIZAID, Alexandre A. C.; MANGIONE, Jose A.; LEMOS, Pedro A.; ESTEVES, Vinicius; CARAMORI, Paulo; TARASOUTCHI, Flavio; BRITO JR., Fabio S.
  • article 12 Citação(ões) na Scopus
    Papel da Avaliação Aortográfica Quantitativa da Regurgitação Aórtica por Videodensitometria na Orientação do Implante da Valva Aórtica
    (2018) MIYAZAKI, Yosuke; MODOLO, Rodrigo; ABDELGHANI, Mohammmad; TATEISHI, Hiroki; CAVALCANTE, Rafael; COLLET, Carlos; ASANO, Taku; KATAGIRI, Yuki; TENEKECIOGLU, Erhan; SARMENTO-LEITE, Rogerio; MANGIONE, Jose A.; ABIZAID, Alexandre; SOLIMAN, Osama I. I.; ONUMA, Yoshinobu; SERRUYS, Patrick W.; LEMOS, Pedro A.; JR, Fabio S. de Brito
    Background: Balloon post-dilatation (BPD) is often needed for optimizing transcatheter heart valve (THV) implantation, since paravalvular leak (PVL) after transcatheter aortic valve implantation is associated with poor outcome and mortality. Quantitative assessment of PVL severity before and after BPD is mandatory to properly assess PVL, thus improving implantation results and outcomes. Objective: To investigate a quantitative angiographic assessment of aortic regurgitation (AR) by videodensitometry before and after BPD. Methods: Videodensitometric-AR assessments (VD-AR) before and after BPD were analysed in 61 cases. Results: VD-AR decreased significantly from 24.0[18.0-30.5]% to 12.0[5.5-19.0]% (p < 0.001, a two-tailed p < 0.05 defined the statistical significance).The relative delta of VD-AR after BPD ranged from -100% (improvement)to + 40% (deterioration) and its median value was -46.2%. The frequency of improvement, no change, and deterioration were 70% (n = 43), 25% (n = 15) and 5% (n = 3), respectively. Significant AR (VD-AR > 17%) was observed in 47 patients (77%) before and in 19 patients (31%) after BPD. Conclusions: VD-AR after THV implantation provides a quantitative assessment of post-TAVI regurgitation and can help in the decision-making process on performing BPD and in determining its efficacy.
  • conferenceObject
    Impact of low-flow, low-gradient aortic stenosis in short-and long-term follow-up after TAVI: Insights from the Brazilian TAVI Registry
    (2018) ROSA, V. Emer Egypto; CAMPOS, C. M.; JATENE, T.; CARVALHO, L. A. F.; SIQUEIRA, D. A.; LEMOS, P. A.; THIAGO, L. E. K. Sao; ESTEVES, V.; TARASOUTCHI, F.; BRITO JR., F. S. De
  • article 2 Citação(ões) na Scopus
    Determinants of success and hemodynamic impact of balloon postdilatation of self-expanding transcatheter aortic valves
    (2018) ABDELGHANI, Mohammad; WINTER, Robbert J. de; MIYAZAKI, Yosuke; MODOLO, Rodrigo; TATEISHI, Hiroki; CAVALCANTE, Rafael; SARMENTO-LEITE, Rogerio; MANGIONE, Jose A.; ABIZAID, Alexandre; SOLIMAN, Osama I. I.; ONUMA, Yoshinobu; LEMOS, Pedro A.; SERRUYS, Patrick W.; BRITO JR., Fabio S. de
    Objectives To explore the rate, the determinants of success, and the hemodynamic impact of balloon postdilatation (BPD) of self-expanding transcatheter heart valves (SE-THVs) Background BPD is commonly used to optimize valve expansion and reduce paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI) without clearly knowing its hemodynamic benefits. Methods Patients (n = 307) who received a SE-THV were stratified according to whether a BPD was performed or not. Patients who received BPD were stratified according to the severity of PVL remaining after BPD into two groups: Successful BPD (<= mild PVL + BPD) and Failed BPD (moderate-severe PVL + BPD). Results BPD was performed in 121 patients (39.4%) and was successful in 106 patients (87.6% of attempts). A ratio of the postdilatation balloon diameter to the annulus diameter <= 0.95 was an independent predictor of BPD failure (OR: 10.72 [2.02-56.76], P = .005). Peak transvalvular pressure gradient (PG) was lower in the Successful BPD group (14[12-22] mm Hg) than in the Failed BPD group (18[16-23] mm Hg, P = .029), and did not rise in either group during follow-up (median [IQR], 364[161-739] days). Conclusion BPD was performed in 39% of patients who received a SE-THV, and was successful in the majority of attempts. BPD failure was more likely in patients with a small postdilatation balloon-to-annulus diameter ratio. Effective BPD improved THV hemodynamic performance, and this was maintained in the intermediate-term post-TAVI.