LEANDRO BATISTI DE FARIA
Índice h a partir de 2011
3
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
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- Surgery of the aortic root: should we go for the valve-sparing root reconstruction or the composite graft-valve replacement is still the first choice of treatment for these patients?(2015) LAMANA, Fernando de Azevedo; DIAS, Ricardo Ribeiro; DUNCAN, Jose Augusto; FARIA, Leandro Batisti de; MALBOUISSON, Luiz Marcelo Sa; BORGES, Luciano de Figueiredo; MADY, Charles; JATENE, Fabio BiscegliObjective: To compare the results of the root reconstruction with the aortic valve-sparing operation versus composite graft-valve replacement. Methods: From January 2002 to October 2013, 324 patients underwent aortic root reconstruction. They were 263 composite graft-valve replacement and 61 aortic valve-sparing operation (43 reimplantation and 18 remodeling). Twenty-six percent of the patients were NYHA functional class III and IV; 9.6% had Marfan syndrome, and 12% had bicuspid aortic valve. There was a predominance of aneurysms over dissections (81% vs. 19%), with 7% being acute dissections. The complete follow-up of 100% of the patients was performed with median follow-up time of 902 days for patients undergoing composite graft-valve replacement and 1492 for those undergoing aortic valve-sparing operation. Results: In-hospital mortality was 6.7% and 4.9%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns). During the late follow-up period, there was 0% moderate and 15.4% severe aortic regurgitation, and NYHA functional class I and II were 89.4% and 94%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns). Root reconstruction with aortic valve-sparing operation showed lower late mortality (P=0.001) and lower bleeding complications (P=0.006). There was no difference for thromboembolism, endocarditis, and need of reoperation. Conclusion: The aortic root reconstruction with preservation of the valve should be the operation being performed for presenting lower late mortality and survival free of bleeding events.
bookPart Pacientes com aneurisma de aorta(2015) FARIA, Leandro Batisti de; DIAS, Ricardo RibeirobookPart Paciente com aneurisma de aorta(2018) FARIA, Leandro Batisti de; DUNCAN, José Augusto; BRANDãO, Carlos Manuel de Almeida; DIAS, Ricardo Ribeiro- Surgical treatment of complex aneurysms and thoracic aortic dissections with the Frozen Elephant Trunk technique(2015) DIAS, Ricardo Ribeiro; DUNCAN, José Augusto; VIANNA, Diego Sarty; FARIA, Leandro Batisti de; FERNANDES, Fábio; RAMIREZ, Félix José Álvares; MADY, Charles; JATENE, Fábio BiscegliAbstract Objective: Report initial experience with the Frozen Elephant Trunk technique. Methods: From July 2009 to October 2013, Frozen Elephant Trunk technique was performed in 21 patients (66% male, mean age 56 ±11 years). They had type A aortic dissection (acute 9.6%, chronic 57.3%), type B (14.3%, all chronic) and complex aneurysms (19%). It was 9.5% of reoperations and 38% of associated procedures (25.3% miocardial revascularization, 25.3% replacement of aortic valve and 49.4% aortic valved graft). Aortic remodeling was evaluated comparing preoperative and most recent computed tomography scans. One hundred per cent of complete follow-up, mean time of 28 months. Results: In-hospital mortality of 14.2%, being 50% in acute type A aortic dissection, 8.3% in chronic type A aortic dissection, 33.3% in chronic type B aortic dissection and 0% in complex aneurysms. Mean times of cardiopulmonary bypass (152±24min), myocardial ischemia (115±31min) and selective cerebral perfusion (60±15min). Main complications were bleeding (14.2%), spinal cord injury (9.5%), stroke (4.7%), prolonged mechanical ventilation (4.7%) and acute renal failure (4.7%). The need for second-stage operation was 19%. False-lumen thrombosis was obtained in 80%. Conclusion: Frozen Elephant Trunk is a feasible technique and should be considered. The severity of the underlying disease justifies high mortality rates. The learning curve is a reality. This approach allows treatment of more than two segments at once. Nonetheless, if a second stage is made necessary, it is facilitated.
bookPart Pacientes com aneurisma de aorta(2015) FARIA, Leandro Batisti de; DIAS, Ricardo RibeirobookPart Pacientes com aneurisma de aorta(2018) FARIA, Leandro Batisti de; DUNCAN, José Augusto; BRANDãO, Carlos Manuel de Almeida; DIAS, Ricardo Ribeiro