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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 120
  • conferenceObject
    (2013) AZEKA, Estela; GALAS, Filomena; TANAMATI, Carla; PENHA, Juliano; FERNANDES, Marcos; SENAHA, Luciano; XAVIER, Johnny; DELGADO, Ana Beatriz Romani; KAJITA, Luiz; AIELLO, Vera; BENVENUTI, Luiz; MIURA, Nana; AULER JUNIOR, Jose Otavio Costa; JATENE, Marcelo
    OBJECTIVE: Heart transplantation has been the treatment of choice for children with refractory to conventional therapy. To report the experience with heart transplantation in a single center. MATERIAL AND METHODS: To report the single center experience of hearttransplantation. Data analysis was demographic characteristics, clinical outcome and survival Kaplan Meier curve. RESULTS: From October 30, 1992 to October 2nd, 2012, 120 transplants were performed and 115 patients were submitted to heart transplantation at Heart Institute (InCor) University of Sao Paulo Medical School, Sao Paulo, Brazil. The causes of indication for transplantation were: cardiomyopathies (76%) and congenital heart disease (24%). Five patients were submitted to re-transplantation. Three of them were re-transplanted on the early postoperative period with high mortality (66.6%). One patient was submitted to simultaneous re-transplantation and kidney transplantation after 13.9 yrs of follow-up and one of patient was successful re-transplanted after 10 yr of follow-up. The post-operative immunosuppression regimen was double immunosuppression and polyclonal anti-thymocyte serum induction therapy. The actuarial survival was 80%, 71%, and 61% at 1, 5, and 10 yr, respectively. CONCLUSION: Heart transplantation has been a promising option for children. The use of double immunosuppression with polyclonal anti-thymocyte serum induction therapy combined with surveillance of acute rejection with non-invasive tests may provide favorable clinical outcome.
  • article 25 Citação(ões) na Scopus
    Nomenclature for Pediatric and Congenital Cardiac Care: Unification of Clinical and Administrative Nomenclature - The 2021 International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Revision of the International Classification of Diseases (ICD-11)
    (2021) JACOBS, Jeffrey P.; FRANKLIN, Rodney C. G.; BELAND, Marie J.; SPICER, Diane E.; COLAN, Steven D.; III, Henry L. Walters; BAILLIARD, Frederique; HOUYEL, Lucile; LOUIS, James D. St.; LOPEZ, Leo; AIELLO, Vera D.; GAYNOR, J. William; KROGMANN, Otto N.; KUROSAWA, Hiromi; MARUSZEWSKI, Bohdan J.; STELLIN, Giovanni; WEINBERG, Paul Morris; JACOBS, Marshall Lewis; BORIS, Jeffrey R.; COHEN, Meryl S.; EVERETT, Allen D.; GIROUD, Jorge M.; GULESERIAN, Kristine J.; HUGHES, Marina L.; JURASZEK, Amy L.; SESLAR, Stephen P.; SHEPARD, Charles W.; SRIVASTAVA, Shubhika; COOK, Andrew C.; CRUCEAN, Adrian; HERNANDEZ, Lazaro E.; LOOMBA, Rohit S.; ROGERS, Lindsay S.; SANDERS, Stephen P.; SAVLA, Jill J.; TIERNEY, Elif Seda Selamet; TRETTER, Justin T.; WANG, Lianyi; ELLIOTT, Martin J.; MAVROUDIS, Constantine; TCHERVENKOV, Christo I.
    Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code (IPCCC) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases (ICD-11). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC. The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature . This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature. The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC, as IPCCC continues to evolve.
  • article 3 Citação(ões) na Scopus
    Morphologic and immunohistochemical features of pulmonary vasculopathy in end-stage left ventricular systolic failure
    (2018) CAMPOS, Pompeu Tome Ribeiro de; LOPES, Antonio Augusto; ISSA, Victor Sali; AIELLO, Vera Demarchi
  • article 0 Citação(ões) na Scopus
    Caso 1/2017 – Insuficiência Cardíaca Rapidamente Progressiva em Homem de 26 Anos
    (2017) MARQUES, Lais Costa; PAULA, Rogerio Silva de; CAMILO, Ivna Lobo; AIELLO, Vera Demarchi
  • conferenceObject
    Mechanical Esophageal Displacement for Esophageal Safety of Mechanical Esophageal Displacement for Esophageal Thermal Injury Prevention During Atrial Fibrillation Ablation in Swine
    (2019) PEREIRA, Renner; PISANI, Cristiano F.; AIELLO, Vera; CESTARI, Idagene A.; MOURA, Daniel; CHOKR, Muhieddine; HARDY, Carina; SISSY, Melo; SCANAVACCA, Mauricio; HACHUL, Denise
  • article 97 Citação(ões) na Scopus
    Classification of Ventricular Septal Defects for the Eleventh Iteration of the International Classification of Diseases-Striving for Consensus: A Report From the International Society for Nomenclature of Paediatric and Congenital Heart Disease
    (2018) LOPEZ, Leo; HOUYEL, Lucile; COLAN, Steven D.; ANDERSON, Robert H.; BELAND, Marie J.; AIELLO, Vera D.; BAILLIARD, Frederique; COHEN, Meryl S.; JACOBS, Jeffrey P.; KUROSAWA, Hiromi; SANDERS, Stephen P.; III, Henry L. Walters; WEINBERG, Paul M.; BORIS, Jeffrey R.; COOK, Andrew C.; CRUCEAN, Adrian; EVERETT, Allen D.; GAYNOR, J. William; GIROUD, Jorge; GULESERIAN, Kristine J.; HUGHES, Marina L.; JURASZEK, Amy L.; KROGMANN, Otto N.; MARUSZEWSKI, Bohdan J.; LOUIS, James D. St; SESLAR, Stephen P.; SPICER, Diane E.; SRIVASTAVA, Shubhika; STELLIN, Giovanni; I, Christo Tchervenkov; WANG, Lianyi; FRANKLIN, Rodney C. G.
    The definition and classification of ventricular septal defects have been fraught with controversy. The International Society for Nomenclature of Paediatric and annually for the past 9 years in an effort to unify by consensus the divergent approaches to describe ventricular septal defects. These efforts have culminated in acceptance of the classification system by the World Health Organization into the 11th Iteration of the International Classification of Diseases. The scheme to categorize a ventricular septal defect uses both its location and the structures along its borders, thereby bridging the two most popular and disparate classification approaches and providing a common language for describing each phenotype. Although the first-order terms are based on the geographic categories of central perimembranous, inlet, trabecular muscular, and outlet defects, inlet and Congenital Heart Disease is a group of international specialists in pediatric cardiology, cardiac surgery, cardiac morphology, and cardiac pathology that has met outlet defects are further characterized by descriptors that incorporate the borders of the defect, namely the perimembranous, muscular, and juxta-arterial types. The Society recognizes that it is equally valid to classify these defects by geography or borders, so the emphasis in this system is on the second-order terms that incorporate both geography and borders to describe each phenotype. The unified terminology should help the medical community describe with better precision all types of ventricular septal defects. (C) 2018 by The Society of Thoracic Surgeons
  • article 2 Citação(ões) na Scopus
    Case 4/2019-26-Year-Old Man with Congenital Chagas Disease and Heart Transplantation
    (2019) PINESI, Henrique Trombini; STRABELLI, Tania Mara Varejao; AIELLO, Vera Demarchi
  • article 0 Citação(ões) na Scopus
    Hydrophilic-coating material guidewire embolization after complex percutaneous coronary intervention: necroscopic findings
    (2019) LEMOS, Stefano G. D.; BENVENUTI, Luiz A.; AIELLO, Vera D.; NICOLAU, Jose C.; RIBEIRO, Expedito E.; RIBEIRO, Henrique B.
  • article 8 Citação(ões) na Scopus
    Parameters associated with outcome in pediatric patients with congenital heart disease and pulmonary hypertension subjected to combined vasodilator and surgical treatments
    (2019) THOMAZ, Ana Maria; KAJITA, Luiz J.; AIELLO, Vera D.; ZORZANELLI, Leina; GALAS, Filomena Regina B. G.; MACHADO, Cleide G.; BARBERO-MARCIAL, Miguel; JATENE, Marcelo B.; RABINOVITCH, Marlene; LOPES, Antonio Augusto
    Management of pediatric pulmonary hypertension associated with congenital heart disease (PHT-CHD) is challenging. Some patients have persistently elevated pulmonary artery pressure (PAP) after cardiac surgery, an undesired condition that is difficult to predict. We investigated the value of clinical, hemodynamic, and histopathological data in predicting the outcome in a prospective cohort. Patients with PHT-CHD received sildenafil orally pre- and postoperatively for six months and then were subjected to a catheter study. Thirty-three patients were enrolled (age range = 4.6-37.0 months). Pulmonary vascular resistance (PVR) was 4.9 (range = 3.9-7.2) Wood units x m(2) (median with IQR). Twenty-two patients had a >= 20% decrease in PVR and pulmonary-to-systemic vascular resistance ratio (PVR/SVR) in response to inhaled nitric oxide (NO). The response was directly related to the degree of medial hypertrophy of pulmonary arterioles (P < 0.05) (morphometric analysis, intraoperative lung biopsy). Subsequently, five of the non-responders had a >= 30% increase in pulmonary blood flow in response to sildenafil (3.0 [2.0-4.0] mg/kg/day). Six months after surgery, PAP and PVR were significantly lower (P < 0.001 vs. baseline), even in seven patients with Heath-Edwards grade III/IV pulmonary vascular lesions (P = 0.018), but still abnormal in 12 individuals (>25 mmHg and >3.0 U x m(2), respectively). A preoperative PVR/SVR of >= 24% during NO inhalation and a wall thickness of arteries accompanying respiratory bronchioli of >= 4.7 (Z score) were identified, respectively, as risk and protection factors for abnormal postoperative hemodynamics (hazard ratio [95% CI] = 1.09 [1.01-1.18], P = 0.036; and 0.69 [0.49-0.98], P = 0.040, respectively). Thus, in PHT-CHD patients receiving oral sildenafil pre- and post-surgical repair of cardiac lesions, mid-term postoperative outcome is predictable to some extent.
  • article 4 Citação(ões) na Scopus
    Atrioventricular Block Pathology in Cardiomyopathy by Desmin Deposition
    (2012) BENVENUTI, Luiz Alberto; AIELLO, Vera Dermarchi; FALCAO, Breno Alencar Araripe; LAGE, Silvia Gelas
    Generally, restrictive cardiomyopathy due to desmin deposition is characterized by restriction to ventricular diastolic filling and different degrees of atrioventricular block (AVB). In this report, we describe the pathological changes of the cardiac conduction system related to AVB. The sinus node, the compact node, and the penetrating bundle (bundle of His) had no abnormalities, however, there was extensive fibrosis of the terminal portions of the branching bundle and the beginning of the left and right bundles at the top of the ventricular septum. The pathogenesis of this fibrous replacement is probably the same that leads to extensive fibrosis of the working ventricular myocardium, and remains to be elucidated.