Volume 23 - Número 1
EDITORIAL
The role of a scientific journal
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
ORIGINAL ARTICLE
Histomorphometric differences between the left and right internal thoracic arteries in humans
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objetivo: O uso do enxerto de artéria torácica interna esquerda (ATIE) é atualmente reconhecido como a melhor opção na cirurgia de revascularização miocárdica, proporcionando menor incidência tardia de eventos cardiovasculares e maior sobrevida. Conseqüentemente, houve grande incremento nas últimas décadas do uso bilateral das artérias torácicas internas (ATIs), com demonstração de melhora adicional de sobrevida em longo-termo. O objetivo desse trabalho foi estudar a estrutura histológica das ATIs esquerda e direita (ATID), com a análise histomorfométrica seqüencial e comparativa entre os segmentos das duas artérias. Métodos: Foram estudados espécimes de ATIs retirados de 18 cadáveres, divididos em nove segmentos proporcionais. Cortes de cada segmento foram corados com técnica de hematoxilina-eosina e Verhoeff-Van Gieson. Foram analisados os seguintes parâmetros: perímetro da luz arterial, espessura da íntima, espessura da camada média e quantidade de fibras elásticas da camada média. Resultados: O perímetro interno de ambas as ATIs diminuiu ao longo do percurso, dos segmentos mais proximais para os mais distais. Os segmentos proximais da ATID apresentaram perímetro significativamente maiores do que os da ATIE. A análise da espessura da íntima revelou não existir diferença significativa entre ATIE e ATID, exceto no segmento 1. A espessura da camada média diminuiu ao longo da extensão das ATIs, não havendo diferença estatística entre elas, exceto no segmento 9. O número de lâminas elásticas nos segmentos distais da ATIE foi estatisticamente superior ao da ATID. Conclusão: Portanto, os dados do presente estudo sugerem haver diferenças estruturais entre as ATIs direita e esquerda.
Keywords: Mammary arteries; Myocardial revascularization; Histology, comparative; Humans; Cadaver
Cardiac transplantation with bicaval anastomosis and prophylactic graft tricuspid annuloplasty
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objective: This study aims to evaluate the effects of prophylactic heart donor tricuspid annuloplasty in patients after heart transplantation with bicaval anastomosis. Methods: From 2002 to 2005, 20 patients undergoing heart transplantation with bicaval anastomosis and with a survival rate over 6 months were deliberately selected. Patients were divided into two groups: Group I - 10 patients who underwent prophylactic heart donor tricuspid annuloplasty by the De Vega technique; and Group II - 10 patients did not undergo annuloplasty. In both groups, presurgical clinical characteristics were the same. The tricuspid regurgitation degree was evaluated by transthoracic Doppler echocardiography and it was qualified from 0 to 3 (0=absent, 1=mild, 2=moderated, 3=severe). Myocardial performance was evaluated by ventricular ejection fraction and invasive hemodynamic study performed during routine endomyocardial biopsies. Results: Mean clinical follow-up was 14.6±4.3 (6 and 16) months. There was only one death in group II. It was not related to annuloplasty. Mean degree of tricuspid regurgitation in Group I was 0.4±0.6 and in Group II was 1.6±0.8 (p < 0.05). There was a statistically significant difference between both groups in right atrium pressure, which was higher in Group II. Conclusions: In view of the limitations of the study, the prophylactic tricuspid annuloplasty in heart donor reduced the degree of valvar regurgitation in the medium term after heart transplantation with bicaval anastomosis, in spite of not interfering with the allograft hemodynamic performance in the period under consideration.
Keywords: Tricuspid valve insufficiency; Heart transplantation; Tissue donors; Tricuspid valve/surgery
Development of isolated swine "working heart model" with parabiotic circulation
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objective: To develop an isolated working heart model with parabiotic circulaton in swines and verify its stability and possibility to allow effective measurements of hemodinamic and metabolic data. Methods: This model was developed during study of association of agents to cardiolegia. There were performed 18 experiments, each with a support animal and a donor animal. Donor animal heart was perfused as isolated working heart with parabiotic circulation from support animal. Isolated heart underwent regional ischemia by interventricular artery clamping, followed by global ischemia. During reperfusion in working heart state mode at 30, 60 and 90 minutes, contractility indices such as elastance, preload recruitable stroke work index and metabolic data were acquired. Results: Support animals were kept stable throughout the procedures without use of blood transfusions or vasoactive drugs. pH, oxygen partial pressure and hematocrit were kept stable and within physiologic ranges. Isolated heart was perfused adequately throughout the experiment. All hemodinamic and metabolic data proposed were adequately measured in working heart state mode. Conclusion: This swine isolated "working heart" model was kept stable throughout the experiments with no administration of vasoactive drugs and it allowed adequate measurements of metabolic and hemodinamic data
Keywords: Heart/surgery; Models, animal; Swine; Cardioplegic solutions; Cardiac surgical procedures; Myocardial reperfusion/methods
Early outcome after off-pump coronary artery bypass grafting: effect on mortality and stroke
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objective: One of the major and devastating complications of the coronary artery bypass grafting (CABG) is the stroke. Avoiding cardiopulmonary bypass (CPB) may reduce this neurological complication. In the past years there was an increased interest in the off-pump coronary artery grafting (OPCAB). The benefit of this method of revascularization in term of stroke and mortality is controversially discussed. Methods: A retrospective analysis of collected data from 252 patients were operated without cardiopulmonary bypass out of 1516 CABG procedures from January 2004 through May 2006. The mean age of the patient population was 70±11years, within a range of 27-88 years. Forty-eight (19%) patients were older than 80 years and there were 172 (69%) males. Mean graft per patient was 1.78±0.79. The internal mammary artery (IMA) graft was used in 95% of the patients. For eight (3.17%) patients this was the second procedure. Results: Hospital mortality was 3.17%; Mean EuroSCORE in these patients was 10.36±6.67. No neurological complications occurred, six (2.38%) patients had temporary psycho syndrome. Postoperative myocardial infarction occurred in three (1.19%) patients. Two patients required rethoracotomy as a result of bleeding. Thirty-eight (15%) patients needed postoperative therapy for atrial fibrillation. Conclusion: CABG with OPCAB technique has the benefit of low mortality and morbidity in terms of stroke. The advantages of this technique depends on the patient's general condition at the time of the operation, the sufficiency of pump function and coronary morphology, as well as on the surgeon's experience.
Keywords: Myocardial revascularization; Coronary artery bypass/adverse effects; Cerebrovascular accident
Blood mesenchymal stem cell culture from the umbilical cord with and without Ficoll-Paque density gradient method
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objectives: Implantation of cell separation and mesenchymal stem cell culture techniques from human umbilical cord blood with and without using the Ficoll-Paque gradient density method (d=1.077g/ml). Methods: Ten samples of the umbilical cord blood obtained from full-term deliveries were submitted to two different procedures of mesenchymal stem cell culture: a) Method without the Ficoll-Paque density gradient, which concentrates all nucleated cells; b) Method with the Ficoll-Paque density gradient, which selects only low-density mononuclear cells. Cells were initially plated into 25 cm2 cultures flasks at a density of 1x107 nucleated cells/cm2 and 1x106 mononuclear cells/cm2. Results: It was obtained 2-13x107 (median = 2.35x107) nucleated cells/cm2 by the method without the Ficoll-Paque gradient density, and 3.7-15.7x106 (median = 7.2x106) mononuclear cells/cm2 by the method with the Ficoll-Paque gradient density. In all cultures adherent cells were observed 24 hours after being cultured. Cells presented fibroblastoid and epithelioid morphology. In most of the cultures, cell proliferation occurred in the first week, but after the second week only some cultures - derived from the method without the Ficoll-Paque gradient density - maintained the growth rate reaching confluence. Those cultures were submitted to trypsinization with 0.25% trypsin/EDTA solution and cultured for two to three months. Conclusion: In the samples analyzed, cell separation and mesenchymal stem cell culture techniques from human umbilical cord blood by the method without the Ficoll-Paque density gradient was more efficient than the method with the Ficoll-Paque density gradient.
Keywords: Umbilical cord blood; Mesenchymal stem cells/cytology; Cells, cultured; Cell culture techniques
The use of the vancomycin paste for sternal hemostasis and mediastinitis prophylaxis
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Introduction: Mediastinitis is one of the most feared complications for thoracic surgeons, being a significant factor in morbidity and mortality in thoracic surgery. Objective: To find a new alternative in order to prevent mediastinitis, reducing the morbidity and mortality. Methods: A retrospective study including 1020 patients operated between February 2002 and October 2005. Patients underwent bypass surgery and vancomycin paste was used rather than bone wax in all cases. Results: Patients were followed-up for 45 months; there were only five (0.49%) cases of mediastinitis; no deaths were observed. Conclusion: The use of Vancomycin paste to replace bone wax proved to be a great allied to prevent mediastinitis after thoracic surgery.
Keywords: Mediastinitis, prevention & control; Vancomycin; Cardiac surgical procedures
Off-pump myocardial revascularization in the elderly:analysis of morbidity and mortality
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objective: To analyze the in-hospital outcome of elderly patients aged 70 years and older who underwent off-pump coronary artery bypass graft surgery with an intraluminal shunt in urgent, emergent, and elective coronary revascularizations. Methods: From July 1989 to July 2005, we analyzed 87 patients ranging in age from 70 to 92 years. Of the 87 patients enrolled, 50 (57.5%) patients had unstable angina, with three (3.4%) acute myocardial infarction; thirty-one (35.6%) patients underwent urgent and emergent surgery; thirteen (14.9%) patients had myocardial infarction in less than 30 days, and 34 (39.1%) in more than 30 days. Results: The main postoperative complications were: atrial fibrillation (32.2%), heart failure (12.6%), pneumonia (10.3%), septicemia (3.4%), acute myocardial infarction (2.3%), mediastinitis (1.1%) transient ischemic attack (1.1%), and pneumothorax (1.1%). The mean extubation time was 18.50±19.09 hours, the length of stay in the intensive care unit was 2.92±2.03 days, and hospital length of stay was 10.55±7.16 days. Packed red cells were given to nine (10.34%) patients and none of them was operated due to bleeding. The in-hospital mortality was 4,6%. Conclusions: In patients over 70 years-old, elective and non-elective off-pump coronary artery bypass grafting with intracoronary shunt showed to be safe and effective, associated with low rates of postoperative complications and mortality in relation to the studied population.
Keywords: Myocardial revascularization; Aged; Coronary disease/surgery; Hospital mortality; Postoperative complications
Cell therapy plus transmyocardial laser revascularization: a proposed alternative procedure for refractory angina
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objective: We tested the hypothesis that TMLR combined with intramyocardial injection of BMC is safe, and may help increase the functional capacity of patient with refractory angina. Methods: Nine patients (eight men), 65±5 years old, with refractory angina for multivessel disease and previous myocardial revascularization procedures (CABG/PCI), not candidates for another procedure due to the extension of the disease were enrolled. TMLR (11±3 laser drills) was performed via a limited thoracotomy using a CO2 Heart Laser System. BMC were obtained immediately prior to surgery, and the lymphomonocytic fraction separated by density gradient centrifugation. During surgery, 5mL containing approximately 1.9±0.3x108 BMC were delivered by multiple injections in the ischemic myocardium. Before (B) and 6 months (6M) after the procedure, patient underwent clinical evaluation and myocardial perfusion assessment by cardiac magnetic resonance imaging (MRI) during pharmacological stress with dypiridamole. Results: No major complications or deaths occurred during the procedure. One patient died after 2 years (non cardiac cause).There was a reduction in the ischemic score as assessed by MRI from 1.64±0.10 (B) to 0.88±0.09 (6M) (P=0.01). Clinically, there was a reduction in functional class of angina from 3.7±0.2 (B) to 1.3±0.2 (6M) (P<0.0001). Conclusions: In this initial experience, the combined strategy of TMLR plus cell therapy appeared to be safe, and may have synergistically acted to reduce myocardial ischemia, with clinically relevant improvement in functional capacity. Provided these data are confirmed in a larger, randomized, controlled trial with longer follow-up, this strategy could be used as a novel therapeutic option for treating pt with refractory angina.
Keywords: Angina pectoris; Stem cells; Myocardial ischemia; Laser surgery; Myocardial revascularization; Coronary disease
Strategies to reduce the use of blood components in cardiovascular surgery
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objective: The aim of this study is to evaluate the strategies adopted by our team to reduce the use of bloods components in patients undergoing cardiovascular surgical procedures. Methods: Between October 2005 and January 2007, 101 patients were operated. Fifty-one (50.5%) were male and 50 (49.5%) female. Patients' age ranged from 13 to 80 years (mean of 50.76 years). The strategy consisted in using antifibrinolytics and normovolemic hemodilution, and reinfusion of all the blood remaining in the CPB circuit. Results: Mean use of blood components was 1.45 UI, red blood cells; 0.75 UI, fresh frozen plasma; 0.89 UI, cryoprecipitate, and 1.43 UI, platelet. Fifty-nine patients (58.4%) had not used blood components and 12 (11.9%) patients used more than 4 UI of red blood cells. In 27 patients (26.7%) whose CPB time was higher than 120 minutes, 17 (63%) needed hemotransfusion. However, 3 (2.97%) developed coagulopathy and 2 (1.98%) needed reoperation due to bleeding. Of the three patients who developed coagulopathy, two were in the elderly subgroup. Conclusion: In the presented series, the measures adopted succeeded in reducing the need of hemotransfusion in the postoperative period of thoracic surgery. Patients with CPB time higher than 120 minutes tended to need hemotransfusion. The association of surgery in elderly patients and CPB time over 120 minutes resulted in significantly greater use of blood components postoperatively.
Keywords: Blood transfusion; Blood component transfusion; Hemodilution; Hemorrhage; Preoperative care; Reoperation; Antifibrinolytic agent
IV Pulmonary trunk reversible banding:analysis of right ventricle acute hypertrophy in an intermittent loading experimental model
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objectives: Adjustable pulmonary trunk (PT) banding device may induce a more physiologic ventricle retraining for the two-stage Jatene operation. This experimental study evaluates the acute hypertrophy (96 hours) of the right ventricle (RV) submitted to an intermittent pressure overload. Methods: Five groups of seven young goats were distributed according to RV intermittent systolic overload duration (0, 24, 48, 72 and 96 hours). The zero-hour group served as a control group. Echocardiographic and hemodynamic evaluations were performed daily. After completing the training program for each group, the animals were sacrificed for water content and cardiac masses evaluation. Results: There was a significant increase in RV free wall thickness starting with the 48-hour group (p<0.05). However, a decreased RV ejection fraction, associated with an important RV dilation and a significant increase in the RV volume to mass ratio was observed at 24-hour training period, when compared to 96-hour period (p=0.003), with subsequent recovery throughout the protocol. A 104.7% increase in RV mass was observed in the 96-hour group, as compared to the control group, with no differences in water content between these two groups. The daily mean increase in RV mass during the study period was 21.6% ± 26.8%. The rate of RV mass acquisition for the overall study period of intermittent systolic overload was 0.084 g/h ± 0.035 g/h. Conclusion: Intermittent PT banding has allowed a significant RV mass acquisition in the 96-hour trained group. No myocardial water content changes were observed in this group, suggesting an increased myocardial protein synthesis.
Keywords: Heart ventricles/physiopathology; Hypertrophy/physiopathology; Right ventricular hypertrophy; Transposition of great vessels/surgery; Cardiac surgical procedures/methods; Goats
Aortic arch surgery with bilateral cerebral perfusion by isolation of brachiocephalic trunk and left carotid artery
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objective: To evaluate the results of a technique described by Carreira et al. using bilateral antegrade selective cerebral perfusion by isolating the brachiocephalic trunk and the left carotid artery. Methods: Fifteen patients were operated between June 2005 and September 2007. Data analysis were performed using Epi Info and statistical significance was set at p<0.05. Results: Of the 15 patients, 53.3% were male; mean age was 59.86±15.4 years; 60% presented with type A acute aortic dissection; 6.7% type B; and 33.3% aneurysm of aorta and arch. Mean CPB and aortic clamping time was 177.6±39.4 and 135.9±34.0 minutes, respectively. In this group, 86.7% were not submitted to total circulatory arrest, with mean unilateral and bilateral selective cerebral perfusion time of 10.9±2.0 and 57.2±21.2 minutes, respectively. Mean hypothermic temperature was 23.0±2.9ºC. Two had left subclavian artery ligature, 60% used separated aortic grafts, and four used aortic endoprosthesis. Three (20%) patients died, all of them in the acute aortic dissection group. There were no neurological complications. The mean follow up time was 11.7±9.6 months. Regarding mortality, none of the parameters were statistically significant (p>0.05). Conclusion: The technique of bilateral selective cerebral perfusion described by Carreira et al. can be performed by others and presents similar results to the international literature. The excellent neurological outcome and easy bleeding control on surgical sutures lines are the major advantages of this new procedure.
Keywords: Cardiac surgical procedures; Hypothermia; Thoracic aorta/surgery; Aortic aneurysm; Brachiocephalic trunk; Carotid arteries
REVIEW ARTICLE
Adult cardiopulmonary bypass in the twentieth century one. Science, art or empiricism?
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
The aim of the present review is to highlight some less discussed aspects of the cardiopulmonary bypass (CPB), taking into consideration the physiology, physiopathology, and some new technologies of perfusion. Thus, some points, to a certain extent philosophical, have motivated this revision: a) To preserve and update the surgeon knowledge regarding CPB, even to keep his/her pedagogical leadership on his/her surgical team; b) To question if elderly and diabetic patients, as a result of their individual characteristics deserve more appropriate protocols similar to those adopted for children; c) One third aspect would be the questioning of the systemic inflammatory reaction caused by the blood exposure to CPB non-endothelized circuit surface, in face of the increasing importance of blood contact with the surgical wound; d) In relation to the treatment of the vasoplegic syndrome, methylene blue continues being the best therapeutical option, even so, many times are not efficient on account of a highly probable existence of a "therapeutical window" based on the guanylate cyclase dynamics of action (saturation and synthesis "de novo") and; finally, e) The reason of the title, highlighting that based on its current patterns, would the CPB be an outcome of empiricism, art, or science? The bottom line of this article carries the certainty of that as much as the empiricism, art, and science are highly related to CPB.
Keywords: Extracorporeal circulation; Cardiopulmonary bypass; Cardiac surgical procedures
Percutaneous aortic aortic valve replacement: myth or reality?
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Aortic valve replacement with mechanical or biological prosthesis with extracorporeal circulation is the gold-standard for the treatment of calcific aortic stenosis. Although the results are excellent with the conventional approach some elderly patients, with multiple high-risk comorbid conditions, reoperations and severe left ventricular dysfunction have high surgical risk. During the last years percutaneous techniques have been developed. The present study aim to analyse the literature, since the experimental development untill clinical application of this novel treatment in patients with high surgical risk aortic stenosis. Percutaneous implantation of aortic valve prosthesis is beeing done in some centers and the cardiovascular surgeon that treats valve disease should be involved in this development.
Keywords: Aortic valve stenosis; Aortic valve; Stents
Myocardial protection to the hypertrophied heart: the eternal challenge
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
The myocardial protection allowed great advance in cardiac surgery, decreasing the mortality and making more feasible complex surgeries. Latterly, the patient population elected for cardiac procedures has been changing towards elderly patients with ventricular function depressed and myocardial hypertrophy. The myocardial hypertrophy condition represents a great challenge since the beginning of the cardiac surgery. Several techniques have been described to protect the myocardial hypertrophy, however with no satisfactory results. In this manuscript we present the state of the art technique of myocardial protection.
Keywords: Cardioplegic solutions; Hypertrophy, left ventricular; Hypertrophy, right ventricular; Heart arrest, induced/methods
SPECIAL ARTICLE
Redering of accounts
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Project of international cooperation in pediatric heart surgery. Actors: National Institute of Cardiology (INC) and Republic Islamic Algerian
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
EXPERIENCE THE OF SERVICE
Radial artery harvesting technique without hemostatic clips and clinical experience
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objective: The various techniques of radial artery (RA) harvesting produce similar results. These techniques use electrocautery, ultrasonic scalpel, or sharp scissors in different combinations, but usually associated with the use of hemostatic clips. We describe a RA harvesting technique with the combination of sharp scissors and electrocautery without the use of hemostatic clips. Methods: We describe a retrospective study of 107 patients ranging from 28 and 78 years of age (mean ± SD; 53.3 ± 8 yrs). Bleeding, re-operation, infarct, and death were analyzed. Results: No bleeding was imputable to the RA and no re-operations were required. There were three (2.8%) infarcts possibly related to the RA anastomosis territory. Mortality was 0.9%, but unrelated to cardiac complications. Conclusion: RA electrocautery harvesting without hemostatic clips presented no bleeding and was an inexpensive procedure, requiring no investments in additional equipment.
Keywords: Radial artery; Myocardial revascularization; Myocardial ischemia; Coronary disease
Surgical ablation of atrial fibrillation using radiofrequency
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Objective: To evaluate the effectiveness of intraoperative atrial fibrillation ablation using radiofrequency during mitral valve procedure. This report describes the early and midterms results. Methods: Between September 2003 and September 2005, 15 patients with mitral disease were operated. All patients were in cronic atrial fibrillation and with congestive symptoms despite full medication. The patients were analysed according to clinical criteria, electrical and echocardiographic findings. Results: There were no hospital mortality or complications related to radiofrequency ablation. The mean follow-up period was 12.16 ± 10.29 months. All patients left operating room in sinus rhythm, however, before hospital discharge, only nine (60%) were in regular cardiac rhythm. During follow-up, two patients presented atrial fibrillation recurrence and currently seven (46.7%) keep sinus rhythm. Conclusion: Despite low morbimortality related to the procedure, initial results in this report showed a less effectiveness of this technique when compared with other papers.
Keywords: Catheter ablation; Atrial fibrillation/therapy; Cardiac surgical procedures; Mitral valve, surgery
CASE REPORT
Intrapericardic surgical treatment of teratoma in infant
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
The intrapericardic cardiac tumors are infrequent; however, the clinical manifestations can be serious, even with symptoms of low cardiac output or cardiogenic shock, depending on the localization of the tumor. We report the case of a 3-month-old infant who progressed to cardiogenic shock due to an intrapericardic tumor compressing the right atrium and the vena cava superior. Emergent surgery for resection of the tumor mass was recommended. The patient had a 6-month uneventful postoperative course.
Keywords: Cardiogenic shock; Infant; Heart neoplasms; Cardiac surgical procedures
Coronary aneurysm after drug-eluting stent implantation
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
The use of drug-eluting stents aiming at by-pass the disadvantage of stainless steel stents have been associated to late thrombosis after withdrawal of anti-platelet agents. We report a case with another complication, the development of a coronary aneurysm in the stent area more than three years after index procedure. Late chronic local inflammatory responses may be responsible for the weakening, erosion and aneusrysm formation.
Keywords: Stents/adverse effects; Coronary aneurysm; Cardiac surgical procedures
Bilateral ostial coronary lesion in cardiovascular syphilis: case report
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Syphilis is an infectious disease occurring through a series of frequently overlapping stages. It can impair the cardiovascular and neurological system. In 30% of the non treated patients, syphilis develops your tertiary form. We report a case of a 46-year-old male patient admitted due to edema pulmonary and acute coronary syndrome with left bundle branch block, submitted to fibrinolytic therapy successfully. Coronary angiography showed a 90% ostial lesion of left main coronary artery and occlusion of the right coronary artery ostium. VDRL was titrated to 1/128. The patient was undergone to CABG and was discharged after treatment with crystalline penicillin.
Keywords: Sífilis cardiovascular; Aortite; Coronariopatia; Edema pulmonar; Infarto do miocárdio
Right atrium myxoid chondrosarcoma
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
We report a case of a 46 years-old woman, Caucasian, with hypertension and a primary dianosis of infectious endocarditis. A transthoracic echocardiogram was performed suggesting right atrium myxoma. The patient was submitted to surgery, which found a tumor mass with a jelly-like exterior. The mass was sent to anatomo-pathological analysis which diagnosed a myxoid chondrosarcoma tumor. After surgical resection, the patient achieved complete recovery with no signs of recidivation after 14 months.
Keywords: Heart neoplasms; Heart atria/surgery; Chondrosarcoma
Agenesis of the right superior vena cava associated with total heart block
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
The superior left vena cava with the absent superior vena cava is a rare abnormality, especially when associated with total heart block. We report a case of a patient in which the presence of superior left vena cava and the absence of the superior vena cava was detected during the implantation of a pacemaker for the correction of a total heart block, which led us to use a different technique for the fixation of the ventricular electrode. To confirm the supposed absence, several image exams were made showing the difficulty on the diagnosis of the described syndrome.
Keywords: Venae cavae; Heart block; Pacemaker, artificial
CLINICAL-SURGICAL CORRELATION
Solitary fibrous tumor in a child's heart
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
Right ventricle and tricuspid valve myxoma
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
HISTORIC ARTICLE
Cardiopulmonary and Heart transplantation: 100 years of history and 40 years of existence
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
SPECIAL
Ethic corporativism
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025
LETTERS TO THE EDITOR
Letters to the Editor
Braz J Cardiovasc Surg 23;
Publish in: 8/2/2025