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Cardiac tumors are rare and encompass a variety of presentations. Clinica symptoms are usually nonspecific, but they can present as obstructive, embolic, or constitutional symptoms. Treatment options and prognosis vary highly depending on the subtype, tumor size, and location. Surgical resection is usually the first-line therapy, except for cardiac lymphomas, and provides favorable long-term prognosis in most benign tumors. Cardiac sarcomas, however, are usually diagnosed in advanced stages, and the treatment relies on a multimodal approach with chemotherapy and radiotherapy. Metastatic cardiac tumors are usually related to advanced disease and carry an overall poor prognosis.
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Terapêutica , Neoplasias Cardíacas , Sarcoma , Tratamento Farmacológico , LinfomaRESUMO
Cardiac tumors are rare and encompass a variety of presentations. Clinica symptoms are usually nonspecific, but they can present as obstructive, embolic, or constitutional symptoms. Treatment options and prognosis vary highly depending on the subtype, tumor size, and location. Surgical resection is usually the first-line therapy, except for cardiac lymphomas, and provides favorable long-term prognosis in most benign tumors. Cardiac sarcomas, however, are usually diagnosed in advanced stages, and the treatment relies on a multimodal approach with chemotherapy and radiotherapy. Metastatic cardiac tumors are usually related to advanced disease and carry an overall poor prognosis.
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Neoplasias Cardíacas , Sarcoma , Humanos , Neoplasias Cardíacas/terapia , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/diagnóstico por imagem , Sarcoma/terapia , Sarcoma/patologia , PrognósticoRESUMO
INTRODUCTION: Coarctation of the aorta (CoA) is a narrowing of the thoracic aorta that often manifests as discrete stenosis but may be tortuous or in long segment. The study aimed to evaluate pre and post-surgical aspects of pediatric patients submitted to CoA surgical correction and to identify possible predisposing factors for aortic recoarctation. METHODS: Twenty-five patients were divided into groups according to presence (N=8) or absence (N=17) of recoarctation after surgical correction of CoA and evaluated according to clinical-demographic profile, vascular characteristics via computed angiotomography (CAT), and other pathological conditions. RESULTS: Majority of males (64%), ≥ 15 days old (76%), ≥ 2.5 kg (80%). There was similarity between groups with and without recoarctation regarding sex (male: 87% vs. 53%; P=0.277), age (≥ 15 days: 62.5 vs. 82%; P=0.505), and weight (≥ 2.5 kg: 87.5 vs. 76.5; P=0,492). Altered values of aortic root/Valsalva diameter, proximal transverse arch, and distal isthmus, and normal values for aorta prevailed in preoperative CAT. Normal values for the aortic root/Valsalva sinus diameter were observed with and without recoarctation, the same for both groups regarding ascending and descending aorta in postoperative CAT. No significant difference for altered values of proximal transverse arch and alteration in distal isthmus was observed. CONCLUSION: No predictive risk for recoarctation was observed. CTA proved to be important in CoA diagnosis and management, since CoA is mainly related with altered diameter of aortic root/sinus of Valsalva and proximal and distal aortic arch/isthmus, however, it failed to show predictive risk for recoarctation.
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Coartação Aórtica , Humanos , Masculino , Criança , Recém-Nascido , Coartação Aórtica/diagnóstico por imagem , Coartação Aórtica/cirurgia , Seguimentos , Angiografia por Tomografia Computadorizada , Aorta/cirurgia , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Estudos RetrospectivosRESUMO
ABSTRACT Introduction: Coarctation of the aorta (CoA) is a narrowing of the thoracic aorta that often manifests as discrete stenosis but may be tortuous or in long segment. The study aimed to evaluate pre and post-surgical aspects of pediatric patients submitted to CoA surgical correction and to identify possible predisposing factors for aortic recoarctation. Methods: Twenty-five patients were divided into groups according to presence (N=8) or absence (N=17) of recoarctation after surgical correction of CoA and evaluated according to clinical-demographic profile, vascular characteristics via computed angiotomography (CAT), and other pathological conditions. Results: Majority of males (64%), ≥ 15 days old (76%), ≥ 2.5 kg (80%). There was similarity between groups with and without recoarctation regarding sex (male: 87% vs. 53%; P=0.277), age (≥ 15 days: 62.5 vs. 82%; P=0.505), and weight (≥ 2.5 kg: 87.5 vs. 76.5; P=0,492). Altered values of aortic root/Valsalva diameter, proximal transverse arch, and distal isthmus, and normal values for aorta prevailed in preoperative CAT. Normal values for the aortic root/Valsalva sinus diameter were observed with and without recoarctation, the same for both groups regarding ascending and descending aorta in postoperative CAT. No significant difference for altered values of proximal transverse arch and alteration in distal isthmus was observed. Conclusion: No predictive risk for recoarctation was observed. CTA proved to be important in CoA diagnosis and management, since CoA is mainly related with altered diameter of aortic root/sinus of Valsalva and proximal and distal aortic arch/isthmus, however, it failed to show predictive risk for recoarctation.
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INTRODUCTION: Since the reduction of healthcare-associated infections has been a focus for quality patient care, this study aimed to evaluate the surgical site infection rate of children who underwent cardiovascular surgery after implementation of ozonized water system for hand and body hygiene allied to previously implemented preventive measures. METHODS: Two uniformly comparable groups of pediatric patients underwent cardiovascular surgery. Group A (187) patients were operated prior to installation of ozonized water system (March 1 to August 31, 2019), and group B (214) patients were operated after installation of ozonized water system (October 1, 2019, to March 31, 2020). Ozonized water was used for professional hand hygiene and patient body hygiene. RESULTS: There was statistical significance for surgical site infection reduction in group B (P=0.0289), with a relative risk of 0.560 (95% confidence interval = 0.298 to 0.920), inferring the risk of being diagnosed with surgical site infections in group B was 44% less than in group A. There was no statistical significance regarding mechanical ventilation time (P=0.1998) or mortality (P=0.4457). CONCLUSION: Ozonized water for professional hand hygiene and patient body hygiene was an adjuvant combined with traditional preventive methods to reduce the risk of surgical site infection, although no impact on hospital stay or mortality was observed.
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Infecção Hospitalar , Infecção da Ferida Cirúrgica , Humanos , Criança , Infecção da Ferida Cirúrgica/prevenção & controle , Água , Infecção Hospitalar/prevenção & controle , Tempo de InternaçãoRESUMO
OBJECTIVES: Ventricular assist devices have been widely accepted as an alternative treatment for advanced heart failure, while heart transplantation is a limited procedure because of the shortage of donors. In face of a scarce availability of these devices, many centers around the world have developed their own technologies. The Institute Dante Pazzanese of Cardiology holds a dedicated engineering center for mechanical circulatory support, being responsible for creating several prototypes and notable devices, like the first Brazilian artificial heart. The objectives of this study were to provide both a historical overview and a detailed characterization of each original device developed by the center. METHODS: We describe historical and technical features of the main ventricular assist devices developed at the Institute Dante Pazzanese of Cardiology through a focused review on the institute's scientific and technical production on ventricular assist devices or blood pumps, from 1990 to 2022, indexed in the electronic databases Latin American and Caribbean Health Sciences Literature (LILACS), PubMed, and the Scientific Electronic Library Online (SciELO). RESULTS: The following devices were selected from the review: (1) The Spiral Pump is a disposable centrifugal pump with an internal conically shaped rotor, a spiral impeller, which carries threads on its surface. The device was designed for cardiopulmonary bypass in 1992, passed through consecutive design modifications and preclinical tests until approval for clinical application in 2007. (2) The Auxiliary Total Artificial Heart is an electromechanical pulsatile blood pump with left and right chambers, originally designed in 1995 to work as a heterotopic artificial heart. Preclinical studies evaluated hydrodynamic performance in mock circulatory loops and in vivo implants were performed in calves from 1999 to 2009. In 2012, it became the first nationally conceived artificial heart approved for clinical trials in Brazil. (3) The Implantable Centrifugal Blood Pump was conceived in 2006 for long-term circulatory assistance with a unique impeller design concept producing a mixed flow. Preclinical studies included hydrodynamic and hemolysis tests, analysis in a hybrid cardiovascular simulator and anatomical positioning in calves. (4) The Apico-Aortic Blood Pump consists of a miniaturized centrifugal pump originally conceived in 2012 for bridge to transplantation strategy. Preclinical studies included hydrodynamic and hemolysis tests, analysis in a hybrid cardiovascular simulator and anatomical positioning in pigs. (5) The Temporary Circulatory Support Device is a new centrifugal blood pump for temporary ventricular assistance developed with the purpose of bridge to decision or bridge to recovery strategies. Originally conceived in 2013, preclinical studies on the device consisted only of hydrodynamic and hemolysis tests. CONCLUSION: From the academic point of view, Brazil count on a few groups with a considerable output in ventricular assist device research and development. Notable devices produced at Institute Dante Pazzanese of Cardiology, from a total artificial heart to varied and innovative centrifugal pumps, have demonstrated excellent results for future clinical applications. More financial and institutional support are needed for the continuation of these promising research projects.
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ABSTRACT Introduction: Since the reduction of healthcare-associated infections has been a focus for quality patient care, this study aimed to evaluate the surgical site infection rate of children who underwent cardiovascular surgery after implementation of ozonized water system for hand and body hygiene allied to previously implemented preventive measures. Methods: Two uniformly comparable groups of pediatric patients underwent cardiovascular surgery. Group A (187) patients were operated prior to installation of ozonized water system (March 1 to August 31, 2019), and group B (214) patients were operated after installation of ozonized water system (October 1, 2019, to March 31, 2020). Ozonized water was used for professional hand hygiene and patient body hygiene. Results: There was statistical significance for surgical site infection reduction in group B (P=0.0289), with a relative risk of 0.560 (95% confidence interval = 0.298 to 0.920), inferring the risk of being diagnosed with surgical site infections in group B was 44% less than in group A. There was no statistical significance regarding mechanical ventilation time (P=0.1998) or mortality (P=0.4457). Conclusion: Ozonized water for professional hand hygiene and patient body hygiene was an adjuvant combined with traditional preventive methods to reduce the risk of surgical site infection, although no impact on hospital stay or mortality was observed.
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INTRODUCTION: End-to-end anastomosis and extended end-to-end anastomosis are typically used as surgical approaches to coarctation of the aorta (CoAo) with access at the subclavian artery or an interposition graft. The objective of this study is to analyze the impact of surgical and anatomical characteristics and techniques on early outcomes after surgical treatment of CoAo without cardiopulmonary bypass through left thoracotomy. METHODS: This is a quantitative, observational, and cross-sectional analysis of patients who underwent repair of CoAo between July 1, 2010 and December 31, 2017. Seventy-two patients were divided into three groups according to age: 34 in group A (≤ 30 days), 24 in group B (31 days to one year), and 14 in group C (≥ 1 year to 18 years). RESULTS: Aortic arch hypoplasia was associated in 30.8% of the cases, followed by ventricular septal defect (13.2%). The preductal location was more frequent in group A (73.5%), ductal in group B (41.7%), and postductal in group C (71.4%). Long coarcted segment was predominant in groups A and C (61.8% and 71.4%, respectively) and localized in group B (58.3%). Extended end-to-end anastomosis technique was prevalent (68%), mainly in group A (91.2%). Mortality in 30 days was 1.4%. CONCLUSION: Most of the patients were children under one year of age, and extended end-to-end anastomosis was the most used technique, secondary to arch hypoplasia. Further, overall mortality was low in spite of moderate morbidity in the first 30 postoperative days.
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Coartação Aórtica , Toracotomia , Adulto , Aorta Torácica/cirurgia , Coartação Aórtica/cirurgia , Criança , Estudos Transversais , Humanos , Lactente , Recém-Nascido , Procedimentos Cirúrgicos VascularesRESUMO
Abstract Introduction: End-to-end anastomosis and extended end-to-end anastomosis are typically used as surgical approaches to coarctation of the aorta (CoAo) with access at the subclavian artery or an interposition graft. The objective of this study is to analyze the impact of surgical and anatomical characteristics and techniques on early outcomes after surgical treatment of CoAo without cardiopulmonary bypass through left thoracotomy. Methods: This is a quantitative, observational, and cross-sectional analysis of patients who underwent repair of CoAo between July 1, 2010 and December 31, 2017. Seventy-two patients were divided into three groups according to age: 34 in group A (≤ 30 days), 24 in group B (31 days to one year), and 14 in group C (≥ 1 year to 18 years). Results: Aortic arch hypoplasia was associated in 30.8% of the cases, followed by ventricular septal defect (13.2%). The preductal location was more frequent in group A (73.5%), ductal in group B (41.7%), and postductal in group C (71.4%). Long coarcted segment was predominant in groups A and C (61.8% and 71.4%, respectively) and localized in group B (58.3%). Extended end-to-end anastomosis technique was prevalent (68%), mainly in group A (91.2%). Mortality in 30 days was 1.4%. Conclusion: Most of the patients were children under one year of age, and extended end-to-end anastomosis was the most used technique, secondary to arch hypoplasia. Further, overall mortality was low in spite of moderate morbidity in the first 30 postoperative days.
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Humanos , Recém-Nascido , Lactente , Criança , Adulto , Coartação Aórtica/cirurgia , Toracotomia , Aorta Torácica/cirurgia , Procedimentos Cirúrgicos Vasculares , Estudos TransversaisRESUMO
Abstract Clinical data: Infant, 7 months, female, referred to our department at one month of age, suspecting of congenital heart disease for further investigation. Chest radiography: Demonstrates cardiomegaly and prominent pulmonary vascular markings. Electrocardiography: Shows right ventricular hypertrophy and left anterior fascicular block. Echocardiography: Evidenced common atrioventricular valve with two orifices and the left superior pulmonary vein draining on the brachiocephalic vein. Computed tomography angiography: This complementary imaging exam was performed to confirm the diagnosis. Diagnosis: The patient presented an association between AVSD and PAPVC, a rare combination. The clinical picture of heart failure was preponderant, characterized by need for diuretics and complementary exams findings, and early surgical treatment was indicated. Operation: The operation was performed through a median sternotomy with 123 minutes of cardiopulmonary bypass and 89 minutes of cross-clamping time. The patient had no postoperative complications, remaining 10 days hospitalized.
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Humanos , Feminino , Lactente , Anormalidades Múltiplas/diagnóstico por imagem , Malformações Vasculares/diagnóstico por imagem , Cardiopatias Congênitas/diagnóstico por imagem , Comunicação Interatrial/diagnóstico por imagem , Veias Pulmonares/anormalidades , Veias Pulmonares/cirurgia , Anormalidades Múltiplas/cirurgia , Ponte Cardiopulmonar , Eletrocardiografia , Malformações Vasculares/cirurgia , Angiografia por Tomografia Computadorizada , Cardiopatias Congênitas/cirurgia , Comunicação Interatrial/cirurgiaAssuntos
Humanos , Feminino , Lactente , Tetralogia de Fallot/complicações , Tetralogia de Fallot/diagnóstico por imagem , Síndrome de Bland-White-Garland/complicações , Síndrome de Bland-White-Garland/diagnóstico por imagem , Tetralogia de Fallot/cirurgia , Ecocardiografia , Radiografia Torácica , Resultado do Tratamento , Eletrocardiografia , Síndrome de Bland-White-Garland/cirurgia , Angiografia por Tomografia ComputadorizadaRESUMO
CLINICAL DATA: Infant, 7 months, female, referred to our department at one month of age, suspecting of congenital heart disease for further investigation. CHEST RADIOGRAPHY: Demonstrates cardiomegaly and prominent pulmonary vascular markings. ELECTROCARDIOGRAPHY: Shows right ventricular hypertrophy and left anterior fascicular block. ECHOCARDIOGRAPHY: Evidenced common atrioventricular valve with two orifices and the left superior pulmonary vein draining on the brachiocephalic vein. COMPUTED TOMOGRAPHY ANGIOGRAPHY: This complementary imaging exam was performed to confirm the diagnosis. DIAGNOSIS: The patient presented an association between AVSD and PAPVC, a rare combination. The clinical picture of heart failure was preponderant, characterized by need for diuretics and complementary exams findings, and early surgical treatment was indicated. OPERATION: The operation was performed through a median sternotomy with 123 minutes of cardiopulmonary bypass and 89 minutes of cross-clamping time. The patient had no postoperative complications, remaining 10 days hospitalized.
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Anormalidades Múltiplas/diagnóstico por imagem , Cardiopatias Congênitas/diagnóstico por imagem , Comunicação Interatrial/diagnóstico por imagem , Malformações Vasculares/diagnóstico por imagem , Anormalidades Múltiplas/cirurgia , Ponte Cardiopulmonar , Angiografia por Tomografia Computadorizada , Eletrocardiografia , Feminino , Cardiopatias Congênitas/cirurgia , Comunicação Interatrial/cirurgia , Humanos , Lactente , Veias Pulmonares/anormalidades , Veias Pulmonares/cirurgia , Malformações Vasculares/cirurgiaAssuntos
Síndrome de Bland-White-Garland/complicações , Síndrome de Bland-White-Garland/diagnóstico por imagem , Tetralogia de Fallot/complicações , Tetralogia de Fallot/diagnóstico por imagem , Síndrome de Bland-White-Garland/cirurgia , Angiografia por Tomografia Computadorizada , Ecocardiografia , Eletrocardiografia , Feminino , Humanos , Lactente , Radiografia Torácica , Tetralogia de Fallot/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Aiming at fostering local development of cardiology and cardiovascular surgery centers in developing countries, the nonprofit organization Children's HeartLink (CHL) encourages centers to participate in the International Quality Improvement Collaborative Database for Congenital Heart Disease (IQIC). The definition of parameters and data to evaluate patient treatment provides an opportunity to improve quality of care, reducing morbidity and mortality. The objective of the study was to analyze the outcomes of the partnership between CHL and IQIC database with a single pediatric cardiology and cardiovascular surgery center for seven years providing continuous follow-up to guide actions aiming at morbidity and mortality reduction in patients with pediatric and congenital heart diseases. METHODS: Data were collected from January 2011 to December 2017 independently and with external audits and included preoperative information (demographic data, nutritional status, chromosomal abnormalities), Risk Adjustment for Congenital Heart Surgery (RACHS-1) score, and postoperative information such as infections or complications within the first 30 days or until hospital discharge and/or death. RESULTS: In the preoperative period, there was a trend toward an increase in the number of newborn patients. The postoperative period showed significant surgical procedure variations between groups for RACHS-1 risk category ( P = .003), prevalence of risk categories 2 and 3, and an increase in risk categories 4, 5, and 6, mainly in the last two years. Decreases in surgical site infection ( P = .03), bacterial sepsis, and other infections (both P < .001) were observed. At the 30-day postoperative follow-up, there was a decrease of in-hospital ( P = .16) and 30-day ( P = .14) mortality. CONCLUSION: The partnership between CHL and this seven-year analysis of IQIC database demonstrated structural and human flaws, whose resolution led to significant decrease in infection and reduction in mortality despite an increase in the complexity of our pediatric and congenital heart disease population.
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Procedimentos Cirúrgicos Cardíacos/normas , Cardiologia , Cardiopatias Congênitas/cirurgia , Prática Associada , Pediatria , Melhoria de Qualidade/organização & administração , Centros Cirúrgicos/normas , Adolescente , Brasil , Criança , Pré-Escolar , Bases de Dados Factuais , Países em Desenvolvimento , Feminino , Humanos , Lactente , Recém-Nascido , MasculinoRESUMO
OBJECTIVE: To analyze data related to surgical treatment in patients with congenital heart defects (CHD) and Down syndrome (DS) based on information from International Quality Improvement Collaborative Database for Congenital Heart Disease (IQIC). METHODS: Between July 1, 2010 and December 31, 2017, 139 patients with CHD and DS underwent surgery at Hospital de Base and Hospital da Criança e Maternidade de São José do Rio Preto (FUNFARME)/Faculdade de Medicina de São José do Rio Preto - SP (FAMERP). A quantitative, observational and cross-sectional study was performed in which the pre, intra and postoperative data were analyzed in an IQIC database. The data included gender, age, prematurity, weight, preoperative procedures, diagnosis, associated cardiac and non-cardiac anomalies, Risk Adjustment for Congenital Heart Surgery (RACHS-1), type of surgery, cardiopulmonary bypass (CPB), perfusion time, aortic clamping time and CPB temperature, bacterial sepsis, surgical site infection and other infections, length of stay in intensive care unit (ICU), length of hospital stay and in-hospital mortality. RESULTS: The most prevalent procedures were complete atrioventricular septal defect repair (58 - 39.45%), followed by closure of ventricular septal defect (36 - 24.49%). The RACHS-1 categories 1, 2, 3 and 4 were distributed as 22 (15%); 49 (33.3%); 72 (49%) and 4 (2.7%), respectively. There were no procedures classified as categories 5 or 6. Bacterial sepsis occurred in 10.2% of cases, surgical site infection in 6.1%, other infections in 14.3%. The median length of ICU stay was 5 days and the median length of hospital stay was 11 days. In-hospital mortality was 6.8%. CONCLUSION: Surgical treatment in patients with CHD and DS usually does not require highly complex surgical procedures, but are affected by infectious complications, resulting in a longer ICU and hospital length of stay with considerable mortality.
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Síndrome de Down , Cardiopatias Congênitas/cirurgia , Estudos Transversais , Síndrome de Down/complicações , Síndrome de Down/mortalidade , Feminino , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/mortalidade , Mortalidade Hospitalar , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Complicações Pós-Operatórias/mortalidade , Melhoria de Qualidade , Medição de Risco , Fatores de Risco , Sepse/microbiologia , Sepse/mortalidade , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/mortalidade , Resultado do TratamentoRESUMO
Abstract Objective: To analyze data related to surgical treatment in patients with congenital heart defects (CHD) and Down syndrome (DS) based on information from International Quality Improvement Collaborative Database for Congenital Heart Disease (IQIC). Methods: Between July 1, 2010 and December 31, 2017, 139 patients with CHD and DS underwent surgery at Hospital de Base and Hospital da Criança e Maternidade de São José do Rio Preto (FUNFARME)/Faculdade de Medicina de São José do Rio Preto - SP (FAMERP). A quantitative, observational and cross-sectional study was performed in which the pre, intra and postoperative data were analyzed in an IQIC database. The data included gender, age, prematurity, weight, preoperative procedures, diagnosis, associated cardiac and non-cardiac anomalies, Risk Adjustment for Congenital Heart Surgery (RACHS-1), type of surgery, cardiopulmonary bypass (CPB), perfusion time, aortic clamping time and CPB temperature, bacterial sepsis, surgical site infection and other infections, length of stay in intensive care unit (ICU), length of hospital stay and in-hospital mortality. Results: The most prevalent procedures were complete atrioventricular septal defect repair (58 - 39.45%), followed by closure of ventricular septal defect (36 - 24.49%). The RACHS-1 categories 1, 2, 3 and 4 were distributed as 22 (15%); 49 (33.3%); 72 (49%) and 4 (2.7%), respectively. There were no procedures classified as categories 5 or 6. Bacterial sepsis occurred in 10.2% of cases, surgical site infection in 6.1%, other infections in 14.3%. The median length of ICU stay was 5 days and the median length of hospital stay was 11 days. In-hospital mortality was 6.8%. Conclusion: Surgical treatment in patients with CHD and DS usually does not require highly complex surgical procedures, but are affected by infectious complications, resulting in a longer ICU and hospital length of stay with considerable mortality.
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Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Síndrome de Down/complicações , Síndrome de Down/mortalidade , Cardiopatias Congênitas/cirurgia , Complicações Pós-Operatórias/mortalidade , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/mortalidade , Recém-Nascido Prematuro , Estudos Transversais , Fatores de Risco , Resultado do Tratamento , Mortalidade Hospitalar , Sepse/microbiologia , Sepse/mortalidade , Medição de Risco , Melhoria de Qualidade , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/mortalidade , Unidades de Terapia Intensiva , Tempo de InternaçãoRESUMO
Many viruses have been associated with runting and stunting syndrome (RSS). These viral infections mainly affect young chickens, causing apathy, depression, ruffled feathers, cloacal pasting, and diarrhea. Chicken Parvovirus (ChPV) is such an infection and has been detected in chickens showing signs of enteric diseases worldwide. Therefore, the present study aims to develop a sensitive real-time fast-qPCR assay based on SYBR® Green for detection and quantification of ChPV. A 561-bp non-structural (NS) gene was amplified and cloned, and a pair of primers was designed based on conserved nucleotide sequences on the NS gene of ChPV, the intercalating DNA reagent SYBR® Green was employed, and the Fast mode of a thermocycler was used. The assay detects 108 to 10¹ copies of the genome (CG). The limit of detection (LoD) was estimated to five CG, and the limit of quantification (LoQ) was estimated at ten CG. The standard curve efficiency was 101.94%, and the melting curve showed a unique clean peak and a melting temperature of 79.3 °C. The assay was specific to amplify the ChPV NS gene, and no amplification was shown from other viral genomes or in the negative controls. A total of 141 samples were tested using the assay, of which 139 samples were found positive. The highest CG value of ChPV was 5.7 × 106 CG/uL of DNA without apparent clinical signs of enteric disturbance, and 4.6 × 106 CG/uL DNA were detected in chickens with RSS.
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A 76-year-old man with situs inversus totalis underwent a successful off-pump three-vessel coronary artery bypass surgery. The postoperative course was uneventful, and the patient was discharged 8 days later. At 9-month follow-up a coronary computed tomography angiography confirmed the viability of all of the grafts, and one year after the operation the patient remained asymptomatic. It comprises the fifth Brazilian case of a coronary surgery in a patient with situs inversus totalis and the first one of the country of a coronary artery bypass surgery without the use of the cardiopulmonary bypass in this condition.
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Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos , Dextrocardia/cirurgia , Situs Inversus/cirurgia , Idoso , Anastomose Cirúrgica/métodos , Brasil , Humanos , MasculinoRESUMO
Abstract A 76-year-old man with situs inversus totalis underwent a successful off-pump three-vessel coronary artery bypass surgery. The postoperative course was uneventful, and the patient was discharged 8 days later. At 9-month follow-up a coronary computed tomography angiography confirmed the viability of all of the grafts, and one year after the operation the patient remained asymptomatic. It comprises the fifth Brazilian case of a coronary surgery in a patient with situs inversus totalis and the first one of the country of a coronary artery bypass surgery without the use of the cardiopulmonary bypass in this condition.