Navegando por Palavras-chave "Heart valve prosthesis"
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- ItemAcesso aberto (Open Access)Biocompatibilidade de materiais empregados na confecção de próteses cardiovasculares: comparação entre pericárdio bovino e Dacron(R)(Faculdade de Saúde Pública da Universidade de São Paulo, 1993-06-01) Pinto, Terezinha de Jesus Andreoli; Saito, Takako; Glerean, Álvaro [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)During the past 25 years, numerous studies relating to medical device biocompatibility have appedared world-wide. Development of biomaterials for grafting cardiovascular applications has contributed to an increase in knowledge of the compatibility between synthetic or biological surfaces and blood. The biocompatibility of one of the materials most commonly used in the fabrication of xenograft heart valves, bovine pericardium, treated with glutaraldehyde and formaldehyde is assessed comparison to a synthetic material, Dacron(R) tricot. An in vitro tissue culture assay, by the agar overlay method, using RC-IAL and Hela cell lines, was applied to treated pericardium and attested the intense toxicity of the treating agents. The subcutaneous grafting of treated pericardium and Dacron(R) was carried out in Wistar rats of 1 to 3 months of age. After the use of the usual histological methods, an evaluation of hematoxylin-eosin stained specimens demonstrated an absence of histocompatibility, mainly as regards for the formaldehyde treated pericardium. Comparatively, the evaluation of implanted Dacron(R) confirmed it's perfect biocompatibility. In conclusion, some improvement in xenograft heart valves is necessary, before the surgical implantation procedure takes place.
- ItemAcesso aberto (Open Access)Cirurgia de troca valvar em gestante(Sociedade Brasileira de Cirurgia Cardiovascular, 2007-12-01) Cunha, Claúdio Ribeiro Da; Santos, Paulo Cesar [UNIFESP]; Castineira, Carolina Pastorin; Pereira, Flávia Souza Fernandes; Sociedade Brasileira de Cirurgia Cardiovascular; Universidade Federal de Uberlândia; Universidade Federal de São Paulo (UNIFESP)We describe a woman with gestational age of 20 weeks, who was submitted to a complex procedure. She underwent replacement of the biological mitral and aortic valve, both by biological prosthesis, valvuloplasty of the tricuspid valve, as well as thrombectomy of the left atrium. Extracorporeal circulation (ECC) was used during 105 minutes. The patient was discharged from hospital in good health conditions and the newborn remained in the Neonatal Intensive Care Unit (NICU) in a stable state. This is a complex procedure with a high maternal and fetal mortality. Therefore, this is an important case regarding valve abnormalities treatment during pregnancy.
- ItemAcesso aberto (Open Access)Implante transcateter de bioprótese valvular pulmonar: revisão sistemática da literatura(Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista - SBHCI, 2013-06-01) Botrel, Tobias Engel Ayer; Clark, Otávio Augusto C.; Queiroga, Marcelo C.; Rossi Filho, Raul I.; Pilla, Carlo B.; Arrieta, Raul S.; Cristovão, Salvador [UNIFESP]; Silva, Célia C. [UNIFESP]; Esteves, Cesar A.; Oliveira, Edmundo Clarindo; Simões, Luiz Carlos; Chamié, Francisco; Neves, Juliana; Max, Roberto; Pedra, Carlos A. C.; Evidências - Credibilidade Científica; Hospital da Unimed João Pessoa; Fundação Universitária de Cardiologia Instituto de Cardiologia Setor de Cardiologia Intervencionista em Cardiopatias Congênitas; Complexo Hospitalar Santa Casa de Porto Alegre Serviço de Cardiologia Pediátrica e Cardiologia Intervencionista; Hospital Beneficência Portuguesa de São Paulo Setor de Intervenções em Cardiopatias Congênitas; Universidade Federal de São Paulo (UNIFESP); Instituto Dante Pazzanese de Cardiologia Seção Médica de Intervenções em Valvopatias Adquiridas; Universidade Federal de Minas Gerais Hospital de Clinicas Departamento de Cardiopatias Congênitas; Hospital Laranjeiras Instituto Nacional de Cardiologia Serviço de Cardiologia da Criança e do Adolescente; Hospital Federal dos Servidores do Estado Setor de Cardiologia Intervencionista dos Defeitos Estruturais e Congênitos; Instituto de Medicina Integral Prof. Fernando Figueira Setor de Hemodinâmica em Cardiopatias Congênitas; Hospital Biocor Departamento de Cardiologia Pediátrica Intervencionista; Instituto Dante Pazzanese de Cardiologia Seção Médica de Intervenções em Cardiopatias CongênitasSurgical repair of some complex congenital heart diseases involves reconstruction of the right ventricular outflow tract using homografts, bioprostheses, bovine jugular grafts or other valved conduits between the right ventricle and the main pulmonary artery. Although these surgical procedures may be performed with low mortality rates, the life span of these implanted valves or conduits is usually short (< 10 years) due to either degeneration and/or calcification. Variable degrees of pulmonary stenosis, often associated with pulmonary insufficiency, are consequences of conduit degeneration. In 2000, Bonhoeffer et al. were the first to report the transcatheter pulmonary valve implantation (TPVI) of a bioprosthetic pulmonary valve later named Melody® valve (Medtronic, Minneapolis, USA). The technique was initially developed to limit the need for multiple surgical procedures, and, ultimately, to work as a surrogate of a new surgical valve replacement. Subsequent clinical studies in Europe and the United States confirmed the safety and efficacy of this technique in a larger number of patients. Since the National Sanitary Surveillance Agency (Agência Nacional de Vigilância Sanitária - Anvisa) granted approval for clinical use of the Melody® transcatheter pulmonary biological valve in February 2103, we deemed that a judicious assessment of this new technology was timely and necessary before the widespread use in our country. The objective of this study was to perform a systematic literature review on the use of TPVI in patients with dysfunctional homografts, valved conduits and bioprostheses implanted surgically in the right ventricular outflow tract.
- ItemAcesso aberto (Open Access)Substituição do tronco da artéria pulmonar em carneiros utilizando heteroenxerto tubular valvado com preservação não-aldeídica(Sociedade Brasileira de Cirurgia Cardiovascular, 2012-09-01) Souza, Helmgton José Brito de [UNIFESP]; Fonseca, José Honório de Almeida Palma da [UNIFESP]; Casagrande, Ivan Sergio Joviano; Christo, Sérgio Campos; Alves-Silva, Luiz Sérgio [UNIFESP]; Almeida, Marco Antônio Cardoso de [UNIFESP]; Gaia, Diego Felipe [UNIFESP]; Buffolo, Enio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Labcor LaboratórioINTRODUCTION: The cardiac bioprostheses are related to thromboembolic events, infectious and degenerative diseases. Wear is mainly attributed to the denaturation of collagen. Glutaraldehyde, the predominant method of preservation of bioprostheses, favors the calcification process and limits their durability. Several techniques try to contain the degenerative process of bioprostheses. OBJECTIVES: To evaluate the process of calcification in vivo pulmonary valve heterografts preserved in non-aldehydic (L-Hydro®). METHODS: Seventeen sheep underwent replacement of the pulmonary artery valved tubular grafts of bovine pericardium. The animals were divided into two groups: Group L-Hydro® (test / n = 14) and Group Glutaraldehyde (control / n = 3). About 150 days after implantation the animals were sacrificed, necropsied and implants subjected to a pathological study, radiological evaluation and measurement of calcium by atomic absorption spectrophotometry. Statistical analysis was obtained through the Fisher's exact test, Student's t or Mann-Whitney test (significance: 5%). RESULTS: The radiological evaluation, the macroscopic and microscopic measurement of serum calcium by atomic absorption spectrophotometry showed increased calcification of the prosthetic group Glutaraldehyde, when compared to denture-HydroR Group L (P = 0.001). Seven animals in Group L-Hydro® (50%) had adherence of the leaflets to the wall of the tube (P = 0.228). CONCLUSIONS: Prostheses preserved in L-Hydro® were more resistant to calcification when compared with glutaraldehyde preserved.