Background: Studies have reported varied prevalence estimates of coronary artery disease (CAD) in cardiac myxoma patients. We performed a systematic review and meta-analysis of observational studies to summarize the point prevalence of CAD in adults with cardiac myxomas. Methods and Results: Two independent investigators searched MEDLINE and LILACS databases using the terms " Myxoma”, " Coronary Angiography" and " Coronary Disease" from inception through December 2014 for all relevant studies. We included 6 observational studies. Publication bias was evaluated through Egger's test and Trim and Fill method. A pooled estimate of CAD prevalence with corresponding 95% confidence interval (CI) was calculated based on a random-effects model. The pooled CAD prevalence in adult cardiac myxoma patients was 20.7% with low heterogeneity (I 2 = 14.86%). Conclusions: It is a matter of debate if preoperative coronary angiography must be done as a routine procedure. Although coronary disease and angiographically detectable neovascularity can alter surgical management, more studies are needed to evaluate this question.

RESUMOA hiperplasia intimal é definida como uma resposta exacerbada à reepitelização de células musculares lisas e matrizes extracelulares no compartimento da íntima que ocorre entre 4-6 semanas de pós-operatório estendendo-se até um ano após o ato cirúrgico. Esse processo parece estar relacionado com a isquemia transitória do enxerto após a retirada do seu habitat natural, reperfusão e estresse na parede do vaso após o implante na circulação coronária. O local mais acometido pela hiperplasia intimal é ao nível das anastomoses. Objetivo: Este estudo objetiva relatar o caso de uma paciente de 67 anos admitida no Hospital São José do Avaí com Síndrome Coronariana Aguda após falha de enxertos por hiperplasia intimal três meses após a revascularização do miocárdio e propor uma alternativa rápida, eficaz e menos invasiva para condição clínica abordada. Materiais e Métodos: este estudo será do tipo relato de caso realizado através de entrevista com a paciente, análise do prontuário, revisão dos exames complementares e levantamento bibliográfico em livros e periódicos médicos relevantes relacionados ao tema. Resultados: Paciente recebeu alta da Unidade de Terapia Intensiva 5 dias após intervenção hemodinâmica percutânea, sem dependência de dispositivos de assistência circulatória ou aminas vasoativas com posterior alta domiciliar em classe funcional I. Conclusão: a intervenção coronária percutânea com stent farmacológico aparece como uma opção eficaz, segura e com boas taxas de sucesso para os casos de Síndrome Coronariana Aguda por falha de enxertos por hiperplasia intimal.Palavras chave: Hiperplasia Intimal; Revascularização do Miocárdio; Síndrome Coronariana Aguda; Intervenção coronária percutânea; Enxertos arteriais e venosos. ABSTRACTIntimal hyperplasia is defined as an exacerbated response to reepithelialization of smooth muscle cells and extracellular matrices in the intimal compartment that occurs 4-6 weeks postoperatively, extending up to one year after the surgical procedure. This process appears to be related to transient ischemia of the graft after removal of its natural habitat, reperfusion and stress on the vessel wall after implantation into the coronary circulation. The site most affected by intimal hyperplasia is at the level of anastomoses. Objective: This study aims to report the case of a 67-year-old patient admitted to Hospital São José do Avaí with Acute Coronary Syndrome after intimal hyperplasia graft failure three months after myocardial revascularization and propose a quick, effective and less invasive alternative to the clinical condition addressed. Materials and Methods: this study will be of the case report type carried out through an interview with the patient, analysis of the medical record, revision of the

Background: Chronic total occlusion is the subtype of lesions with the lowest procedural success rates, as well as the most common cause of incomplete revascularization and coronary artery bypass grafting. Their recanalization requires advanced techniques, dedicated materials, skilled operators and, usually, double arterial access, which makes the procedure more complex, increasing the chance of complications. Our goal is to characterize the most frequent complications in percutaneous treatment of chronic total occlusions in contemporary practice. Methods: We searched the PubMed/MEDLINE databases using the keywords "coronary chronic total occlusion", "complications" and "angioplasty". We followed the PRISMA recommendations. Results: Of a total of 430 references initially reviewed, 6 met the inclusion and exclusion criteria of the analysis, and accounted for the final sample. The procedural success rate was high, between 76% and 96%. The most commonly reported complications were periprocedural myocardial injury (8.6%), vascular access-related complications (2.5%), and cardiac tamponade secondary to coronary perforations (1.3%). Conclusion: Percutaneous treatment of chronic total occlusions creates a challenging scenario, with a high potential for complications. Patient selection must be focused on the anticipated benefits, and operators must be properly trained and capable of successfully conducting the procedure, recognizing and preventing potential procedural adverse events, and managing them when needed.

An 85-year-old patient with multiple comorbidities presents with severe symptomatic aortic stenosis and concomitant infrarenal abdominal aortic aneurysm with 100mm in diameter. A transcatheter aortic valve replacement was done along with concomitant percutaneous repair of the aneurysm. The therapeutic strategy was initially to implant the transcatheter aortic valve prosthesis, and then to perform the implantation of the aortic bifurcated endograft, with extensions to the right and to the left, to exclude a large fusiform aneurysm, due to the high risk of rupture with the hemodynamic changes after aortic bioprosthesis implant. The procedure was performed without complications, and the patient was discharged from hospital after 4 days, with no alterations in renal function, minimal paravalvular regurgitation, and no endoleak at the exclusion of the abdominal aneurysm.