Introduction Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015. Objective To analyze the profile, risk factors and outcomes of patients undergoing CABG in Brazil, as well as to examine the predominant surgical strategy, based on the data included in the BYPASS Registry. Methods A cross-sectional study of 2292 patients undergoing CABG surgery and cataloged in the BYPASS Registry up to November 2018. Demographic data, clinical presentation, operative variables, and postoperative hospital outcomes were analyzed. Results Patients referred to CABG in Brazil are predominantly male (71%), with prior myocardial infarction in 41.1% of cases, diabetes in 42.5%, and ejection fraction lower than 40% in 9.7%. The Heart Team indicated surgery in 32.9% of the cases. Most of the patients underwent cardiopulmonary bypass (87%), and cardioplegia was the strategy of myocardial protection chosen in 95.2% of the cases. The left internal thoracic artery was used as a graft in 91% of the cases; the right internal thoracic artery, in 5.6%; and the radial artery in 1.1%. The saphenous vein graft was used in 84.1% of the patients, being the only graft employed in 7.7% of the patients. The median number of coronary vessels treated was 3. Operative mortality was 2.8%, and the incidence of cerebrovascular accident was 1.2%. Conclusion CABG data in Brazil provided by the BYPASS Registry analysis are representative of our national reality and practice. This database constitutes an important reference for indications and comparisons of therapeutic procedures, as well as to propose subsequent models to improve patient safety and the quality of surgical practice in the country.
ObjectiveTo report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients.MethodsData collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1). The study population consists of patients over 18 years of age, and the types of operations recorded were: coronary artery bypass graft (CABG), mitral valve, aortic valve (either conventional or transcatheter), surgical correction of atrial fibrillation, cardiac transplantation, mechanical circulatory support and congenital heart diseases in adults.Results83.1% of patients came from the public health system (SUS), 9.6% from the supplemental (private insurance) healthcare systems; and 7.3% from private (out-of -pocket) clinic. Male patients comprised 66%, 30% were diabetics, 46% had dyslipidemia, 28% previously sustained a myocardial infarction, and 9.4% underwent prior cardiovascular surgery. Patients underwent coronary artery bypass surgery were 54.1% and 31.5% to valve surgery, either isolated or combined. The overall postoperative mortality up to the 7th postoperative day was 4%; for CABG was 2.6%, and for valve operations, 4.4%.ConclusionThis first report outlines the consecution of the Brazilian surgical cardiac database, intended to serve primarily as a tool for providing information for clinical improvement and patient safety and constitute a basis for production of research protocols.
Este trabalho objetiva determinar a prevalência de eventos tromboembólicos em mulheres em idade fértil em clínica privada, verificar uso de anticoncepcionais hormonais nesse grupo e identificar concomitância com outros fatores de risco. Estudo descritivo, retrospectivo transversal realizado no Hospital do Coração, Aracaju, Sergipe, a partir análise dos prontuários, complementado com entrevista de pacientes do sexo feminino entre 12 e 45 anos, admitidas no hospital com evento tromboembólico confirmado entre janeiro de 2004 e novembro de 2016. Analisados 6684 prontuários com amostra final de 24 mulheres. A prevalência de eventos foi de 46,37/10.000, com IC 95% de 30/10.000 a 60/10.000. Das 24 participantes, 9 (37,5%) faziam uso de contraceptivo hormonal, sendo a maioria do tipo oral, 8 (88,8%), e por duração maior que 10 anos, 5 (55,5%). Não se observou diferença na distribuição do número de fatores de risco associados ao tromboembolismo no grupo que usou contraceptivo em relação ao grupo que não usou (p=0,48). A prevalência de eventos tromboembólicos em mulheres em idade fértil é baixa, com maior ocorrência dos tromboembolismos venosos. O anticoncepcional não representou fator de risco isolado quando associado a outros fatores de risco nessas mulheres.
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