Objectives: Recent experimental flow studies based on angiography and magnetic resonance have shown that total cavopulmonary anastomosis (TCPA) is a valid concept for surgical treatment of many congenital heart defects, but there is not agreement of the best surgical arrangement. The aim of this study is to assess the immediate results with three different techniques of TCPA.Methods: Clinical study of all TCPA performed from January 2005 to July 2008; there were 40 patients, all with previous Glenn anastomosis, with mean age of 6.4 ± 3.2 years. Three different techniques were employed: Group 1 (G1) lateral tunnel, Group 2 (G2) extracardiac conduits, Group 3 (G3) intracardiac conduit directed to the left pulmonary branch. All patients had a fenestration performed and pre-and postoperative variables were assessed.Results: G1 had 11 patients, G2 10 patients and G3 19 patients. Preoperative variables were similar in the 3 groups (P>0.05). Surgical mortality was higher in Groups 1 and 2 (9.1% and 10%) compared to Group 3 (0%) but there was no statistical significance (P=0.3841). Pleural effusion was absent in Group 3 (0%), which was statistically significant in relation to the other groups (P=0.0128). The length of hospital stay was also significantly lower in G3 (8 days) in relation to G1 (18 days) and G2 (13 days) (P=0.0164). Conclusion:Intracardiac TCPA was associated with lower postoperative morbidity and is currently our preferred technique on total cavopulmonary anastomosis. Rev Bras Cir Cardiovasc 2009; 24(4): 463-469 technique in which a olytetrafluoroethylene (PTFE) conduit is placed between the inferior vena cava and pulmonary artery, through the right atrium via the foramen ovale into the left atrium roof, where it is exteriorized and sutured to the trunk or left pulmonary artery branch. This technique allowed to reach the left pulmonary artery branch with a prosthesis smaller, with fewer curves and angles, thus minimizing the presence of inflexible material in the system. The aim of this study was to review the immediate results of patients undergoing the Fontan operation at a single institution with three models of total cavopulmonary anastomosis. FANTINI, FA ET AL -Fontan operation: a technique in evolution METHODS Study designWe performed clinical trial with 40 patients with univentricular physiology undergoing the Fontan operation in Biocor Institute,

The use of colloids represented here by modified fluid gelatin associated with crystalloids or the use of crystalloids alone did not change the postoperative prognosis of patients undergoing SMR without CPB. Perhaps maintenance of the hemodynamic balance during the surgery is more important than the type of fluid administered.

No abstract

Congenital mitral valve stenosis is a rare and severe disease, usually associated with other heart defects. The appropriate intervention depends on the site and mechanism of valvular obstruction and the aim is to avoid or delay valve replacement since it is associated with significant morbidity and mortality. Early single-stage complete repair is associated with better prognosis.We report the case of a 20-month-old child with a supravalvar mitral ring combined with a ventricular septal defect; pulmonary arterial systolic pressure before the surgery was 79 mmHg. The patient underwent a successful surgical repair with good clinical resolution.

Results: Among 13.3 million MEDLINE records identified during the study period, 0.35% of publications discussed AI. The frequency of AI publications in MEDLINE increased by 190% during the study period, from 0.16% in 2000 to 0.47% in 2016 (Fig). In 2016, the percentage of AI-related papers by therapeutic area was 0.49% for neurology, 0.32% for oncology, 0.31% for ischemic heart disease, and 0.18% for vascular disease. The increase in AI-related publications during the 17-year evaluation period was 451% for neurology, 306% for ischemic heart disease, 222% for oncology, and 147% for vascular disease.Conclusions: Utilization of AI for medical applications is growing rapidly. However, AI appears to be under-reported in vascular disease management. Future investigations will be needed for development of AI vascular disease applications including data digitization and data exchange and acquisition.