IntroductionThe result of surgical ablation of atrial fibrillation remains controversial, although prospective and randomized studies have shown significant differences in the return to sinus rhythm in patients treated with ablation versus control group. Surgery of the Labyrinth, proposed by Cox and colleagues, is complex and increases the morbidity rate. Therefore, studies are needed to confirm the impact on clinical outcomes and quality of life of these patients.ObjectiveTo analyze the results obtained in the treatment of atrial fibrillation by surgical approach, by Gomes procedure, for mitral valve surgery in patients with rheumatic heart disease associated with chronic atrial fibrillation.MethodsWe studied 20 patients with mitral valve dysfunction of rheumatic etiology, evolving with chronic atrial fibrillation, submitted to surgical treatment of valvular dysfunction and atrial fibrillation by Gomes procedure.ResultsThe mean duration of infusion ranged from 65.8±11.22 and aortic clamping of 40.8±7.87 minutes. Of 20 patients operated, 19 (95%) patients were discharged with normal atrial heart rhythm. One (5%) patient required permanent endocardial pacing. In the postoperative follow-up of six months, 18 (90%) patients continued with regular atrial rhythm, one (5%) patient returned to atrial fibrillation and one (5%) patient continued to require endocardial pacemaker to maintain regular rhythm.ConclusionGomes procedure associated with surgical correction of mitral dysfunction simplified the surgical ablation of atrial fibrillation in patients with rheumatic mitral valve disease and persistent atrial fibrillation. The results showed that it is a safe and effective procedure.

Ectopia cordis is a rare congenital malformation, which is commonly associated with other intracardiac defects. A two-day-old full-term baby girl was admitted to Santa Casa de Misericórdia Hospital Montes Claros, NG, Brazil, with thoracic ectopia cordis. A transthoracic echocardiographic study did not identify any associated congenital heart diseases. The infant underwent surgical treatment using a rib graft to create a neo-sternum. She was discharged after presenting a good outcome on the 20 th postoperative day.Descriptors: Heart defects, congenital. Ectopia cordis. Thoracic wall, abnormalities. Infant, newborn. ResumoA ectopia cardíaca é uma má formação congênita rara, normalmente associada a outras más formações intracardíacas. Uma criança do sexo feminino com dois dias de vida, nascida a termo de uma primeira gestação sem intercorrências (G1P1A0), por parto cesariano, foi admitida na Santa Casa de Montes Claros, em Minas Gerais, apresentando ectopia cardíaca na forma torácica. O estudo ecocardiográfico transtorácico não evidenciou cardiopatia congênita associada. A paciente foi submetida a tratamento cirúrgico, utilizando enxerto de costela. Apresentou boa evolução, recebendo alta hospitalar no vigésimo dia de pós-operatório.Descritores: Cardiopatias congênitas. Ectopia cardíaca. Parede torácica, anormalidades. Recém-nascido. 246GONÇALVES, FD ET AL -Thoracic ectopia cordis with anatomically normal heart Braz J Cardiovasc Surg 2007; 22(2): 245-247

GONÇALVES, FD ET AL -Influence of tranexamic acid in postoperative bleeding of cardiac surgery with cardiopulmonary bypassRev Bras Cir Cardiovasc 2002; 17(4): 331-338 Abstract Objective: To analyze the influence of tranexamic acid in postoperative bleeding of cardiac surgery with cardiopulmonary bypass.Method: 51 patients who underwent heart surgery with cardiopulmonary bypass were randomly divided in 2 groups: Group I -control, with 12 coronary artery disease patients and 14 valve disease patients. Results: Concerning the postoperative bleeding and transfusion required, there was a statistically significant reduction in its average in valve disease patients in Group II. In coronary disease patients there was only a slight tendency. There was no significant statistical difference as far as the thromboembolic or renal complications were concerned.Conclusion: In valve disease patients, there was a reduction in bleeding and the need of transfusions of red blood cells, both of which had statistical differences. In coronary disease patients there was only a reduced tendency. The use of tranexamic acid was not related to further thromboembolic complications or renal insufficiency in the assessed groups.Descriptors: Tranexamic acid, therapeutic use. Cardiac surgical procedures. Fibrinogen