RBCCV 44205-847 Avaliação da intensidade de dor e da funcionalidade no pós-operatório recente de cirurgia cardíacaPain intensity and postoperative functional assessment after heart surgery Abstract Objective: To evaluate, in patients submitted to heart surgery, the intensity of pain and the level of functionality during the preoperative period, on the 7 th postoperative day and at hospital discharge. A secondary objective was to evaluate any possible relationship between pain and functionality taking into account the following variables: gender, age, first heart surgery or re-interventions, use of cardiopulmonary bypass (CPB), type of surgery and physiotherapeutic follow-up.Method: Forty-one patients who had undergone elective heart surgery at the Teaching Hospital of Botucatu/UNESP were studied. Pain intensity was measured using the VAS scale and functionality by the FIM scale (Functional Independence Measure) in the physical domain.Results: It was observed that the intensity of pain was higher on the 7 th postoperative day when compared with the preoperative period and at hospital discharge. No pain rating score was shown in the preoperative period, while a median pain intensity of 3 (moderate pain), was noted at hospital discharge. The highest levels of functional loss occurred on the 7 th postoperative day compared to the total scores obtained in the preoperative period and at hospital discharge. A significant correlation between pain and functionality was observed; a decrease in level of pain between the 7 th postoperative day and hospital discharge contributed to an increase in the functional levels.Conclusion: The evaluations performed in the BORGES, JBC ET AL -Pain intensity and postoperative functional assessment after heart surgery Braz J Cardiovasc Surg 2006; 21(4): 393-402

A 6-year-old female child sought medical service due to a gastrointestinal malformation. During medical follow-up, partial absence of the inferior vena cava was diagnosed, a rare congenital alteration affecting the vascular drainage from the inferior segment of the body. Imaging exams were accomplished, contributing to evaluation and description of the case. Conservative treatment with oral anticoagulant was maintained. The patient presents good evolution after long-term cardiovascular follow-up.

Fatores de risco pré-operatórios para o desenvolvimento de insuficiência renal aguda em cirurgia cardíacaPreoperative risk factors for the development of acute renal failure in cardiac surgery 34KOCHI, AC ET AL -Preoperative risk factors for the development of acute renal failure in cardiac surgery Braz J Cardiovasc Surg 2007; 22(1): 33-40

Avaliação da intensidade de dor e da funcionalidade no pós-operatório recente de cirurgia cardíaca

Background: Published data suggest that rates of thromboembolism and bleeding in patients with mechanical heart valve prostheses can be greatly reduced if anticoagulant therapy is optimized.Objectives: To evaluate the occurrence of complications in patients with mechanical prosthetic heart valves undergoing anticoagulant therapy optimized by means of specialized clinics.Methods: We studied the occurrence of complications during 10 years in 261 patients with mechanical heart valve prostheses with anticoagulation and followed up in specialized clinics. These patients were divided into two groups according to percentage of consultations with prothrombin time (INR) within the desired range: G1-0% to 50.00% and G2-50, 01% to 100% of the consultations. We evaluated the occurrence of thromboembolic complications and bleeding in their entirety or subdivided into major and minor, according to severity. The results are presented in an actuarial study and linearized frequency of occurrence of events.Results: The actuarial study showed that, over time, in G2 (with 50.01% to 100% of the consultations with INR in desired range) more patients were free of the occurrence of any event type, minor bleeding events or the accentuated increase of INR. The linearized frequency of occurrence in all event types was also lower in group G2.Conclusions: The length of stay within the desired range of anticoagulation is directly related to the occurrence of complications. However, even with optimized monitoring by specialized outpatient clinic, only about a third of patients had adequate anticoagulation level in more than half of the consultations.Keywords: Anticoagulants. Embolism and thrombosis. Hemorrhage. Heart valve prosthesis. 458CAMPOS, NLKL ET AL -Oral anticoagulation in carriers of mechanical heart valve prostheses. Experience of ten years Rev Bras Cir Cardiovasc 2010; 25(4): 457-465Resumo Introdução: Dados da literatura sugerem que as taxas de tromboembolismo e sangramento em pacientes com próteses valvares cardíacas mecânicas podem ser muito reduzidas se a terapia anticoagulante for otimizada.Objetivos: Avaliar a ocorrência de complicações em portadores de próteses valvares cardíacas mecânicas submetidos à terapêutica anticoagulante, otimizada por meio de ambulatório especializado.Métodos: Estudou-se a ocorrência de complicações ao longo de 10 anos em 261 pacientes com próteses valvares cardíacas mecânicas, anticoagulados e acompanhados em ambulatório especializado. Esses pacientes foram divididos em dois grupos conforme porcentual de consultas com tempo de protrombina (RNI) dentro do intervalo desejado: G1-0% a 50,00% e G2-50,01% a 100% das consultas. Foram avaliadas as ocorrências de complicações tromboembólicas e hemorrágicas na sua totalidade, ou subdivididas em maiores e menores, de acordo com a gravidade. Os resultados estão apresentados sob forma de estudo atuarial e de frequência linearizada de ocorrência de eventos.Resultados: O estudo atuarial mostrou que, ao longo do tempo, no grupo G2 (com 50,01% a 100% das co...