ABSTRACT
A fibrilação atrial (FA) no pré-operatório de operações cardíacas abertas, incluindo revascularização cirúrgica do miocárdio (RCM) e operações valvares, representa fator de risco independente para eventos cardíacos maiores e redução de sobrevida. Devido à complexidade do assunto, principalmente na avaliação das taxas de sucesso, foi proposta recentemente uma declaração de consenso pela International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS), com o intuito de determinar se a ablação operatória da FA promove resultados clínicos favoráveis em pacientes submetidos a outras operações cardíacas na comparação com operações isoladas sem ablação. O objetivo deste trabalho é apresentar dados da literatura que possam contribuir para o consenso sobre o tratamento operatório da FA e ser utilizado como fonte de atualização. A metodologia envolveu revisão integrativa da literatura, com análise e síntese dos dados obtidos de forma descritiva, apresentando o conhecimento atual sobre o tema apresentado.
When atrial fibrillation (AF) is present in pre-operative open heart surgeries, including coronary artery bypass grafting and valve operations, it represents an independent risk factor for cardiac events and reduced survival. Due to the complexity of the subject, especially when evaluating success rates (reversion and maintenance of normal sinus rhythm), a consensus statement was recently proposed by the International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS), in order to determine whether the intraoperative ablation of AF promotes favorable clinical outcomes in patients undergoing other cardiac operations in comparison with individual operations without ablation. The aim of this paper is to present published data which has contributed to consensus statement and can be useful as update source. The integrative review was the methodology that provides synthesis of knowledge and applicability of results of significant studies about presented topic.
Subject(s)
Humans , Ablation Techniques/adverse effects , Atrial Fibrillation/surgery , Ablation Techniques/methods , Consensus Development Conferences as TopicABSTRACT
Barrett's esophagus [BE] has a malignant potential. Neither acid suppression nor anti reflux surgery produce consistent or complete regression of metaplastic epithelium. Is to determine the efficacy of endoscopic therapy in management of BE. This study was carried out on 25 patients [18 males and 7 Females], with BE that was confirmed by biopsy and histopatholoay. According to the histopathological examination, 24 patients had BE with no dysplasia or low-grade dysplasia [LGD]. Ablation of Barrett's mucosa in those patients was done using argon plasma coagulation [APC]. Also, one patient who had [BE] with high-grade dysplasia [HGD]. Ablation of Barrett's mucosa in this patient was done using EMR [endoscopic mucosal resection]. As regards APC, successful ablation was achieved with complete clearance of BE in [71%] of patients and during the follow-up period only [12%] of those patients revealed buried BE glands on histopathological examinations. Complications as self-limiting chest discomfort [25%], odynophagia [20%], and temporary dysphagia [4%] were observed during the follow-up period. As regards EMR, it was performed only in one patient who had BE with HGD. The procedure was performed using lift and cut technique. EMR in this study was successful with no complications. Argon plasma coagulation [APC] ablative therapy for [BE] proved to be safe and well tolerated, with only minor self-limiting side effects. -Endoscopic mucosal resection [EMR], in ablation of BE with HGD, is an emerging and promising technique in treatment of 4splastic and malignant lesions within BE