Marina Saadi - Academia.edu (original) (raw)

Papers by Marina Saadi

Research paper thumbnail of OUES and mortality in heart failure: a comparison of absolute and percent-predicted values across different equations

European journal of preventive cardiology, Jun 1, 2024

Research paper thumbnail of Long-term reduced functional capacity and quality of life in hospitalized COVID-19 patients

Frontiers in medicine, Mar 6, 2024

Background: Persistent symptoms and exercise intolerance have been reported after COVID-19, even ... more Background: Persistent symptoms and exercise intolerance have been reported after COVID-19, even months after the acute disease. Although, the long-term impact on exercise capacity and health-related quality of life (HRQoL) is still unclear. Research question: To assess the long-term functional capacity and HRQoL in patients hospitalized due to COVID-19. Study design and methods: This is a prospective cohort study, conducted at two centers in Brazil, that included post-discharge COVID-19 patients and paired controls. The cohort was paired by age, sex, body mass index and comorbidities, using propensity score matching in a 1:3 ratio. Patients were eligible if signs or symptoms suggestive of COVID-19 and pulmonary involvement on chest computed tomography. All patients underwent cardiopulmonary exercise testing (CPET) and a HRQoL questionnaire (SF-36) 6 months after the COVID-19. The main outcome was the percentage of predicted peak oxygen consumption (ppVO2). Secondary outcomes included other CPET measures and HRQoL. Results: The study sample comprised 47 post-discharge COVID-19 patients and 141 healthy controls. The mean age of COVID-19 patients was 54 ± 14 years, with 19 (40%) females, and a mean body mass index of 31 kg/m 2 (SD, 6). The median follow-up was 7 months (IQR, 6.5-8.0) after hospital discharge. PpVO2 in COVID-19 patients was lower than in controls (83% vs. 95%, p = 0.002) with an effect size of 0.38 ([95%CI], 0.04-0.70). Mean peak VO2 (22 vs. 25 mL/ kg/min, p = 0.04) and OUES (2,122 vs. 2,380, p = 0.027) were also reduced in the COVID-19 patients in comparison to controls. Dysfunctional breathing (DB) was present in 51%. HRQoL was significantly reduced in post COVID patients and positively correlated to peak exercise capacity.

Research paper thumbnail of Avaliação Ecográfica Point-Of-Care De Congestão No Paciente Cardiológico

Research paper thumbnail of Teste de Exercício Cardiopulmonar em Pacientes Pós-COVID-19: Novos Insights sobre a Intolerância ao Exercício

Arquivos Brasileiros de Cardiologia

Research paper thumbnail of Totally Percutaneous Access Using Perclose Proglide for Endovascular Treatment of Aortic Diseases Abbreviations, acronyms & symbols ACT CFA CEVAR EVAR ICU PEVAR SD SEVAR SPSS TAVI TEVAR = Activated clotting time = Common femoral artery = Common femoral ar

Objective: To evaluate our experience following the introduction of a percutaneous program for en... more Objective: To evaluate our experience following the introduction of a percutaneous program for endovascular treatment of aortic diseases using Perclose Proglide® assessing efficacy, complications and identification of potential risk factors that could predict failure or major access site complications. Methods: A retrospective cohort study during a two-year period was performed. All the patients submitted to totally percutaneous endovascular repair (PEVAR) of aortic diseases and transcatheter aortic valve implantation since we started the total percutaneous approach with the preclosure technique from November 2013 to December 2015 were included in the study. The primary endpoint was major ipsilateral access complication, defined according to PEVAR trial. Results

Research paper thumbnail of Aortic Endograft Infection after Abdominal Aortic Endovascular Repair : Report of a Case Successfully Managed Conservatively

Even though aggressive surgical management is recommended for most cases of aortic endoprosthesis... more Even though aggressive surgical management is recommended for most cases of aortic endoprosthesis infection, because of the high surgical risk presented, conservative treatment should also be considered in selected cases. We present here a clinical case of a 84-year-old patient, presenting with low back pain, fever and weight loss for two months. He had undergone an endovascular infra renal aortic aneurysm repair three years ago. A computed tomography scans demonstrated bubbles inside the sac and a perianeurysmatic collection. A puncture of this collection was undertaken and the diagnosis of aortic endograft infection, caused by Propionibacterium sp, was made. The patient was successfully managed conservatively with parenteral followed by long-term oral antibiotic therapy.

Research paper thumbnail of Endovascular Treatment of a Late Complication of an Open Repair of Abdominal Aortic Aneurysm

Abdominal aortic aneurysms (AAA) are the most common type of aortic aneurysms. Traditionally it h... more Abdominal aortic aneurysms (AAA) are the most common type of aortic aneurysms. Traditionally it has been treated by open surgical repair (OSR), but in the last years endovascular repair (EVAR) became the first choice treatment in patients with suitable anatomy. Although the mortality and morbidity are lower with EVAR, late complications, such as endoleaks, remain a problem. Late complications after OSR are less frequent than after EVAR, but they still occur. We report a case of a patient with an uncommon late complication after OSR: limb occlusion of the Dacron prosthesis of an aortobifemoral bypass 14 years after. The rescue was performed by an unusual, but successful, urgent endovascular approach using intra-arterial thrombolysis with recombinant tissue plasminogen activator(r-tPA) followed by covered stents implantation in the Dacron limb prosthesis and balloon angioplasty in the origin of a previous saphenous vein femoropopliteal bypass grafting. Late complications after EVAR an...

Research paper thumbnail of Implante de válvula aórtica transcateter em bioprótese degenerada (valve in valve) : relato de caso

Research paper thumbnail of Endovascular Treatment of Coarctation of the Aorta with a Self-Expanding Endoprosthesis: How I Do It Using the Braile Dominus® Coarctation Aorta Device

Brazilian Journal of Cardiovascular Surgery, 2021

The coarctation of the aorta is a relatively highly prevalent congenital heart disease and may be... more The coarctation of the aorta is a relatively highly prevalent congenital heart disease and may be diagnosed as an underline cause of hypertension in adolescents and adults. The gold standard treatment for coarctation of the aorta in these patients is being replaced-from open surgery to endovascular therapy. Some prostheses have been developed to treat the coarctation with less acute and chronic complications. The Dominus ®

Research paper thumbnail of Sutureless Aortic Prosthesis Implantation: The First Brazilian Experience with Perceval Device

Brazilian Journal of Cardiovascular Surgery, 2016

previous thoracic surgery or chest radiation, comorbidities or overall frailty [2]. In this scena... more previous thoracic surgery or chest radiation, comorbidities or overall frailty [2]. In this scenario, transcatheter aortic valve implantation (TAVI) has assumed an important role. It was initially designed for high risk patients, but now it can be used even in moderate risk ones [Society of Thoracic Surgeons (STS) score from 4% to 8%] [3]. Nevertheless, not all patients are candidates for TAVI, some due aortic root or valve abnormalities, others because additional cardiac procedures are needed (other valve replacement, coronary artery bypass grafting or repair of the aortic root). As alternatives to these difficulties, modern sutureless aortic prostheses have emerged. Since now, the Perceval prosthesis (LivaNova Biomedica Cardio Srl, Sallugia, Italy) has been considered the device that surgeons have more expertise. Its surgical implant allows complete and safe annulus decalcification and can be performed through minimally invasive procedures. A special subgroup of patients who could benefit from this device is that with a very small annulus, that could require aortic annular enlargement during aortic valve replacement or the elderly patients with comorbidities and calcified aorta. Considering that the Perceval sutureless aortic prosthesis is the most worldwide studied and implanted valve, this report

Research paper thumbnail of A predictive score for COVID-19 diagnosis using clinical, laboratory and chest image data

The Brazilian Journal of Infectious Diseases

Research paper thumbnail of Update in Heart Rhythm Abnormalities and Indications for Pacemaker After Transcatheter Aortic Valve Implantation

Brazilian Journal of Cardiovascular Surgery

Objective: Rhythm abnormalities following transcatheter aortic valve implantation (TAVI) and indi... more Objective: Rhythm abnormalities following transcatheter aortic valve implantation (TAVI) and indications for permanent pacemaker implantation (PPI) were reviewed, which aren't well established in the current guidelines. New left bundle branch block and atrioventricular block are the most common electrocardiographic changes after TAVI. PPI incidence ranges from 9-42% for selfexpandable and 2.5-11.5% for balloon expandable devices. Not only anatomical variations in conduction system have an important role in conduction disorders, but different valve characteristics and their relationship with cardiac structures as well. Previous right bundle branch block has been confirmed as one of the most significant predictors for PPI.

Research paper thumbnail of Endovascular recanalization of occluded superior mesenteric artery using retrograde access through the inferior mesenteric artery

Journal of Vascular Surgery Cases and Innovative Techniques

Symptomatic occlusion of the superior mesenteric artery can be treated by open repair, hybrid pro... more Symptomatic occlusion of the superior mesenteric artery can be treated by open repair, hybrid procedure, or endovascular revascularization. In most cases, endovascular procedures are done by the antegrade approach. We report a case of a 67-year-old woman who presented with acute-on-chronic mesenteric ischemia successfully treated by retrograde endovascular recanalization of an occluded common hepatomesenteric trunk through the inferior mesenteric artery and arc of Riolan.

Research paper thumbnail of Totally Percutaneous Access Using Perclose Proglide for Endovascular Treatment of Aortic Diseases

Brazilian Journal of Cardiovascular Surgery, 2017

Objective: To evaluate our experience following the introduction of a percutaneous program for en... more Objective: To evaluate our experience following the introduction of a percutaneous program for endovascular treatment of aortic diseases using Perclose Proglide® assessing efficacy, complications and identification of potential risk factors that could predict failure or major access site complications. Methods: A retrospective cohort study during a two-year period was performed. All the patients submitted to totally percutaneous endovascular repair (PEVAR) of aortic diseases and transcatheter aortic valve implantation since we started the total percutaneous approach with the preclosure technique from November 2013 to December 2015 were included in the study. The primary endpoint was major ipsilateral access complication, defined according to PEVAR trial. Results: In a cohort of 123 patients, immediate technical success was obtained in 121 (98.37%) patients, with only two (0.82%) cases in 242 vascular access sites that required intervention immediately after the procedure. Pairwise comparisons revealed increased major access complication among patients with >50% common femoral artery (CFA) calcification vs. none (P=0.004) and > 50% CFA calcification vs. < 50% CFA calcification (P=0.002). Small artery diameter (<6.5 mm) also increased major access complication compared to bigger diameters (> 6.5 mm) (P=0.027). Conclusion: The preclosure technique with two Perclose Proglide® for PEVAR is safe and effective. Complications occur more often in patients with unfavorable access site anatomy and the success rate can be improved with proper patient selection.

Research paper thumbnail of OUES and mortality in heart failure: a comparison of absolute and percent-predicted values across different equations

European journal of preventive cardiology, Jun 1, 2024

Research paper thumbnail of Long-term reduced functional capacity and quality of life in hospitalized COVID-19 patients

Frontiers in medicine, Mar 6, 2024

Background: Persistent symptoms and exercise intolerance have been reported after COVID-19, even ... more Background: Persistent symptoms and exercise intolerance have been reported after COVID-19, even months after the acute disease. Although, the long-term impact on exercise capacity and health-related quality of life (HRQoL) is still unclear. Research question: To assess the long-term functional capacity and HRQoL in patients hospitalized due to COVID-19. Study design and methods: This is a prospective cohort study, conducted at two centers in Brazil, that included post-discharge COVID-19 patients and paired controls. The cohort was paired by age, sex, body mass index and comorbidities, using propensity score matching in a 1:3 ratio. Patients were eligible if signs or symptoms suggestive of COVID-19 and pulmonary involvement on chest computed tomography. All patients underwent cardiopulmonary exercise testing (CPET) and a HRQoL questionnaire (SF-36) 6 months after the COVID-19. The main outcome was the percentage of predicted peak oxygen consumption (ppVO2). Secondary outcomes included other CPET measures and HRQoL. Results: The study sample comprised 47 post-discharge COVID-19 patients and 141 healthy controls. The mean age of COVID-19 patients was 54 ± 14 years, with 19 (40%) females, and a mean body mass index of 31 kg/m 2 (SD, 6). The median follow-up was 7 months (IQR, 6.5-8.0) after hospital discharge. PpVO2 in COVID-19 patients was lower than in controls (83% vs. 95%, p = 0.002) with an effect size of 0.38 ([95%CI], 0.04-0.70). Mean peak VO2 (22 vs. 25 mL/ kg/min, p = 0.04) and OUES (2,122 vs. 2,380, p = 0.027) were also reduced in the COVID-19 patients in comparison to controls. Dysfunctional breathing (DB) was present in 51%. HRQoL was significantly reduced in post COVID patients and positively correlated to peak exercise capacity.

Research paper thumbnail of Avaliação Ecográfica Point-Of-Care De Congestão No Paciente Cardiológico

Research paper thumbnail of Teste de Exercício Cardiopulmonar em Pacientes Pós-COVID-19: Novos Insights sobre a Intolerância ao Exercício

Arquivos Brasileiros de Cardiologia

Research paper thumbnail of Totally Percutaneous Access Using Perclose Proglide for Endovascular Treatment of Aortic Diseases Abbreviations, acronyms & symbols ACT CFA CEVAR EVAR ICU PEVAR SD SEVAR SPSS TAVI TEVAR = Activated clotting time = Common femoral artery = Common femoral ar

Objective: To evaluate our experience following the introduction of a percutaneous program for en... more Objective: To evaluate our experience following the introduction of a percutaneous program for endovascular treatment of aortic diseases using Perclose Proglide® assessing efficacy, complications and identification of potential risk factors that could predict failure or major access site complications. Methods: A retrospective cohort study during a two-year period was performed. All the patients submitted to totally percutaneous endovascular repair (PEVAR) of aortic diseases and transcatheter aortic valve implantation since we started the total percutaneous approach with the preclosure technique from November 2013 to December 2015 were included in the study. The primary endpoint was major ipsilateral access complication, defined according to PEVAR trial. Results

Research paper thumbnail of Aortic Endograft Infection after Abdominal Aortic Endovascular Repair : Report of a Case Successfully Managed Conservatively

Even though aggressive surgical management is recommended for most cases of aortic endoprosthesis... more Even though aggressive surgical management is recommended for most cases of aortic endoprosthesis infection, because of the high surgical risk presented, conservative treatment should also be considered in selected cases. We present here a clinical case of a 84-year-old patient, presenting with low back pain, fever and weight loss for two months. He had undergone an endovascular infra renal aortic aneurysm repair three years ago. A computed tomography scans demonstrated bubbles inside the sac and a perianeurysmatic collection. A puncture of this collection was undertaken and the diagnosis of aortic endograft infection, caused by Propionibacterium sp, was made. The patient was successfully managed conservatively with parenteral followed by long-term oral antibiotic therapy.

Research paper thumbnail of Endovascular Treatment of a Late Complication of an Open Repair of Abdominal Aortic Aneurysm

Abdominal aortic aneurysms (AAA) are the most common type of aortic aneurysms. Traditionally it h... more Abdominal aortic aneurysms (AAA) are the most common type of aortic aneurysms. Traditionally it has been treated by open surgical repair (OSR), but in the last years endovascular repair (EVAR) became the first choice treatment in patients with suitable anatomy. Although the mortality and morbidity are lower with EVAR, late complications, such as endoleaks, remain a problem. Late complications after OSR are less frequent than after EVAR, but they still occur. We report a case of a patient with an uncommon late complication after OSR: limb occlusion of the Dacron prosthesis of an aortobifemoral bypass 14 years after. The rescue was performed by an unusual, but successful, urgent endovascular approach using intra-arterial thrombolysis with recombinant tissue plasminogen activator(r-tPA) followed by covered stents implantation in the Dacron limb prosthesis and balloon angioplasty in the origin of a previous saphenous vein femoropopliteal bypass grafting. Late complications after EVAR an...

Research paper thumbnail of Implante de válvula aórtica transcateter em bioprótese degenerada (valve in valve) : relato de caso

Research paper thumbnail of Endovascular Treatment of Coarctation of the Aorta with a Self-Expanding Endoprosthesis: How I Do It Using the Braile Dominus® Coarctation Aorta Device

Brazilian Journal of Cardiovascular Surgery, 2021

The coarctation of the aorta is a relatively highly prevalent congenital heart disease and may be... more The coarctation of the aorta is a relatively highly prevalent congenital heart disease and may be diagnosed as an underline cause of hypertension in adolescents and adults. The gold standard treatment for coarctation of the aorta in these patients is being replaced-from open surgery to endovascular therapy. Some prostheses have been developed to treat the coarctation with less acute and chronic complications. The Dominus ®

Research paper thumbnail of Sutureless Aortic Prosthesis Implantation: The First Brazilian Experience with Perceval Device

Brazilian Journal of Cardiovascular Surgery, 2016

previous thoracic surgery or chest radiation, comorbidities or overall frailty [2]. In this scena... more previous thoracic surgery or chest radiation, comorbidities or overall frailty [2]. In this scenario, transcatheter aortic valve implantation (TAVI) has assumed an important role. It was initially designed for high risk patients, but now it can be used even in moderate risk ones [Society of Thoracic Surgeons (STS) score from 4% to 8%] [3]. Nevertheless, not all patients are candidates for TAVI, some due aortic root or valve abnormalities, others because additional cardiac procedures are needed (other valve replacement, coronary artery bypass grafting or repair of the aortic root). As alternatives to these difficulties, modern sutureless aortic prostheses have emerged. Since now, the Perceval prosthesis (LivaNova Biomedica Cardio Srl, Sallugia, Italy) has been considered the device that surgeons have more expertise. Its surgical implant allows complete and safe annulus decalcification and can be performed through minimally invasive procedures. A special subgroup of patients who could benefit from this device is that with a very small annulus, that could require aortic annular enlargement during aortic valve replacement or the elderly patients with comorbidities and calcified aorta. Considering that the Perceval sutureless aortic prosthesis is the most worldwide studied and implanted valve, this report

Research paper thumbnail of A predictive score for COVID-19 diagnosis using clinical, laboratory and chest image data

The Brazilian Journal of Infectious Diseases

Research paper thumbnail of Update in Heart Rhythm Abnormalities and Indications for Pacemaker After Transcatheter Aortic Valve Implantation

Brazilian Journal of Cardiovascular Surgery

Objective: Rhythm abnormalities following transcatheter aortic valve implantation (TAVI) and indi... more Objective: Rhythm abnormalities following transcatheter aortic valve implantation (TAVI) and indications for permanent pacemaker implantation (PPI) were reviewed, which aren't well established in the current guidelines. New left bundle branch block and atrioventricular block are the most common electrocardiographic changes after TAVI. PPI incidence ranges from 9-42% for selfexpandable and 2.5-11.5% for balloon expandable devices. Not only anatomical variations in conduction system have an important role in conduction disorders, but different valve characteristics and their relationship with cardiac structures as well. Previous right bundle branch block has been confirmed as one of the most significant predictors for PPI.

Research paper thumbnail of Endovascular recanalization of occluded superior mesenteric artery using retrograde access through the inferior mesenteric artery

Journal of Vascular Surgery Cases and Innovative Techniques

Symptomatic occlusion of the superior mesenteric artery can be treated by open repair, hybrid pro... more Symptomatic occlusion of the superior mesenteric artery can be treated by open repair, hybrid procedure, or endovascular revascularization. In most cases, endovascular procedures are done by the antegrade approach. We report a case of a 67-year-old woman who presented with acute-on-chronic mesenteric ischemia successfully treated by retrograde endovascular recanalization of an occluded common hepatomesenteric trunk through the inferior mesenteric artery and arc of Riolan.

Research paper thumbnail of Totally Percutaneous Access Using Perclose Proglide for Endovascular Treatment of Aortic Diseases

Brazilian Journal of Cardiovascular Surgery, 2017

Objective: To evaluate our experience following the introduction of a percutaneous program for en... more Objective: To evaluate our experience following the introduction of a percutaneous program for endovascular treatment of aortic diseases using Perclose Proglide® assessing efficacy, complications and identification of potential risk factors that could predict failure or major access site complications. Methods: A retrospective cohort study during a two-year period was performed. All the patients submitted to totally percutaneous endovascular repair (PEVAR) of aortic diseases and transcatheter aortic valve implantation since we started the total percutaneous approach with the preclosure technique from November 2013 to December 2015 were included in the study. The primary endpoint was major ipsilateral access complication, defined according to PEVAR trial. Results: In a cohort of 123 patients, immediate technical success was obtained in 121 (98.37%) patients, with only two (0.82%) cases in 242 vascular access sites that required intervention immediately after the procedure. Pairwise comparisons revealed increased major access complication among patients with >50% common femoral artery (CFA) calcification vs. none (P=0.004) and > 50% CFA calcification vs. < 50% CFA calcification (P=0.002). Small artery diameter (<6.5 mm) also increased major access complication compared to bigger diameters (> 6.5 mm) (P=0.027). Conclusion: The preclosure technique with two Perclose Proglide® for PEVAR is safe and effective. Complications occur more often in patients with unfavorable access site anatomy and the success rate can be improved with proper patient selection.