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Papers by robinson poffo

ABC Heart Failure & Cardiomyopathy, 2021

To report the first CHLT in Brazil, performed in a patient with ATTR with a mixed phenotype, in t... more To report the first CHLT in Brazil, performed in a patient with ATTR with a mixed phenotype, in the context of cardiogenic shock, who, as an additional risk factor, had HLA hypersensitivity.

Journal of Heart and Lung Transplantation, Apr 1, 2016

Between January and June 2015, the project provided CME-accredited education about organ donation... more Between January and June 2015, the project provided CME-accredited education about organ donation for physician office staff in 122 randomized participating clinics across Western Pennsylvania and West Virginia. This included online and in-person training (lunch and learns) to over 1,500 PCP office staff participants as well as PCP office kits that included tabletop posters, brochures and office forms which included a survey and designation form. Results: Over 21,000 patient-completed organ donation survey forms were collected. About half of all participants were already registered organ donors. 764 (8.1%) completed the designation form and became registered organ donors upon receiving information from this pilot project. Due to the program's success, both Organ Procurement Organizations in Pennsylvania (CORE and Gift of Life) have committed to funding the program as a statewide initiative, to be launched in January 2016. Conclusion: Unique initiatives like the PSL project can help create awareness amongst people regarding the critical value of organ donation.

ABC: Heart Failure & Cardiomyopathy, 2021

To report the first CHLT in Brazil, performed in a patient with ATTR with a mixed phenotype, in t... more To report the first CHLT in Brazil, performed in a patient with ATTR with a mixed phenotype, in the context of cardiogenic shock, who, as an additional risk factor, had HLA hypersensitivity.

JTCVS Techniques, Nov 30, 2023

Arquivos Brasileiros De Cardiologia, 2016

Brazilian Journal of Cardiovascular Surgery, 2022

Annals of Cardiothoracic Surgery

Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular, 2009

Trabalho realizado no Hospital Israelita Albert Einstein – Sao Paulo– SP e no Hospital Hans Diete... more Trabalho realizado no Hospital Israelita Albert Einstein – Sao Paulo– SP e no Hospital Hans Dieter Schmidt – Joinville – SC1. Coordenador do Programa de Cirurgia Cardiaca MinimamenteInvasiva do Hospital Israelita Albert Einstein – Sao Paulo – SP.Coordenador do Servico de Cirurgia Cardiaca do Hospital HansDieter Schmidt – Joinville – SC.Mestre em Clinica Cirurgica pela Universidade Federal do Parana.

Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular, 2009

CARACTERIZACAO DO PACIENTEPaciente do sexo masculino, 42 anos, caucasiano epesando 92 kg. A histo... more CARACTERIZACAO DO PACIENTEPaciente do sexo masculino, 42 anos, caucasiano epesando 92 kg. A historia clinica referia desconfortoretroesternal e fadiga aos medios esforcos. Como historiamorbida pregressa, havia sido submetido a angioplastiacom stent nao farmacologico do ramo interventricularanterior (RIA) ha um ano, em decorrencia de angina estavel.Negava qualquer outro problema associado e estava emuso de aspirina e betabloqueador. Ao exame fisicoapresentava-se corado, eupneico e sem queixas. A ausculta,os campos pleuro-pulmonares encontravam-se livres e aausculta cardiaca o ritmo era sinusal, com desdobramentofixo de segunda bulha.A radiografia de torax mostrava area cardiaca aumentadaa custa do ventriculo direito (VD). O ecocardiogramademonstrou dimensao do atrio esquerdo (AE) normal (4,0cm) e ventriculo esquerdo (VE) com diâmetro cavitarionormal (diâmetro sistolico de VE: 2,70 cm – diâmetrodiastolico de VE: 5,0 cm) e espessura miocardica normal. OVD encontrava-se aumentado (diâme...

Innovations (Philadelphia, Pa.)

The periareolar access has been the preferred technique used at our institution for minimally inv... more The periareolar access has been the preferred technique used at our institution for minimally invasive cardiac surgery since 2006. The surgical approach consists of video-assisted minithoracotomy in the 4th right intercostal space, through a periareolar incision. Initially, the technique was restricted to minimally invasive mitral valve surgeries but, due to its feasibility and safety, was soon incorporated as an ideal access for other cardiac pathologies such as tricuspid valve disease, atrial septal defect, atrial fibrillation, and pacemaker leads endocarditis. The technique was performed in 214 patients, and it is associated with excellent aesthetic and functional results, with low morbimortality and no reoperations at long-term follow-up. Here, we describe and support the use of periareolar access as a routine surgical technique for correction of several cardiac pathologies, especially in women.

Annals of Cardiothoracic Surgery, 2017

Background: Brazil, the largest country and economy in South America, is a major driving force be... more Background: Brazil, the largest country and economy in South America, is a major driving force behind the development of new medical technologies in the region. Robotic cardiac surgery (RCS) has been evolving rapidly since 2010, when the first surgery using the DaVinci ® robotic system was performed in Latin America. The aim of this article is to evaluate short and mid-term results in patients undergoing robotic cardiac surgery in Brazil. Methods: From March 2010 to December 2015, 39 consecutive patients underwent robotic cardiac surgery. Twenty-seven patients were male (69.2%), with the mean age of 51.3±17.9 years. Participants had a mean ejection fraction of 62±5%. The procedures included in this study were mitral valve surgery, surgical treatment of atrial fibrillation, atrial septal defect closure, resection of intra-cardiac tumors, totally endoscopic coronary artery bypass and pericardiectomy. Results: The mean time spent on cardiopulmonary bypass (CPB) during RCS was 154.9±94.2 minutes and the mean aortic cross-clamp time was 114.48±75.66 minutes. Thirty-two patients (82%) were extubated in the operating room immediately after surgery. The median intensive care unit (ICU) length of stay was 1 day (ranging from 0 to 25) and the median hospital length of stay was 5 days (ranging from 3 to 25). For each type of procedure, endpoints were individually reported. There were no conversions to sternotomy and no intra-operative complications. Patient follow-up was complete in 100% of the participants, with two early deaths unrelated to the procedures and no re-operations at mid-term. Conclusions: Despite the heterogeneity of this series, RCS appears to be feasible, safe and effective when used for the correction of various intra-and extra-cardiac pathologies. Adopting the robotic system has been a challenge in Brazil, where its limited clinical application may be related to the lack of specific training and the high cost of technology.

Arquivos Brasileiros de Cardiologia, 2016

Rev Bras Cir Cardiovasc, 2009

Revista Brasileira de Cirurgia Cardiovascular, 2012

Revista Brasileira de Cirurgia Cardiovascular, 2009

Objective: To demonstrate the possibilities of the use of videothoracoscopy in cardiac surgery us... more Objective: To demonstrate the possibilities of the use of videothoracoscopy in cardiac surgery using cardiopulmonary bypass (CPB). Methods: Between February 2006 and November 2008, 102 patients underwent consecutively minimally invasive video-assisted cardiac surgery. The cardiac pathologies approached were: mitral valvopathy (n=56), aortic (n=14), interatrial communication (IC) (n=32), six patients presented associated tricuspid insufficiency and 12 presented atrial fibrillation. The age ranged from 18 to 68 years and 57 were female. The surgical approach was: femoral arterial and venous cannulation, minithoracotomy ranging from four to six centimeters (cm) at the level of the 3° or 4° right intercostal space (RICS), depending on the pathology of the patient, between anterior axillary line and hemiclavicular line, submammary or right periareolar groove through the right breast and thoracoscopy. Results: The surgical procedures were: plasty (n=20) or mitral valve replacement (n=36), aortic valve replacement (n=14), atrioseptoplasty using pericardial patch (n=32), tricuspid valve repair with rigid ring (n=6) and surgical correction of atrial fibrillation with radiofrequency (n=12). There were no complications during the procedures. There was no conversion to thoracotomy in neither case. Two patients developed atrial fibrillation in the postoperative period. There was an episode of stroke seven days after the hospital discharge and one death (0,9%) due to systemic inflammatory response syndrome (SIRS). Conclusion: This study demonstrates the coverage of pathologies that are possible to be approached by videoassisted cardiac surgery with cardiopulmonary bypass being a safe and effective procedure with low morbimortality. Minimally invasive video-assisted cardiac surgery is already a reality in Brazil, demonstrating excellent aesthetic and functional results. Descriptors: Minimally invasive surgical procedures, methods. Video assisted thoracic surgery. Heart valves, surgery. Congenital Heart defects, surgery. Atrial fibrillation/therapy. Resumo Objetivo: Demonstrar as possibilidades da utilização da videotoracoscopia na cirurgia cardíaca com circulação extracorpórea (CEC). Métodos: Entre fevereiro de 2006 e novembro de 2008, 102 pacientes foram submetidos consecutivamente a cirurgia cardíaca minimamente invasiva videoassistida. As doenças cardíacas abordadas foram valvopatia mitral (n=56), aórtica (n=14), comunicação interatrial (n=32), seis pacientes apresentavam insuficiência tricúspide associada e do grupo total, doze tinham fibrilação atrial. A idade variou de 18 a 68 anos, sendo 57 pacientes do sexo feminino. O método

Revista Brasileira de Cirurgia Cardiovascular, 2009

ABC Heart Failure & Cardiomyopathy, 2021

To report the first CHLT in Brazil, performed in a patient with ATTR with a mixed phenotype, in t... more To report the first CHLT in Brazil, performed in a patient with ATTR with a mixed phenotype, in the context of cardiogenic shock, who, as an additional risk factor, had HLA hypersensitivity.

Journal of Heart and Lung Transplantation, Apr 1, 2016

Between January and June 2015, the project provided CME-accredited education about organ donation... more Between January and June 2015, the project provided CME-accredited education about organ donation for physician office staff in 122 randomized participating clinics across Western Pennsylvania and West Virginia. This included online and in-person training (lunch and learns) to over 1,500 PCP office staff participants as well as PCP office kits that included tabletop posters, brochures and office forms which included a survey and designation form. Results: Over 21,000 patient-completed organ donation survey forms were collected. About half of all participants were already registered organ donors. 764 (8.1%) completed the designation form and became registered organ donors upon receiving information from this pilot project. Due to the program's success, both Organ Procurement Organizations in Pennsylvania (CORE and Gift of Life) have committed to funding the program as a statewide initiative, to be launched in January 2016. Conclusion: Unique initiatives like the PSL project can help create awareness amongst people regarding the critical value of organ donation.

ABC: Heart Failure & Cardiomyopathy, 2021

To report the first CHLT in Brazil, performed in a patient with ATTR with a mixed phenotype, in t... more To report the first CHLT in Brazil, performed in a patient with ATTR with a mixed phenotype, in the context of cardiogenic shock, who, as an additional risk factor, had HLA hypersensitivity.

JTCVS Techniques, Nov 30, 2023

Arquivos Brasileiros De Cardiologia, 2016

Brazilian Journal of Cardiovascular Surgery, 2022

Annals of Cardiothoracic Surgery

Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular, 2009

Trabalho realizado no Hospital Israelita Albert Einstein – Sao Paulo– SP e no Hospital Hans Diete... more Trabalho realizado no Hospital Israelita Albert Einstein – Sao Paulo– SP e no Hospital Hans Dieter Schmidt – Joinville – SC1. Coordenador do Programa de Cirurgia Cardiaca MinimamenteInvasiva do Hospital Israelita Albert Einstein – Sao Paulo – SP.Coordenador do Servico de Cirurgia Cardiaca do Hospital HansDieter Schmidt – Joinville – SC.Mestre em Clinica Cirurgica pela Universidade Federal do Parana.

Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular, 2009

CARACTERIZACAO DO PACIENTEPaciente do sexo masculino, 42 anos, caucasiano epesando 92 kg. A histo... more CARACTERIZACAO DO PACIENTEPaciente do sexo masculino, 42 anos, caucasiano epesando 92 kg. A historia clinica referia desconfortoretroesternal e fadiga aos medios esforcos. Como historiamorbida pregressa, havia sido submetido a angioplastiacom stent nao farmacologico do ramo interventricularanterior (RIA) ha um ano, em decorrencia de angina estavel.Negava qualquer outro problema associado e estava emuso de aspirina e betabloqueador. Ao exame fisicoapresentava-se corado, eupneico e sem queixas. A ausculta,os campos pleuro-pulmonares encontravam-se livres e aausculta cardiaca o ritmo era sinusal, com desdobramentofixo de segunda bulha.A radiografia de torax mostrava area cardiaca aumentadaa custa do ventriculo direito (VD). O ecocardiogramademonstrou dimensao do atrio esquerdo (AE) normal (4,0cm) e ventriculo esquerdo (VE) com diâmetro cavitarionormal (diâmetro sistolico de VE: 2,70 cm – diâmetrodiastolico de VE: 5,0 cm) e espessura miocardica normal. OVD encontrava-se aumentado (diâme...

Innovations (Philadelphia, Pa.)

The periareolar access has been the preferred technique used at our institution for minimally inv... more The periareolar access has been the preferred technique used at our institution for minimally invasive cardiac surgery since 2006. The surgical approach consists of video-assisted minithoracotomy in the 4th right intercostal space, through a periareolar incision. Initially, the technique was restricted to minimally invasive mitral valve surgeries but, due to its feasibility and safety, was soon incorporated as an ideal access for other cardiac pathologies such as tricuspid valve disease, atrial septal defect, atrial fibrillation, and pacemaker leads endocarditis. The technique was performed in 214 patients, and it is associated with excellent aesthetic and functional results, with low morbimortality and no reoperations at long-term follow-up. Here, we describe and support the use of periareolar access as a routine surgical technique for correction of several cardiac pathologies, especially in women.

Annals of Cardiothoracic Surgery, 2017

Background: Brazil, the largest country and economy in South America, is a major driving force be... more Background: Brazil, the largest country and economy in South America, is a major driving force behind the development of new medical technologies in the region. Robotic cardiac surgery (RCS) has been evolving rapidly since 2010, when the first surgery using the DaVinci ® robotic system was performed in Latin America. The aim of this article is to evaluate short and mid-term results in patients undergoing robotic cardiac surgery in Brazil. Methods: From March 2010 to December 2015, 39 consecutive patients underwent robotic cardiac surgery. Twenty-seven patients were male (69.2%), with the mean age of 51.3±17.9 years. Participants had a mean ejection fraction of 62±5%. The procedures included in this study were mitral valve surgery, surgical treatment of atrial fibrillation, atrial septal defect closure, resection of intra-cardiac tumors, totally endoscopic coronary artery bypass and pericardiectomy. Results: The mean time spent on cardiopulmonary bypass (CPB) during RCS was 154.9±94.2 minutes and the mean aortic cross-clamp time was 114.48±75.66 minutes. Thirty-two patients (82%) were extubated in the operating room immediately after surgery. The median intensive care unit (ICU) length of stay was 1 day (ranging from 0 to 25) and the median hospital length of stay was 5 days (ranging from 3 to 25). For each type of procedure, endpoints were individually reported. There were no conversions to sternotomy and no intra-operative complications. Patient follow-up was complete in 100% of the participants, with two early deaths unrelated to the procedures and no re-operations at mid-term. Conclusions: Despite the heterogeneity of this series, RCS appears to be feasible, safe and effective when used for the correction of various intra-and extra-cardiac pathologies. Adopting the robotic system has been a challenge in Brazil, where its limited clinical application may be related to the lack of specific training and the high cost of technology.

Arquivos Brasileiros de Cardiologia, 2016

Rev Bras Cir Cardiovasc, 2009

Revista Brasileira de Cirurgia Cardiovascular, 2012

Revista Brasileira de Cirurgia Cardiovascular, 2009

Objective: To demonstrate the possibilities of the use of videothoracoscopy in cardiac surgery us... more Objective: To demonstrate the possibilities of the use of videothoracoscopy in cardiac surgery using cardiopulmonary bypass (CPB). Methods: Between February 2006 and November 2008, 102 patients underwent consecutively minimally invasive video-assisted cardiac surgery. The cardiac pathologies approached were: mitral valvopathy (n=56), aortic (n=14), interatrial communication (IC) (n=32), six patients presented associated tricuspid insufficiency and 12 presented atrial fibrillation. The age ranged from 18 to 68 years and 57 were female. The surgical approach was: femoral arterial and venous cannulation, minithoracotomy ranging from four to six centimeters (cm) at the level of the 3° or 4° right intercostal space (RICS), depending on the pathology of the patient, between anterior axillary line and hemiclavicular line, submammary or right periareolar groove through the right breast and thoracoscopy. Results: The surgical procedures were: plasty (n=20) or mitral valve replacement (n=36), aortic valve replacement (n=14), atrioseptoplasty using pericardial patch (n=32), tricuspid valve repair with rigid ring (n=6) and surgical correction of atrial fibrillation with radiofrequency (n=12). There were no complications during the procedures. There was no conversion to thoracotomy in neither case. Two patients developed atrial fibrillation in the postoperative period. There was an episode of stroke seven days after the hospital discharge and one death (0,9%) due to systemic inflammatory response syndrome (SIRS). Conclusion: This study demonstrates the coverage of pathologies that are possible to be approached by videoassisted cardiac surgery with cardiopulmonary bypass being a safe and effective procedure with low morbimortality. Minimally invasive video-assisted cardiac surgery is already a reality in Brazil, demonstrating excellent aesthetic and functional results. Descriptors: Minimally invasive surgical procedures, methods. Video assisted thoracic surgery. Heart valves, surgery. Congenital Heart defects, surgery. Atrial fibrillation/therapy. Resumo Objetivo: Demonstrar as possibilidades da utilização da videotoracoscopia na cirurgia cardíaca com circulação extracorpórea (CEC). Métodos: Entre fevereiro de 2006 e novembro de 2008, 102 pacientes foram submetidos consecutivamente a cirurgia cardíaca minimamente invasiva videoassistida. As doenças cardíacas abordadas foram valvopatia mitral (n=56), aórtica (n=14), comunicação interatrial (n=32), seis pacientes apresentavam insuficiência tricúspide associada e do grupo total, doze tinham fibrilação atrial. A idade variou de 18 a 68 anos, sendo 57 pacientes do sexo feminino. O método

Revista Brasileira de Cirurgia Cardiovascular, 2009