Joaquim Oliveira | Universidade Estadual de Campinas (original) (raw)

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Papers by Joaquim Oliveira

The surgical management of transposition complex with aortic arch obstruction remains technically... more The surgical management of transposition complex with aortic arch obstruction remains technically demanding due to anatomic complexity.

W pracy przedstawiono przypadek 26-letniej pacjentki będącej w II trymestrze ciąży, u której rozp... more W pracy przedstawiono przypadek 26-letniej pacjentki będącej w II trymestrze ciąży, u której rozpoznano bardzo dużego, bezobjawowego tętniaka prawdziwego aorty wstępującej. W wywiadzie -przebyta operacja koarktacji aorty w 15. roku życia i rozpoznana dwupłatkowa zastawka aortalna. Pacjentkę zoperowano w 22. tygodniu ciąży, wszczepiając prostą protezę nadwieńcowo. Operację przeprowadzono w krążeniu pozaustrojowym z pozostawieniem dobrze funkcjonującej zastawki aortalnej. Nie stwierdzono komplikacji w okresie pooperacyjnym. W 38. tygodniu ciąży pacjentka urodziła zdrowe dziecko z 10 punktami w skali Apgar. U pacjentki zaplanowano zabieg wszczepienia stengraftów do aorty zstępującej, ponieważ badanie tomograficzne klatki piersiowej wykonane kilka miesięcy po porodzie potwierdziło obecność dużego tętniaka poniżej odejścia lewej tętnicy podobojczykowej. Słowa kluczowe: tętniak aorty, ciąża, operacja kardiochirurgiczna.

37.74 vs. 36.01, p = 0.031). Patients with CoA and type 1A BAV had significantly less valve regur... more 37.74 vs. 36.01, p = 0.031). Patients with CoA and type 1A BAV had significantly less valve regurgitation (13.6 vs. 55.8 %, p < 0.001) and smaller diameters of the ascending aorta (33.7 vs. 37.8 mm, p < 0.001) and aortic arch (25.8 vs. 30.2 mm, p < 0.001) than patients with isolated BAV. Conclusions Type 1A BAV with complete raphe is associated with more aortic regurgitation and root dilatation. The majority of CoA patients have incomplete raphes, associated with smaller aortic root diameters and less valve regurgitation.

OBJECTIVES: Systemic hypertension is the main late complication after arch reconstruction in pati... more OBJECTIVES: Systemic hypertension is the main late complication after arch reconstruction in patients with arch obstruction. Gothic arch geometry is suspected to be one of its possible causes. Accordingly, we evaluated here if a modified arch repair technique using an autologous pulmonary patch is effective in preventing gothic arch development.

Aims: Stent placement as treatment for coarctation of the aorta (CoA) has become a more common ch... more Aims: Stent placement as treatment for coarctation of the aorta (CoA) has become a more common choice in the last 20 years. Clinical results of CoA stenting are usually reported in small retrospective case series. This systematic review provides an overview of clinical experience with stenting for CoA.

OBJECTIVES: To analyse early and long-term results of thoracic endovascular aortic repair (TEVAR)... more OBJECTIVES: To analyse early and long-term results of thoracic endovascular aortic repair (TEVAR) in patients with pseudoaneurysms after open aortic coarctation (CoA) repair.

Objective: The purpose of this study was to determine the prevalence of bicuspid aortic valves (B... more Objective: The purpose of this study was to determine the prevalence of bicuspid aortic valves (BAVs) and thoracic ascending aortic aneurysms (TAAs) in a retrospective cohort of patients treated for intracranial aneurysms (IAs).

Background--Mild transverse aortic arch (TAA) hypoplasia is common after coarctation treatment, b... more Background--Mild transverse aortic arch (TAA) hypoplasia is common after coarctation treatment, but is considered benign in the absence of an arm-leg systolic blood pressure (SBP) difference. Hypertension (HTN) is a common long-term morbidity after successful coarctation treatment. We examined whether mild TAA hypoplasia after coarctation treatment is associated with late systemic HTN.

Shone's complex is a rare congenital heart disease consisting of multisite obstruction on the lef... more Shone's complex is a rare congenital heart disease consisting of multisite obstruction on the left side of the heart. The obstructive membrane in the arch of aorta is never described among these obstructions. We report echocardiographic findings in a patient with Shone's complex with the obstructive membrane in the arch of aorta.

We report the application of patient-specific computational models to plan the treatment of compl... more We report the application of patient-specific computational models to plan the treatment of complex aortic re-coarctation (rCoA) with a proximal aberrant right subclavian artery in a patient who had previously undergone bare metal stenting.

Background-Aortic arch obstruction can be evaluated by catheter peak-to-peak gradient or by Doppl... more Background-Aortic arch obstruction can be evaluated by catheter peak-to-peak gradient or by Doppler peak instantaneous pressure gradient. Previous studies have shown moderate correlation in discrete coarctation, but few have assessed correlation in patients with more complex aortic reconstruction.

Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of th... more Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the continuous use of three antihypertensive agents in optimal dose, including diuretic, and lifestyle changes. According to data from United States of America and Europe, the prevalence ranges from 10 up to 30% in patients with hypertension. Numerous biological and lifestyle factors can contribute to the development of resistant hypertension: medications, volume overload, obesity, diabetes mellitus, older age, renal parenchymal and renovascular disease, primary aldosteronism, obstructive sleep apnea, pheochormocytoma, Cushing's syndrome, thyroid diseases, aortic coarctation. For diagnosing patient's history is important, assessing compliance, regular blood pressure measurement, physical examination, biochemical evaluation and noninvasive imaging. The evaluation including 24h ambulatory monitoring of blood pressure (ABPM) in the identification of "non-dipper" hypertension. Non-dipper has particular importance and the prevalence of abnormally high sleep blood pressure is very often in chronic kidney patients. Therapeutic restoration of normal physiologic blood pressure reduction during night-time sleep (circadial variation) is the most significant independent predictor of decreased risk and the basis for the chronotherapy. The resistant hypertension treatment is achieved with nonpharmacological and pharmacological approach, treating secondary hypertension causes and invasive procedures.

Coarctation of the aorta (CoA) is a constriction of the proximal descending thoracic aorta and is... more Coarctation of the aorta (CoA) is a constriction of the proximal descending thoracic aorta and is one of the most common congenital cardiovascular defects. Treatments for CoA improve life expectancy, but morbidity persists, particularly due to the development of chronic hypertension (HTN). Identifying the mechanisms of morbidity is difficult in humans due to confounding variables such as age at repair, follow-up duration, coarctation severity and concurrent anomalies. We previously developed an experimental model that replicates aortic pathology in humans with CoA without these confounding variables, and mimics correction at various times using dissolvable suture. Here we present the most comprehensive description of differentially expressed genes (DEGs) to date from the pathology of CoA, which were obtained using this model. Aortic samples (n=4/group) from the ascending aorta that experiences elevated blood pressure (BP) from induction of CoA, and restoration of normal BP after its correction, were analyzed by gene expression microarray, and enriched genes were converted to human orthologues. 51 DEGs with >6 fold-change (FC) were used to determine enriched Gene Ontology terms, altered pathways, and association with National Library of Medicine Medical Subject Headers (MeSH) IDs for HTN, cardiovascular disease (CVD) and CoA. The results generated 18 pathways, 4 of which (cell cycle, immune system, hemostasis and metabolism) were shared with MeSH ID's for HTN and CVD, and individual genes were associated with the CoA MeSH ID. A thorough literature search further uncovered association with contractile, cytoskeletal and regulatory proteins related to excitation-contraction coupling and metabolism that may explain the structural and PLOS ONE |

Aortic coarctation, a congenital narrowing in the region of the ligamentum arteriosium, is a rare... more Aortic coarctation, a congenital narrowing in the region of the ligamentum arteriosium, is a rare etiology for multi-drugresistant hypertension in adulthood; however, advances in stenting modalities may offer long-term improvements in morbidity and possibly even cure. We report on a female patient in her late 50s presenting with refractory hypertension and severely elevated renin levels, ultimately diagnosed with aortic coarctation and treated with percutaneous stent implantation, which resulted in successful blood pressure control with verapamil monotherapy. This case highlights the efficacy of endovascular stent implantation for the treatment of coarctation and the need for clinicians to consider this disease entity in the differential diagnosis of refractory hypertension even in late adulthood J Clin Hypertens (Greenwich). 2015;17:313-316. ª

Background--Patients with congenital heart disease (CHD) may be at increased risk of ischemic str... more Background--Patients with congenital heart disease (CHD) may be at increased risk of ischemic stroke due to residual shunts, arrhythmias, and other cardiovascular abnormalities. We studied the relative risk and potential factors for developing ischemic stroke in children and young adults with CHD in Sweden.