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Browsing by Author "Faria, H"

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  • Invasive strategy in non-ST elevation acute coronary syndromes: risks and benefits in an elderly population
    Publication . Lourenço, C; Teixeira, R; António, N; Saraiva, F; Baptista, R; Jorge, E; Monteiro, S; Gonçalves, F; Monteiro, P; Matos, V; Calisto, J; Faria, H; Gonçalves, L; Freitas, M; Providência, LA
    2010Journal article Open access Show more
  • Mean pulmonary arterial pressure after percutaneous mitral valvuloplasty predicts long-term adverse outcomes
    Publication . Jorge, E; Baptista, R; Faria, H; Calisto, J; Matos, V; Gonçalves, L; Monteiro, P; Providência, LA
    INTRODUCTION AND AIM: Percutaneous mitral valvuloplasty (PMV) is an effective treatment option for mitral stenosis (MS), but its success is assessed on the basis of clinical and echocardiographic outcomes in studies with relatively short follow-up. We aimed to characterize a cohort of patients undergoing PMV with long-term follow-up and to determine independent predictors of post-PMV mitral re-intervention and event-free survival. METHODS: We studied 91 consecutive patients with MS who underwent PMV with a median clinical follow-up duration of 99 months. Two endpoints were considered: post-PMV mitral re-intervention (PMV or mitral surgery) and a composite clinical events endpoint including cardiovascular death, mitral valve re-intervention and hospital admission due to decompensated heart failure. We compared patients who required post-PMV mitral re-intervention with those who did not during follow-up. RESULTS: The study population included 83.5% females and mean age was 48.9±13.9 years. The 1-, 3-, 5-, 7- and 9-year rates of clinical event-free survival were 93.0±2.8%, 86.0±3.9%, 81.0±4.4%, 70.6±5.6%, and 68.4±5.8%, respectively. The 1-, 3-, 5-, 7- and 9-year rates of mitral re-intervention-free survival were 98.8±1.2%, 97.5±1.7%, 92.1±3.1%, 85.5±4.5%, and 85.5±4.5%, respectively. The median time to mitral re-intervention was 6.2 years. Patients who required mitral re-intervention during follow-up were younger (43.3 vs. 51.2 years, p=0.04) and had higher pre- and post-PMV mitral gradient (14.9 vs. 11.5mmHg, p=0.02 and 6.4 vs. 2.1mmHg, p<0.001) and higher post-PMV mean pulmonary artery pressure (mPAP) (30.0 vs. 23.2mmHg, p=0.01). In a Cox proportional hazards model, mPAP ≥25mmHg was the sole predictor of both mitral re-intervention (HR 5.639 [1.246-25.528], p=0.025) and clinical events (HR 3.622 [1.070-12.260], p=0.039). CONCLUSION: In our population, immediate post-PMV mPAP was the sole predictor of post-PMV mitral intervention. These findings may help identify patients in need of closer post-PMV follow-up.
    2012Journal article Open access Show more
  • 2014Journal article Open access Show more
  • 2013Journal article Open access Show more
  • Results of the routine use of 4F catheters for diagnostic catheterization in a cath lab
    Publication . Lourenço, C; António, N; Santos, L; Teixeira, R; Costa, S; Matos, V; Calisto, J; Faria, H; Gonçalves, L; Providência, LA
    INTRODUCTION: Complications at the site of vascular access are the most common adverse events in cardiac catheterization. The use of small gauge catheters may reduce this risk and allow earlier ambulation, the main disadvantage according to some authors being inferior image quality. The aim of our study was to evaluate the safety and image quality of 4 French diagnostic catheters. METHODS: We performed a retrospective study of 1656 patients who underwent diagnostic cardiac catheterization with 4F catheters via the femoral artery between January 2006 and December 2007, and analyzed the complications during and immediately after the procedure. The quality of the films was assessed in 125 consecutive patients from this group, who were also followed up on average one month after hospital discharge. RESULTS: Cardiac catheterization with 4F catheters was technically possible in all cases. Patients were able to ambulate and were discharged from hospital on average four and six hours respectively after the procedure. Complications during or immediately after the procedure occurred in 5.8% of cases. In the subgroup with clinical follow-up, there was minor bleeding at the access site in 16.4% and hematoma in 14.4%; in the latter group, only one patient had major hematoma requiring therapeutic intervention. No other major complications were recorded and the patients resumed their daily activities on average 7 days after discharge. Image analysis revealed that most of the films were of good quality. Conclusion: The use of 4F catheters for diagnostic cardiac catheterization via the femoral approach enables rapid hemostasis and early ambulation, with a low incidence of complications at the access site. This type of catheter provides good quality images and there were no problems in their handling. 4F catheters are therefore a good option to consider for cardiac catheterization, especially when no therapeutic procedures are expected.
    2010Journal article Open access Show more