Publications (6)3.43 Total impact
-
Article: [Radiofrequency catheter ablation of supraventricular tachycardia in a patient with congenital absence of inferior vena cava].
[show abstract] [hide abstract]
ABSTRACT: We describe a case of a 54-year-old female referred for ablation of supraventricular tachycardia (recurrent episodes under anti arrhythmic therapy). During a first procedure catheters progressed on the left side of the spine draining to the superior vena cava. Multi-row detector CT angiography revealed infrahepatic interruption of the inferior vena cava with venous blood drainage into the superior vena cava, via the azygos venous system, a previously unknown asymptomatic anomaly. Ablation was subsequently performed successfully using a mixed approach via the right suclavian vein (ablation catheter) and the azygos venous system (diagnostic catheter in the coronary sinus).Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 03/2010; 29(3):439-43. -
Article: Left atrial volume calculated by multi-detector computed tomography may predict successful pulmonary vein isolation in catheter ablation of atrial fibrillation.
[show abstract] [hide abstract]
ABSTRACT: Catheter ablation (CA) of atrial fibrillation (AF) might be a definitive curative therapy for selected groups of patients (pts). However, current ablation protocols are not standardized and predictors of CA success and sinus rhythm maintenance are not clearly defined. To evaluate whether left atrium (LA) volume quantification provided by multi-detector computed tomography (MDCT) might predict the success of pulmonary vein (PV) isolation procedure. We evaluated 99 pts, 66 male, mean age 54.4 +/- 10.1 years, referred for CA because of drug resistant AF. All pts were submitted to 64-slice MDCT scan for electroanatomic mapping integration, pulmonary veins anatomy delineation, LA thrombi exclusion, and LA volume estimation. Complete isolation of all the PVs was always performed with eventual cavo-tricuspid isthmus ablation. For a mean follow-up period (Fup) of 16.7 +/- 6.6 months, clinical success was assessed after a 3-month blanking period. Anti-arrhythmic drug therapy was discontinued or modified at the clinician's criteria. At the end of the Fup, 29 pts suspended anti-arrhythmic drug therapy and 26% were of oral anticoagulation. Univariate analysis showed that the probability of AF relapse after CA was higher in pts with non-paroxysmal forms of AF. The probability of relapse was significantly higher in pts with LA volumes greater than 100 mL when assessed by MDCT. We found that the LA volume of 145 mL was a good cut-off value for AF recurrence prediction. Patients with LA volumes greater than 145 mL had significantly higher recurrence rates of arrhythmia, even when adjusted for the effect of age, gender, body mass index, hypertension, and type of AF. Left atrium volume estimated by MDCT may be useful to identify pts in whom successful AF ablation can be achieved with simpler ablation procedures, restricted to PV isolation.Europace 08/2009; 11(10):1289-94. · 1.98 Impact Factor -
Article: Characterization of pulmonary vein morphology using multi-detector row CT study prior to radiofrequency ablation for atrial fibrillation.
[show abstract] [hide abstract]
ABSTRACT: To classify the drainage patterns of the pulmonary veins as depicted by multi-detector row CT and to measure their ostial diameters. Over a period of two years contrast material-enhanced 64-slice CT scans were performed in 188 consecutive patients who were referred to our department for cardiac CT study prior to ablation of atrial fibrillation with radiofrequency energy. A classification was formulated based on both the number of venous ostia on each side and the pulmonary vein drainage patterns. The frequency of each pattern was determined and the diameters of the pulmonary vein ostia were measured. Most patients had two ostia on the left side (n=158; 84%) and on the right side (n=161; 85.6%). Thirty patients (16%) had variant anatomy on the left: common ostium (n=24; 12.8%), accessory lingular vein (n=5; 2.7%) and accessory upper lobe vein (n=1; 0.5%). Twenty-seven patients (14.4%) had variant anatomy on the right: accessory middle lobe vein (n=20; 10.6%), accessory upper lobe vein (n=2; 1.1%), accessory lower lobe vein (n=4; 2.1%) and common ostium (n=1; 0.5%). Mean pulmonary vein anterior-posterior and superior-inferior ostial diameters were variable: right superior, 17.9 +/- 3.4 mm and 18.2 +/- 2.9 mm; left superior, 16.2 +/- 2.9 mm and 17.0 +/- 2.7 mm; right inferior, 16.4 +/- 2.9 mm and 16.9 +/- 2.6 mm; left inferior, 15.2 +/- 2.6 mm and 16.5 +/- 2.5 mm. Multi-detector row CT provides a valuable means for mapping pulmonary vein anatomy prior to atrial fibrillation ablation. A system for classifying pulmonary venous anatomy was developed.Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 06/2009; 28(5):545-59. -
Article: Dilated cardiomyopathy in a young adult: a diagnostic challenge.
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 10/2008; 27(9):1195-200. -
Article: Anomalous origin of the right coronary artery diagnosed by cardiac computed tomography.
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 04/2007; 26(3):297-9. -
Article: Fetus in fetu--diagnostic criteria and differential diagnosis--a case report and literature review.
[show abstract] [hide abstract]
ABSTRACT: Fetus-in-fetu (FIF) is a rare congenital condition in which a vertebrate fetus is incorporated within its twin. The authors report the case of a newborn boy with prenatal ultrasonographic diagnosis of intraabdominal mass, provoking compression of the left kidney. Plain abdominal radiography, ultrasonography, and computer tomography showed a cystic mass containing multiple calcifications. Pathologic examination showed an irregular fetiforme mass, weighing 8 g, attached to an amniotic sac by a rudimentary umbilical cord with 2 rudimentary limbs, vertebral bodies, encephalus, coroidal plexus, stomach, duodenum, bowel, adrenal glands, upper and lower respiratory tissue, spleen, lymphoid tissue, single cavity heart, and kidney. Molecular analysis using an informative genetic marker, for uniparental isodisomy of chromosomes 14 and 15 showed no genetic difference between the host infant and the fetiform mass. Serum alpha-fetoprotein was < or = 16.000 UI/mL (reference values for age, 4 to 18.9904 UI/mL) before surgery and 8.364 UI/mL after surgery.Journal of Pediatric Surgery 04/2004; 39(4):616-8. · 1.45 Impact Factor
