Browsing by Author "Jalles, N"
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- Aortic Arch Geometry after Aortic Coarctation Repair: Systematic Magnetic Resonance Study in a Consecutive Series of PatientsPublication . Martins, JD; Thomas, B; Jalles, N; Pinto, MF
- Cardiac Hydatid Cyst in a ChildPublication . Macedo, AJ; Magalhães, MP; Jalles, N; Bento, L; Sampayo, F; Lima, MCardiac hydatid cyst is a rare disease, especially in children. An 11-year-old boy with a previous anaphylactic reaction and episodes of abdominal pain was admitted for workup of an acquired long systolic murmur. Echocardiographic investigation disclosed a tumor of the right ventricular anterior wall, with multiple loculations. Magnetic resonance imaging characterized it as a multilobular tumor with cyst formation and disclosed another cyst in the right pulmonary artery. With a positive ELISA reaction the child was admitted for surgery with the diagnosis of cardiac and pulmonary hydatid cysts. Cardiac surgery was performed with good results, followed by medical treatment with albendazole.
- Documento de Consenso Sobre Codificação de Exames de Ressonância Magnética Cardíaca em PortugalPublication . Ferreira, AM; Almeida, AG; Oliveira, L; Bettencourt, N; Marques, H; Matos, P; Abecasis, J; Abreu, J; Alpendurada, F; Botelho, A; Campos, P; Castela, S; Cunha, D; Donato, P; Ferreira, MJ; Rocha Lopes, L; Pinho, T; Sá, I; Saraiva, C; Jalles, N; Themudo, RUm dos obstáculos a uma utilização mais frequente e apropriada da ressonância magnética cardíaca (RMC) em Portugal tem sido a ausência de códigos específicos que descrevam adequadamente os exames tal como são efetuados actualmente. Este documento de consenso fornece recomendações para a atualização e uniformização dos códigos empregues na RMC. São igualmente feitas recomendações quanto às técnicas e códigos a utilizar nas indicações clínicas mais frequentes.
- Fístulas Arteriovenosas Renais. Tratamento Conservador por Embolização ArterialPublication . Jalles, N; Martins, JM; Reis Santos, JM; Matos Ferreira, A; Pisco, JMFazem-se considerações gerais sobre as FAV, incidindo particularmente nas renais. Descrevem-se dois casos de FAV renais traumáticas com hematúria, tratadas por embolização.
- Impact of Treatment Modality on Vascular Function in Coarctation of the Aorta: The LOVE - COARCT StudyPublication . Martins, JD; Zachariah, J; Selamet Tierney, E; Truong, U; Morris, S; Kutty, S; de Ferranti, S; Guarino, M; Thomas, B; Oliveira, D; Marinho, A; António, M; Gauvreau, K; Jalles, N; Geva, T; Mota Carmo, M; Prakash, ABackground Optimally treated patients with coarctation of the aorta remain at risk for late vascular dysfunction. The effect of treatment modality on vascular function is unknown. The LOVE-COARCT (Long-term Outcomes and Vascular Evaluation After Successful Coarctation of the Aorta Treatment) study was done to compare vascular function in patients with coarctation of the aorta treated with surgery, balloon dilation (BD), or stent implantation. Methods and Results In treated coarctation of the aorta patients without residual coarctation, we prospectively compared aortic stiffness by applanation tonometry and cardiac magnetic resonance; endothelial function by endothelial pulse amplitude testing; blood pressure ( BP ) phenotype by office BP , ambulatory BP monitoring, and BP response to exercise; left ventricular mass by cardiac magnetic resonance; and blood biomarkers of endothelial function, inflammation, vascular wall function, and extracellular matrix. Participants included 75 patients treated with surgery (n=28), BD (n=23), or stent (n=24). Groups had similar age at enrollment, coarctation of the aorta severity, residual gradient, and metabolic profile, but differed by age at treatment. Prevalence of systemic hypertension, aortic stiffness, endothelial function, and left ventricular mass were similar among treatment groups. However, BD patients had more-distensible ascending aortas, lower peak systolic BP during exercise, less impairment in diurnal BP variation, and lower inflammatory biomarkers. Results were unchanged after adjustment for potential confounders, including age at treatment. Conclusions In our cohort of patients without residual coarctation, treatment modality was not associated with major vascular outcomes, even though there were some favorable vascular characteristics in the BD patients. Although this suggests that choice of treatment modality should continue to be driven by likelihood of achieving a good anatomical result, more long-term studies are required to assess the clinical significance of the more-optimal results of secondary markers of vascular function in BD patients. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 03262753.
- Implantação Percutânea de Válvulas Pulmonares: Experiência InicialPublication . Martins, JD; Ewert, P; Sousa, L; Freitas, I; Trigo, C; Jalles, N; Matos, P; Agapito, A; Cruz Ferreira, R; Pinto, MFOs doentes com cardiopatias submetidos a intervenção cirúrgica com implantação de condutos entre o ventrículo direito e a artéria pulmonar (VD-AP) podem desenvolver estenose e/ou insuficiência pulmonares ao longo do tempo. Nestas situações, associadas a arritmias cardíacas, disfunção ventricular direita e morte súbita, a re-intervenção cirúrgica permanece um desafio pela complexidade, mortalidade e morbilidade significativas. A implantação percutânea de válvulas pulmonares (IPVP), recentemente desenvolvida, representa uma abordagem alternativa para estes doentes. Objectivo: Reportar a experiência inicial com a IPVP, analisando o seu impacto no manejo destes doentes. Material e Métodos: Avaliação prospectiva dos dados clínicos, ecocardiográficos, da ressonância magnética, hemodinâmicos e angiográficos dos doentes submetidos a IPVP. Resultados: Seis doentes em classe funcional igual ou superior a II com disfunção do conduto VD-AP foram submetidos a IPVP. Tinham todos evidência de insuficiência e 5/6 de estenose. O procedimento consistiu na implantação de stents não cobertos no conduto para reforçar a sua rigidez e prevenir fracturas dos stents valvulados pulmonares Melody ® (Medtronic), que foram em seguida implantados com sucesso em todos. Obteve-se uma redução da pressão ventricular direita (94±27 para 44±7mmHg), da relação entre a pressão ventricular direita e esquerda (94±27 para 44±7%), do gradiente do conduto (65±28 para 11±4mmHg) e ausência de regurgitação pulmonar. O procedimento teve uma duração mediana de 180 minutos e decorreu sem complicações major. Os doentes tiveram alta em mediana dois dias após o procedimento. Na última avaliação, em mediana 7,8 meses após o procedimento, os doentes encontramse em classe funcional I (5) ou II (1), sem evidência não invasiva de disfunção do conduto. Conclusões: Os nossos resultados acompanham a experiência actual com esta modalidade terapêutica, com excelentes resultados nestes grupo de doentes complexos. A implementação da IPVP em doentes com cardiopatia congénita que requerem re-intervenção no tracto de saída do ventrículo direito tem-se revelado uma técnica promissora, embora complexa, alternativa a mais uma intervenção cirúrgica.
- Intracardiac Mass Due to Fibrosing Mediastinitis: The First Reported CasePublication . Pereira-da-Silva, T; Galrinho, A; Ribeiro, A; Jalles, N; Martelo, F; Fragata, J; Cruz Ferreira, RWe report a case of a woman, aged 53 years, presenting with a right atrial mass due to idiopathic fibrosing mediastinitis with periaortic involvement. This challenging diagnosis was confirmed by different imaging modalities and histopathologic analysis. The diagnosis of cardiac tumours is often difficult. To our knowledge, this is the first reported case of an intracavitary cardiac mass due to fibrosing mediastinitis. This rare disorder, which is characterized by invasive proliferation of fibrous tissue within the mediastinum, should be included in the differential diagnosis of intracardiac tumours.
- Late Gadolinium Enhancement in the Left Ventricular Wall Is Associated with Atrial Fibrillation in Patients with Hypertrophic CardiomyopathyPublication . Castelo, A; Aguiar Rosa, S; Fiarresga, A; Jalles, N; Vaz Ferreira, V; Garcia Brás, P; Branco, L; Oliveira, M; Cruz Ferreira, RPurpose: Atrial fibrillation (AF) is the most common arrhythmia in patients with hypertrophic cardiomyopathy (HCM). The aim of this study was to evaluate the relation between AF and left ventricular (LV) late gadolinium enhancement (LGE). Methods: 55 patients with HCM were retrospectively included. Patients were divided in HCM with AF and HCM without AF. Baseline clinical, echocardiographic and cardiovascular magnetic resonance (CMR) characteristics were collected and compared between groups. Results: In univariable analysis, the factors related to AF development were HCM risk score for sudden cardiac death (SCD) > 2.29% (p = 0.002), left atrium (LA) diameter > 42.5 mm (p = 0.014) and LGE in the mid anterior interventricular septum (IVS) (p = 0.021), basal inferior IVS (p = 0.012) and mid inferior IVS (p = 0.012). There were no differences in LV diastolic function and LA strain between groups. Independent predictors of AF were LA diameter (p = 0.022, HR 5.933) and LGE in mid inferior IVS (p = 0.45, HR 3.280). Combining LA diameter (> 42.5 mm or < 42.5 mm) and LGE in mid inferior IVS (present or absent) in a model with four groups showed a statistically significant difference between groups (p = 0.013 for the model). Conclusions: LGE in mid inferior IVS is an independent predictor for AF occurrence in patients with HCM. Combining both LGE in mid inferior IVS and enlarged LA improves prediction of AF and may be preferred for risk stratification.
- Quilopericárdio Primário IdiopáticoPublication . Timóteo, AT; Albino, JP; Branco, LM; Banazol, N; Colarinha, P; Jalles, N; Cruz Ferreira, RO quilopericárdio é uma entidade rara, que é encontrada mais frequentemente associada a traumatismos (com lesão do canal torácico), neoplasias e infiltrações por filária. As formas primárias são mais raras e associam-se a malformações da circulação linfática. Apresenta-se o caso clínico de um doente de 52 anos, sexo masculino, com o diagnóstico de quilopericárdio primário, sendo discutida a abordagem diagnóstica, assim como a evolução clínica favorável com tratamento conservador.
- Stenosis of the Branches of the Neopulmonary Artery after the Arterial Switch Operation: a Cardiac Magnetic Resonance Imaging StudyPublication . Thomas, B; Martins, JD; Jalles, N; Lopes, A; Pinto, MF; Fragata, JBackground : The neonatal arterial switch operation (ASO) is now the standard of care for children born with transposition of the great arteries. Stenosis of the neopulmonary artery on long‑term follow up is a known complication. Methods : We performed a retrospective analysis of eleven patients who underwent a cardiac magnetic resonance imaging (MRI) due to echocardiographic evidence suggestive of stenosis of the neopulmonary artery or its branches (mean estimated Doppler gradient 48 mmHg, min 30 mmHg, max 70 mmHg). A comprehensive evaluation of anatomy and perfusion was done by cardiac MRI. Results : The branches of the neopulmonary artery (neo PA) showed decreased caliber in three patients unilaterally and in two patients, bilaterally. Magnetic resonance (MR) perfusion studies showed concomitant decreased flow, with discrepancy between the two lungs of 35/65% or worse, only in the three patients with unilateral obstruction, by two different MR perfusion methods. Conclusions : Cardiac MR can be used as a comprehensive non‑invasive imaging technique to diagnose stenosis of the branches of the neopulmonary after the ASO, allowing evaluation of anatomy and function of the neoPA, its branches, and the differential perfusion to each lung, thus facilitating clinical decision making.