Browsing by Author "Teixeira, P"
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- Fibromioma e Infertilidade: o Papel da MiomectomiaPublication . Teixeira, P; Teresinha Ferreira, H; Pires, LCOs autores analisaram 60 casos de miomectomia em mulheres operadas na Unidade de Infertilidade, do Serviço de Ginecologia da Maternidade Dr. Alfredo da Costa, nos anos de 1987 a 1991. 50% tinham infertilidade primária, 40% infertilidade 2ª e 10% não tinham infertilidade. Não houve diferença significativa de resultados quando se consideram os seguintes factores: idade, infertilidade 1ª ou 2ª, número e localização dos fibromiomas e entrada na cavidade. Após um período de observação de 2 a 5 anos, verificou-se nas mulheres expostas a gravidez no pós-operatório, uma taxa corrigida de gravidez de 54,2%. Nas mulheres com fibromioma isolado esta taxa foi de 57,1%, correspondendo, neste grupo, a 38,1% de filhos vivos. Considerando ainda os casos com fibromioma isolado, a percentagem de aborto espontâneo desceu de 100% para 23,1%.
- Left Atrial Appendage Volume As a New Predictor of Atrial Fibrillation Recurrence After Catheter AblationPublication . Teixeira, P; Oliveira, MM; Ramos, R; Rio, P; Cunha, PS; Delgado, AS; Pimenta, R; Cruz Ferreira, RPURPOSE: Recurrence of atrial fibrillation (AF) after catheter ablation is common, being clinically relevant to identify predictors of recurrence. The left atrial appendage (LAA) role as an AF trigger is scarcely explored. Our aim was to identify if LAA volume is an independent predictor of AF recurrence after catheter ablation. METHODS: We analysed 52 patients (aged 54 ± 10 years, 58% male) with paroxysmal and persistent AF who underwent a first AF catheter ablation and had performed contrast-enhanced cardiac computed tomography (CT) prior to the procedure. RESULTS: The mean left atrial and LAA volumes measured by cardiac CT were 98.9 ± 31.8 and 9.3 ± 3.5 mL, respectively. All patients received successful pulmonary vein isolation and were followed up for 24 months. AF recurrence occurred in 17 patients (33%). LAA volume was significantly greater in patients with AF recurrence than in those without recurrence (11.3 ± 2.9 vs. 8.2 ± 3.4 mL; p = 0.002). Multivariable analysis using Cox regression revealed that LAA volume (hazard ratio 1.32; 95% confidence interval 1.12-1.55; p = 0.001) and persistent AF (hazard ratio 4.22; 95% confidence interval 1.48-12.07; p = 0.007) were independent predictors for AF recurrence. An LAA volume greater than 8.825 mL predicted AF recurrence with 94% sensitivity and 66% specificity. The Kaplan-Meier analysis showed a lower rate free from AF recurrence in the group with an LAA volume >8.825 mL (p < 0.001). CONCLUSIONS: Larger LAA volume was associated with AF recurrence after catheter ablation in patients with paroxysmal and persistent AF.
- Modified Continuity Equation Using Left Ventricular Outflow Tract Three-Dimensional Imaging for Aortic Valve Area EstimationPublication . Teixeira, P; Ramos, R; Rio, P; Branco, LM; Portugal, G; Abreu, A; Galrinho, A; Marques, H; Figueiredo, L; Cruz Ferreira, RPURPOSE: Aortic valve area (AVA) is usually estimated by the continuity equation (CE) in which the left ventricular outflow tract (LVOT) area is calculated assuming a circular shape. This study aimed to compare measurements of LVOT area using standard 2D transthoracic echocardiography (2DTTE), 3D transesophageal echocardiography (3DTEE), and multidetector computed tomography (MDCT) and assess their relative impact on AVA estimated by the CE. METHODS AND RESULTS: We prospectively enrolled 60 patients with severe aortic stenosis (AS) referred for transcatheter aortic valve replacement (TAVR) who systematically underwent 2DTTE, 3DTEE, and MDCT. Mean LVOT areas obtained by 2DTTE (3.28±0.66 cm2 ) and 3DTEE (3.95±0.90 cm2 ) were significantly underestimated when compared to the mean MDCT LVOT area (4.31±0.99 cm2 ). LVOT was rather elliptical than round, with a mean eccentricity index of 1.47 (ratio of maximum to minimum LVOT diameters) assessed by MDCT. Mean TTE AVA estimated by the CE was 0.62±0.20 cm2 . Substitution of 2DTTE LVOT area by 3DTEE LVOT area in the CE resulted in AVA of 0.74±0.24 cm2 , while using MDCT LVOT area held an AVA of 0.80±0.24 cm2 . MDCT-derived AVA was similar to MDCT planimetric AVA and allowed 24% of patients to be reclassified from severe to moderate AS. CONCLUSIONS: 2DTTE and 3DTEE underestimate LVOT area when compared to MDCT with significant impact on AVA estimation. Assessment through MDCT fusion AVA may be of incremental value in patients with discrepant severity criteria for AS.
- PentaRay Catheter in Persistent Atrial Fibrillation AblationPublication . Teixeira, P; Cunha, PS; Delgado, AS; Pimenta, R; Oliveira, MM; Cruz Ferreira, R
- Radiologia. A Visão da MedicinaPublication . Mata, J; Teixeira, P
- Validation of Two US Risk Scores for Percutaneous Coronary Intervention in a Single-Center Portuguese Population of Patients with Acute Coronary SyndromePublication . Timóteo, AT; Viveiros Monteiro, A; Portugal, G; Teixeira, P; Aidos, H; Ferreira, ML; Cruz Ferreira, RINTRODUCTION: New scores have been developed and validated in the US for in-hospital mortality risk stratification in patients undergoing coronary angioplasty: the National Cardiovascular Data Registry (NCDR) risk score and the Mayo Clinic Risk Score (MCRS). We sought to validate these scores in a European population with acute coronary syndrome (ACS) and to compare their predictive accuracy with that of the GRACE risk score. METHODS: In a single-center ACS registry of patients undergoing coronary angioplasty, we used the area under the receiver operating characteristic curve (AUC), a graphical representation of observed vs. expected mortality, and net reclassification improvement (NRI)/integrated discrimination improvement (IDI) analysis to compare the scores. RESULTS: A total of 2148 consecutive patients were included, mean age 63 years (SD 13), 74% male and 71% with ST-segment elevation ACS. In-hospital mortality was 4.5%. The GRACE score showed the best AUC (0.94, 95% CI 0.91-0.96) compared with NCDR (0.87, 95% CI 0.83-0.91, p=0.0003) and MCRS (0.85, 95% CI 0.81-0.90, p=0.0003). In model calibration analysis, GRACE showed the best predictive power. With GRACE, patients were more often correctly classified than with MCRS (NRI 78.7, 95% CI 59.6-97.7; IDI 0.136, 95% CI 0.073-0.199) or NCDR (NRI 79.2, 95% CI 60.2-98.2; IDI 0.148, 95% CI 0.087-0.209). CONCLUSION: The NCDR and Mayo Clinic risk scores are useful for risk stratification of in-hospital mortality in a European population of patients with ACS undergoing coronary angioplasty. However, the GRACE score is still to be preferred.