Abstract A vasoplegic syndrome is a state of hypotension that develops due to low systemic vascular resistance and is associated with a high mortality rate. Methylene blue is known to improve hypotension and reduce vasopressor requirements by increasing resistance in vasoplegia by inhibiting nitric oxide synthase. Here, we aimed to report on the use and effectiveness of methylene blue to treat severely hypotensive five vasoplegic syndrome cases despite extracorporeal membrane oxygenation. We concluded that Methylene blue can be used as […]

Abstract Background Refractory cardiogenic shock (CS) is associated with high mortality rates, and the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a therapeutic option has generated discussions. Therefore, its cost-effectiveness, especially in low- and middle-income countries like Brazil, remains uncertain.Objectives: To conduct a cost-utility analysis from the Brazilian Unified Health System perspective to assess the cost-effectiveness of VA-ECMO combined with standard care compared to standard care alone in adult refractory CS patients. Methods We followed a cohort of refractory […]

Abstract Background Only two papers have addressed the early outcomes of patients with hypoplastic left heart syndrome (HLHS) undergoing the Norwood operation, in Brazil. Objectives We evaluated patients with HLHS undergoing the first-stage Norwood operation in order to identify the predictive factors for early (within the first 30 days after surgery) and intermediate (from early survival up to the Glenn procedure) mortality. Methods Patients with HLHS undergoing the stage I Norwood procedure from January 2016 through April 2019, in our […]

Introduction Aortic stenosis is a common heart valve disease, mostly caused by degenerative aortic valve disease in the elderly. Aortic stenosis obstructs the forward flow of the left ventricle to the aorta, leading to a pressure differential between the left ventricle and the aorta and increased left ventricular pressure secondary to left ventricular hypertrophy. As the disease progresses, it leads to left ventricular systolic and diastolic dysfunction and myocardial ischemia due to decreased coronary blood flow. However, cardiogenic shock secondary […]