Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The reduction of the systolic function of the left ventricle in patients with congestive heart failure is related with increased ventricular volume. Despite of the advances in conservative treatments the prognosis is guarded with a high mortality rate. This work proposed the development of a surgical protocol of cardiac chamber reduction through partial ventriculectomy in dogs with dilated cardiomiopathy. The post operative control was made by cardiac biopsy by videothoracoscopy. A post operative control was performed and a short term evaluation was made by electrocardiogram and simple thorax radiography. The latter exams, serum biochemistry and physiological evaluation during sixty days allowed the approval of the technique for the animals survived while evaluated and the histological examination of the biopsies revealed that the procedures were conservative since the only change observed was subepicardiac fibrosis. / A redução na função sistólica do ventrículo esquerdo em pacientes com insuficiência cardíaca congestiva, está relacionada ao aumento de volume do ventrículo. A despeito dos avanços no tratamento conservador, o prognóstico é mau com alta taxa de mortalidade. Este trabalho propôs o estabelecimento de um protocolo cirúrgico de redução cardíaca, através de ventriculectomia parcial, para tratamento de cães com a referida patologia e, através de biópsias cardíacas por videotoracoscopia, fez o controle pós-operatório destes animais. Também avaliou a curto prazo, através de eletrocardiograma e radiografia simples de tórax, sua evolução em função do procedimento. Tanto estes exames, como a bioquímica sérica e avaliação de parâmetros fisiológicos destes pacientes, observados durante sessenta dias, revelaram bons resultados da técnica uma vez que os animais sobreviveram ao período de observações e, pela análise histológica dos fragmentos de miocárdio obtidos nas biópsias, concluiu-se que o procedimento é conservador do tecido cardíaco sendo a única alteração observada a fibrose subepicárdica.

Made available in DSpace on 2014-12-17T14:13:57Z (GMT). No. of bitstreams: 1 JeanCarloFC.pdf: 596709 bytes, checksum: 314bab688733510c66bd2bd077bef4f9 (MD5) Previous issue date: 2005-04-14 / Analyze, in patients with primary hyperhidrosis (PH) who was undergone to videothoracoscopic sympathicotomy, the degree of vascular denervation after surgical transection of the thoracic sympathetic chain by measuring ultrasonografic parameters in carotid and vertebral arteries. Methods: Twenty-four patients with PH underwent forty-eight endoscopic thoracic sympathicotomy and were evaluated by duplex eco-doppler measuring systolic peak velocity (SPV), diastolic peak velocity (DPV), pulsatility index (PI) and resistivity index (RI) in bilateral common, internal and external carotids, besides bilateral vertebral arteries. The exams were performed before operations and a month later. Wilcoxon test was used to analyse the differences between the variables before and after the sympatholisis. Results: T3 sympathicotomy segment was the most frequent transection done (95,83%), as only ablation (25%) or in association with T4 (62,50%) or with T2 (8,33%). It was observed increase in RI and PI of the common carotid artery ( p<0,05). The DPV of internal carotid artery decreased in both sides (p<0,05). The SPV and the DPV of the right and left vertebral arteries also increased (p<0,05). Asymmetric findings were observed so that, arteries of the right side were the most frequently affected. Conclusions: Hemodynamic changes in vertebral and carotid arteries were observed after sympathicotomy for PH. SPV was the most often altered parameter, mostly in the right side arteries, meaning significant asymmetric changes in carotid and vertebral vessels. Therefore, the research findings deserve further investigations to observe if they have clinical inferences / O delineamento desse estudo objetiva a an?lise das repercuss?es na hemodin?mica das art?rias car?tidas e vertebrais, respons?veis pela irriga??o do enc?falo, ap?s a desnerva??o da cadeia simp?tica ao n?vel de T2, T3 e/ou T4, provocada pela simpaticotomia tor?cica videotoracosc?pica para tratamento da hiperidrose prim?ria. Foram estudados pacientes submetidos a 48 simpaticotomias tor?cicas por v?deo, utilizando como par?metros de compara??o pr? e p?s-operat?rios vari?veis num?ricas de velocidade de pico sist?lico, velocidade de pico diast?lico, ?ndice de resist?ncia e ?ndice de pulsatibilidade. As vari?veis foram obtidas a partir do exame de eco-doppler das art?rias car?tidas e vertebrais bilateralmente utilizando o mesmo aparelho de ultrassom e o mesmo examinador no per?odo de uma semana que antecedeu ao procedimento cir?rgico e 30 dias depois da opera??o. As diferen?as das vari?veis do pr? e do p?s-operat?rio foram mensuradas pelo teste de Wilcoxon, utilizando o software SPSS? 7.5 for Windows (SPSS, Inc., Chicago, IL). Os achados de altera??es significativas foram discutidos, observando os dados da literatura m?dica relacionados com estudos na mesma linha de investiga??o e enfatizando os aspectos de interdisciplinaridade cient?fica