A novel method for high-speed fabrication of large scale periodic arrays of nanoparticles (diamet... more A novel method for high-speed fabrication of large scale periodic arrays of nanoparticles (diameters 40-200 nm) is developed. This method is based on a combination of nanosphere lithography and laser-induced transfer. Fabricated spherical nanoparticles are partially embedded into a polymer substrate. They are arranged into a hexagonal array and can be used for sensing applications. An optical sensor with the sensitivity of 365 nm/RIU and the figure of merit of 21.5 in the visible spectral range is demonstrated.
Revista Portuguesa De Cardiologia Orgao Oficial Da Sociedade Portuguesa De Cardiologia Portuguese Journal of Cardiology an Official Journal of the Portuguese Society of Cardiology, Jun 1, 2004
For years, the treatment of high-risk pulmonary embolism (PE) was based on two well-defined strat... more For years, the treatment of high-risk pulmonary embolism (PE) was based on two well-defined strategies: thrombolysis, whose benefits have been documented in randomized trials, and surgical embolectomy. However, mechanical reperfusion by percutaneous techniques is used in an increasing number of patients, and is a valid therapeutic option when there is a formal contraindication to thrombolysis, as rescue therapy when thrombolysis fails to improve hemodynamics, and/or when emergency surgical thrombectomy is unavailable or contraindicated. This article discusses the indications for the use of percutaneous techniques in PE, reports the initial experience of our center with the AngioJet® thrombectomy device (Possis Medical Inc, Minneapolis, MN, USA) and reviews the available evidence, the most recent recommendations and the main complications associated with this procedure.
... Rev Port Pneumol 2007; XIII (2): 239-254 Hipertensão Arterial Pulmonar Experiência do Centr... more ... Rev Port Pneumol 2007; XIII (2): 239-254 Hipertensão Arterial Pulmonar Experiência do Centro Hospitalar de Vila Nova de Gaia Ana Oliveira, Daniela Ferreira, António Caiado, Susana Ferreira, Paula Ferreira, Lino Santos, Manuel Gonçalves, Teresa Shiang ...
We report the case of a 77-year-old man with heart failure (NYHA class IV), angina (CCS class III... more We report the case of a 77-year-old man with heart failure (NYHA class IV), angina (CCS class III) and multiple comorbidities. The evaluation showed severe aortic sten osis and left main coronary disease. Due to the very high perioperative risk, conventional surgery was denied. It was therefore decided to perform a combined percutaneous intervention. First, left main PCI was successfully performed. A few days later, a percutaneous aortic valve prosthesis was implanted via a femoral approach using the CoreValve ReValving system. Immediately after prosthesis implantation, the control angiogram showed severe paravalvular aortic regurgitation, which was corrected by implanting another percutaneous aortic prosthesis inside the first one (valve-in-valve procedure). During follow-up the patient experienced a remarkable improvement in hemodynamic and clinical status. We demonstrate that the combination of two different percutaneous interventions in severe aortic and coronary disease is feasible and can be a suitable alternative approach in high surgical risk patients.
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology
To compare the value of the myocardial perfusion imaging with 99Tc sestamibi (MIBI) with clinical... more To compare the value of the myocardial perfusion imaging with 99Tc sestamibi (MIBI) with clinical data and stress EKG (SEKG) variables, in the detection of angiographic restenosis (AR: lesion > 50%), in a group of patients (pts) with single vessel disease (angiographic lesion above 70% in one epicardial artery), submitted to coronary angioplasty (PTCA) with stenting. Fifty-nine pts, followed prospectively, (49 males and 10 females aged 57 +/- 10) were submitted to 61 angioplasties, with dilatation of 59 vessels, and with stenting in 63 (1.07 stent/vessel). Clinical evaluation was performed in the first, third and sixth month, SEKG with MIBI in the fourth month and recatheterization for angiographic control in the sixth month. The pts were divided in two groups: R-positive angiographic restenosis (AR)--14 pts: NR--without AR--45 pts; the angiographic restenosis rate was 23.7%. The patients' history, cause of admission, procedure characteristics, medication at discharge, clinic...
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology
Assays of serum enzymes, such as aspartate aminotransferase (AST), lactate dehydrogenase (LDH), c... more Assays of serum enzymes, such as aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK) and isoenzyme MB, are widely performed in the early phase of suspected ischemic myocardial injury. However, these enzymes are not restricted to cardiac muscle tissue and increases in their serum concentrations have been observed in non-cardiac conditions. The levels of CK, and especially those of the myocardial specific isoform (CK-MB), have served as essential components for clinical decision in emergency rooms for over 25 years. This standard diagnostic test is far from perfect in specificity and the time delay necessary for the detection of a rise in levels. The clinician needs specific and sensitive biological parameters that can be rapidly measured in serum immediately after ischemic damage. In the last years, several new serum markers of myocardial damage have been developed. Currently, an important place is reserved for some non-enzyme muscle constituents, such...
Introdução: O encerramento percutâneo da comunicação interauricular tipo ostium secundum (CIA) e ... more Introdução: O encerramento percutâneo da comunicação interauricular tipo ostium secundum (CIA) e do foramen ovale persistente (FOP) é uma alternativa eficaz e segura à cirurgia. Para evitar o desconforto do ecocardiograma transesofágico (ETE) e a necessidade de anestesia geral durante o procedimento, existe a possibilidade do controlo ecocardiográfico ser efectuado por ecocardiograma intracardíaco (EIC). Objectivo: Determinar a eficácia e segurança do encerramento percutâneo de CIA e FOP assistido por EIC. Métodos: De Abril de 2001 a Novembro de 2002, todos os encerramentos percutâneos de CIA e FOP foram efectuados com recurso ao EIC durante o procedimento, totalizando 31 doentes. A selecção dos doentes foi efectuada com base na clínica e ETE prévios. Todos os doentes foram tratados sem anestesia geral ou sedação. A técnica de oclusão percutânea foi assistida por EIC e fluoroscopia. Em todos os doentes foi utilizado dispositivo Amplatzer ® para encerramento de CIA e FOP, sendo o seu...
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology
Revista portuguesa de cirurgia cardio-toracica e vascular: orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular
The transcatheter closure of the atrial septal defect (ASD) has been proposed as an alternative t... more The transcatheter closure of the atrial septal defect (ASD) has been proposed as an alternative to surgical therapy for the ostium secundum ASD. It is considered an effective and safe procedure, although rare but potentially fatal complications have been reported. The authors report a case of early migration of a device for transcatheter closure of an ASD to the right pulmonary artery.
... Rev Port Pneumol 2007; XIII (2): 239-254 Hipertensão Arterial Pulmonar Experiência do Centr... more ... Rev Port Pneumol 2007; XIII (2): 239-254 Hipertensão Arterial Pulmonar Experiência do Centro Hospitalar de Vila Nova de Gaia Ana Oliveira, Daniela Ferreira, António Caiado, Susana Ferreira, Paula Ferreira, Lino Santos, Manuel Gonçalves, Teresa Shiang ...
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 1999
The purpose of this study was to evaluate the in-hospital and follow-up prognostic value of cardi... more The purpose of this study was to evaluate the in-hospital and follow-up prognostic value of cardiac troponin I in patients admitted in the Coronary Care Unit and discharged with the diagnosis of unstable angina. 118 patients were admitted in the Coronary Care Unit, discharged with the diagnosis of unstable angina with a follow-up of 13.5 months. Cardiac Troponin I (cTnI) was measured on admission, 4 and 12 hours later. For the purposes of the study, we chose a cut-off value of 0.4 ng/mL as the minimal acceptable concentration of cTnI. The patients were divided in two groups: Group A (n = 82) if all measurements with cTnI < or = 0.4 ng/mL and Group B (n = 36) if any measurement with cTnI > 0.4 ng/mL. In both groups, multiple coronary events during hospitalisation and follow-up were evaluated: death; acute myocardial infarction; angina; hospitalisation; coronary surgery or angioplasty; and also the severity of coronary artery disease and the number of patients without coronary e...
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2004
A considerable number of patients present a single intermediate lesion (>40% and <70%) in o... more A considerable number of patients present a single intermediate lesion (>40% and <70%) in one coronary artery on coronary angiography, with no clear evidence that the lesion is responsible for the patient's symptoms. Fractional flow reserve is a method of evaluating the functional importance of stenosis, a value of <0.75 indicating hemodynamically significant lesions. The aim of this study is to determine the safety of non-revascularization of an angiographically moderate and hemodynamically non-significant lesion. Fractional flow reserve (FFR) was evaluated in 87 patients over a period of 34 months. Retrospective analysis and follow-up were conducted of patients referred for coronary angiography, without acute coronary syndrome, who presented an angiographically moderate lesion of a single epicardial coronary artery with an FFR of 0.75, and in whom intervention was deferred. We found 21 patients with a mean age of 66 years, 66.7% male. All patients presented vascular r...
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2002
Mitral stenosis is the most common valvular heart lesion found in pregnancy. When severe, it lead... more Mitral stenosis is the most common valvular heart lesion found in pregnancy. When severe, it leads to significant maternal and fetal morbidity and mortality, since the hemodynamic adaptations to pregnancy are badly tolerated. Pregnancy can lead to development of heart failure in patients with asymptomatic or even unknown mitral stenosis, as a result of the increased mitral valve pressure gradient caused by the physiologic increase in heart rate and blood volume in pregnancy. When symptoms persist despite optimal medical therapy, the poor prognosis justifies the correction of mitral stenosis during pregnancy. To present our experience in treating severe mitral stenosis in women who develop severe heart failure during pregnancy, using percutaneous balloon mitral valvuloplasty. From 1996 to March 2002, in our department, 47 balloon mitral valvuloplasties were successfully performed in women, three of them pregnant. These were patients with congestive heart failure, New York Heart Assoc...
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2003
To compare the efficacy, safety and morbidity of surgical versus percutaneous atrial septal defec... more To compare the efficacy, safety and morbidity of surgical versus percutaneous atrial septal defect (ASD) closure. We studied all cases of ASD closure (surgical or percutaneous) performed in our hospital during the last 5 years. We analyzed the clinical and echocardiographic characteristics of both groups and compared the success rate of the procedure, events, days of hospital stay and evolution during the 1st year. 63 patients (pts) with ostium secundum ASD were treated in our hospital in the last 5 years; 25 (60% female) underwent surgery (A) while 38 (68% female) underwent percutaneous closure with an Amplatzer device (B); mean age was 38 (13-67) and 40 years (15-72), respectively. Dyspnea and fatigue were the most frequent symptoms in both groups (57% A; 29% B), while the most frequent signs were fixed splitting of S2 (78% A; 88% B) and systolic murmur at the left sternal border (82% A; 87% B). Previous ECG presented incomplete right bundle branch block in 63% of both groups. The...
A novel method for high-speed fabrication of large scale periodic arrays of nanoparticles (diamet... more A novel method for high-speed fabrication of large scale periodic arrays of nanoparticles (diameters 40-200 nm) is developed. This method is based on a combination of nanosphere lithography and laser-induced transfer. Fabricated spherical nanoparticles are partially embedded into a polymer substrate. They are arranged into a hexagonal array and can be used for sensing applications. An optical sensor with the sensitivity of 365 nm/RIU and the figure of merit of 21.5 in the visible spectral range is demonstrated.
Revista Portuguesa De Cardiologia Orgao Oficial Da Sociedade Portuguesa De Cardiologia Portuguese Journal of Cardiology an Official Journal of the Portuguese Society of Cardiology, Jun 1, 2004
For years, the treatment of high-risk pulmonary embolism (PE) was based on two well-defined strat... more For years, the treatment of high-risk pulmonary embolism (PE) was based on two well-defined strategies: thrombolysis, whose benefits have been documented in randomized trials, and surgical embolectomy. However, mechanical reperfusion by percutaneous techniques is used in an increasing number of patients, and is a valid therapeutic option when there is a formal contraindication to thrombolysis, as rescue therapy when thrombolysis fails to improve hemodynamics, and/or when emergency surgical thrombectomy is unavailable or contraindicated. This article discusses the indications for the use of percutaneous techniques in PE, reports the initial experience of our center with the AngioJet® thrombectomy device (Possis Medical Inc, Minneapolis, MN, USA) and reviews the available evidence, the most recent recommendations and the main complications associated with this procedure.
... Rev Port Pneumol 2007; XIII (2): 239-254 Hipertensão Arterial Pulmonar Experiência do Centr... more ... Rev Port Pneumol 2007; XIII (2): 239-254 Hipertensão Arterial Pulmonar Experiência do Centro Hospitalar de Vila Nova de Gaia Ana Oliveira, Daniela Ferreira, António Caiado, Susana Ferreira, Paula Ferreira, Lino Santos, Manuel Gonçalves, Teresa Shiang ...
We report the case of a 77-year-old man with heart failure (NYHA class IV), angina (CCS class III... more We report the case of a 77-year-old man with heart failure (NYHA class IV), angina (CCS class III) and multiple comorbidities. The evaluation showed severe aortic sten osis and left main coronary disease. Due to the very high perioperative risk, conventional surgery was denied. It was therefore decided to perform a combined percutaneous intervention. First, left main PCI was successfully performed. A few days later, a percutaneous aortic valve prosthesis was implanted via a femoral approach using the CoreValve ReValving system. Immediately after prosthesis implantation, the control angiogram showed severe paravalvular aortic regurgitation, which was corrected by implanting another percutaneous aortic prosthesis inside the first one (valve-in-valve procedure). During follow-up the patient experienced a remarkable improvement in hemodynamic and clinical status. We demonstrate that the combination of two different percutaneous interventions in severe aortic and coronary disease is feasible and can be a suitable alternative approach in high surgical risk patients.
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology
To compare the value of the myocardial perfusion imaging with 99Tc sestamibi (MIBI) with clinical... more To compare the value of the myocardial perfusion imaging with 99Tc sestamibi (MIBI) with clinical data and stress EKG (SEKG) variables, in the detection of angiographic restenosis (AR: lesion > 50%), in a group of patients (pts) with single vessel disease (angiographic lesion above 70% in one epicardial artery), submitted to coronary angioplasty (PTCA) with stenting. Fifty-nine pts, followed prospectively, (49 males and 10 females aged 57 +/- 10) were submitted to 61 angioplasties, with dilatation of 59 vessels, and with stenting in 63 (1.07 stent/vessel). Clinical evaluation was performed in the first, third and sixth month, SEKG with MIBI in the fourth month and recatheterization for angiographic control in the sixth month. The pts were divided in two groups: R-positive angiographic restenosis (AR)--14 pts: NR--without AR--45 pts; the angiographic restenosis rate was 23.7%. The patients' history, cause of admission, procedure characteristics, medication at discharge, clinic...
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology
Assays of serum enzymes, such as aspartate aminotransferase (AST), lactate dehydrogenase (LDH), c... more Assays of serum enzymes, such as aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK) and isoenzyme MB, are widely performed in the early phase of suspected ischemic myocardial injury. However, these enzymes are not restricted to cardiac muscle tissue and increases in their serum concentrations have been observed in non-cardiac conditions. The levels of CK, and especially those of the myocardial specific isoform (CK-MB), have served as essential components for clinical decision in emergency rooms for over 25 years. This standard diagnostic test is far from perfect in specificity and the time delay necessary for the detection of a rise in levels. The clinician needs specific and sensitive biological parameters that can be rapidly measured in serum immediately after ischemic damage. In the last years, several new serum markers of myocardial damage have been developed. Currently, an important place is reserved for some non-enzyme muscle constituents, such...
Introdução: O encerramento percutâneo da comunicação interauricular tipo ostium secundum (CIA) e ... more Introdução: O encerramento percutâneo da comunicação interauricular tipo ostium secundum (CIA) e do foramen ovale persistente (FOP) é uma alternativa eficaz e segura à cirurgia. Para evitar o desconforto do ecocardiograma transesofágico (ETE) e a necessidade de anestesia geral durante o procedimento, existe a possibilidade do controlo ecocardiográfico ser efectuado por ecocardiograma intracardíaco (EIC). Objectivo: Determinar a eficácia e segurança do encerramento percutâneo de CIA e FOP assistido por EIC. Métodos: De Abril de 2001 a Novembro de 2002, todos os encerramentos percutâneos de CIA e FOP foram efectuados com recurso ao EIC durante o procedimento, totalizando 31 doentes. A selecção dos doentes foi efectuada com base na clínica e ETE prévios. Todos os doentes foram tratados sem anestesia geral ou sedação. A técnica de oclusão percutânea foi assistida por EIC e fluoroscopia. Em todos os doentes foi utilizado dispositivo Amplatzer ® para encerramento de CIA e FOP, sendo o seu...
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology
Revista portuguesa de cirurgia cardio-toracica e vascular: orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular
The transcatheter closure of the atrial septal defect (ASD) has been proposed as an alternative t... more The transcatheter closure of the atrial septal defect (ASD) has been proposed as an alternative to surgical therapy for the ostium secundum ASD. It is considered an effective and safe procedure, although rare but potentially fatal complications have been reported. The authors report a case of early migration of a device for transcatheter closure of an ASD to the right pulmonary artery.
... Rev Port Pneumol 2007; XIII (2): 239-254 Hipertensão Arterial Pulmonar Experiência do Centr... more ... Rev Port Pneumol 2007; XIII (2): 239-254 Hipertensão Arterial Pulmonar Experiência do Centro Hospitalar de Vila Nova de Gaia Ana Oliveira, Daniela Ferreira, António Caiado, Susana Ferreira, Paula Ferreira, Lino Santos, Manuel Gonçalves, Teresa Shiang ...
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 1999
The purpose of this study was to evaluate the in-hospital and follow-up prognostic value of cardi... more The purpose of this study was to evaluate the in-hospital and follow-up prognostic value of cardiac troponin I in patients admitted in the Coronary Care Unit and discharged with the diagnosis of unstable angina. 118 patients were admitted in the Coronary Care Unit, discharged with the diagnosis of unstable angina with a follow-up of 13.5 months. Cardiac Troponin I (cTnI) was measured on admission, 4 and 12 hours later. For the purposes of the study, we chose a cut-off value of 0.4 ng/mL as the minimal acceptable concentration of cTnI. The patients were divided in two groups: Group A (n = 82) if all measurements with cTnI < or = 0.4 ng/mL and Group B (n = 36) if any measurement with cTnI > 0.4 ng/mL. In both groups, multiple coronary events during hospitalisation and follow-up were evaluated: death; acute myocardial infarction; angina; hospitalisation; coronary surgery or angioplasty; and also the severity of coronary artery disease and the number of patients without coronary e...
Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2004
A considerable number of patients present a single intermediate lesion (>40% and <70%) in o... more A considerable number of patients present a single intermediate lesion (>40% and <70%) in one coronary artery on coronary angiography, with no clear evidence that the lesion is responsible for the patient's symptoms. Fractional flow reserve is a method of evaluating the functional importance of stenosis, a value of <0.75 indicating hemodynamically significant lesions. The aim of this study is to determine the safety of non-revascularization of an angiographically moderate and hemodynamically non-significant lesion. Fractional flow reserve (FFR) was evaluated in 87 patients over a period of 34 months. Retrospective analysis and follow-up were conducted of patients referred for coronary angiography, without acute coronary syndrome, who presented an angiographically moderate lesion of a single epicardial coronary artery with an FFR of 0.75, and in whom intervention was deferred. We found 21 patients with a mean age of 66 years, 66.7% male. All patients presented vascular r...
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2002
Mitral stenosis is the most common valvular heart lesion found in pregnancy. When severe, it lead... more Mitral stenosis is the most common valvular heart lesion found in pregnancy. When severe, it leads to significant maternal and fetal morbidity and mortality, since the hemodynamic adaptations to pregnancy are badly tolerated. Pregnancy can lead to development of heart failure in patients with asymptomatic or even unknown mitral stenosis, as a result of the increased mitral valve pressure gradient caused by the physiologic increase in heart rate and blood volume in pregnancy. When symptoms persist despite optimal medical therapy, the poor prognosis justifies the correction of mitral stenosis during pregnancy. To present our experience in treating severe mitral stenosis in women who develop severe heart failure during pregnancy, using percutaneous balloon mitral valvuloplasty. From 1996 to March 2002, in our department, 47 balloon mitral valvuloplasties were successfully performed in women, three of them pregnant. These were patients with congestive heart failure, New York Heart Assoc...
Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2003
To compare the efficacy, safety and morbidity of surgical versus percutaneous atrial septal defec... more To compare the efficacy, safety and morbidity of surgical versus percutaneous atrial septal defect (ASD) closure. We studied all cases of ASD closure (surgical or percutaneous) performed in our hospital during the last 5 years. We analyzed the clinical and echocardiographic characteristics of both groups and compared the success rate of the procedure, events, days of hospital stay and evolution during the 1st year. 63 patients (pts) with ostium secundum ASD were treated in our hospital in the last 5 years; 25 (60% female) underwent surgery (A) while 38 (68% female) underwent percutaneous closure with an Amplatzer device (B); mean age was 38 (13-67) and 40 years (15-72), respectively. Dyspnea and fatigue were the most frequent symptoms in both groups (57% A; 29% B), while the most frequent signs were fixed splitting of S2 (78% A; 88% B) and systolic murmur at the left sternal border (82% A; 87% B). Previous ECG presented incomplete right bundle branch block in 63% of both groups. The...
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