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Introduction: After the years of lead, as known, the military dictatorship that took part in the country, declaredly contrary to the democratic rule of law that existed in Brazil until then, and that took over power through the use of force between the years 1964 and 1985, in 1988 the Citizen Constitution was promulgated, the Constitution of the Federative Republic of Brazil of 1988 (CRFB/1988), not without a struggle but as a possible, but not perfect, combination of the democratic and social need that was curbed by conservatism and the roots lying down from dictatorialism and the rightwing vision of the instituted powers of the elite, and that made amnesty possible for coup leaders and dictators, as well as those who fought for the democratic rule of law and for social justice through the widespread use of violence at the time, which became begins with the cowardly coup of 1964. The 1988 Constitution brought to society, on its side, important mechanisms for the protection of individuals and society against the will of the State and of society itself, declared and instituted fundamental rights and created legal instruments for the protection and guarantee of fundamental rights, such as, among many, we can highlight public civil actions, the collective writ of mandamus and popular action. However, social reality depends on the implementation of fundamental rights through the effective action of the State and society, and through the appreciation of democratic institutions, such as the CRFB/1988. On the other hand, the coup and the lack of appreciation for democracy and the democratic rule of law, however, live in the shadows and underworld of violence and fake news more recently, and during the more than thirty years of promulgation of the celebrated Constitution Federal of 1988, the institutions and the constitutionally established democratic regime have been questioned by the coup, of which the dantesque event of the attacks on democracy perpetrated by vandals, possible terrorists and financiers of chaos, and purely coupists, on January 8, 2023, at the headquarters of the three branches of government in Brasília, DF. fundamental rights, occurs with great emphasis in the scope of the realization of these same fundamental rights and affects more seriously, above all, the vulnerable, marginalized population, and the black majority, with a cowardly mechanism of structural racism sedimented over the nation in Brazil and which adds to the lack of appreciation for democracy on the part of the population, and which affects, notably, and with greater gravity the economically needy people who live in poverty. Objective: As a general objective, this manuscript aims to describe important mechanisms achieved for the defense and implementation of fundamental rights based on the Constitution of the Federative Republic of Brazil of 1988. Methods: The present work was developed through bibliographical research, on the conquest of rights inserted in the context of the constitutionality and normative force of the Constitution of the Federative Republic of Brazil of 1988, representative of the sedimentation of democracy in Brazil. The research approach method is deductive. Results: This research describes the evolution of generations of fundamental rights enshrined in the 1988 Constitution of the Federative Republic of Brazil,, among which the current stage of new fundamental rights, resulting from bioethics and technological advances. Conclusion: It is concluded that fundamental rights had a great evolution in a short period of time, notably driven by the barbarism created by the warlike, coup-mongering and dictatorial movements that rested from the 20th century onwards, and notably by the incidence of technological evolution resulting from the advance of science in the same historical period, and which underlie the conquest of rights and the need to implement goals to avoid the social, economic and existential collapse of humanity, with the aim of perpetuating good social coexistence and guaranteeing and promoting the quality of life of people and societies, permeated by rights that are partly individual and partly collective. [ABSTRACT FROM AUTHOR]

Bicuspid aortic valve (BAV) is the most common form of congenital heart disease and frequently leads to premature valvular dysfunction. BAV is associated with aortic wall abnormalities and a high prevalence of ascending aorta dilatation and coarctation of the aorta (CoA). Consequently, in patients with BAV a careful assessment of the valve, and also of the aortic root and the ascending aorta, should be performed. The most feared complication is aortic dissection, however, the actual incidence of this complication is low. We report the case of a 58-year-old man who presented with New York Heart Association class III heart failure. The work-up revealed BAV with severe stenosis and severe compromise of left ventricle systolic function. In addition, CoA in the isthmus region, and type B dissection of the aorta were diagnosed. [ABSTRACT FROM AUTHOR]

We report the case of 67-year old male patient who was admitted with a 2-week history of progressively worsening chest pain and dyspnea. Diagnostic investigation showed a type B aortic dissection with a retrograde intramural hematoma and bilateral pulmonary embolism. These simultaneous findings highly complicated patient management. Patient was started on anticoagulation therapy with partial resolution of pulmonary embolism after which surgical correction was performed. The patient was successfully submitted to a modified Frozen Elephant Trunk technique with a 3-branched customized Dacron tube and aortic arch replacement with E-Vita Open Plus. Patient post-operative period was uneventful, and he was discharged at the tenth postoperative day. The authors consider this case to be highly unusual regarding the clinical aspects, the challenging decision-making process and the complex surgical approach performed with a favorable outcome.

Introduction: Older age is often regarded as a relative contraindication for open surgery for aortic aneurysms. These individuals often have a greater comorbidity burden that predispose them for development of postoperative complications. The aim of our study is to evaluate the surgical outcomes of selected octogenarians after open aortic surgery., Methods: We performed a retrospective observational study. We collected data from patients operated on by our team between January of 2012 to September of 2017. We performed univariate logistic regression and survival analysis to construct Kaplan Meier survival curves., Results: We analysed data from 430 patients, and 31 patients fulfilled the inclusion criteria. 67.7% of the patients were male. The mean age was 81.5 ± 1.8 years. The preoperative comorbidities were hypertension (83.9%), aortic valve disease (54.8%), dyslipidaemia (48.4%), renal impairment (9.7%), type 2 diabetes mellitus (9.7%) and COPD (3.2%). As for the procedures performed the majority was aortic valve replacement and graft interposition (48.4%) followed by graft interposition (35.5%), ascending aorta and arch replacement (9.7%) and graft interposition and combined CABG (6.5%). 16.1% of the procedures were reoperations and 6.5% were performed as urgent. In-hospital mortality was 9.4% and 1-year survival was 77.4%. The mean survival time after surgery was 736.4 ± 530.3 days. As for complications, 22.6% developed respiratory complications, 6.5% had infectious complications and 3.2 developed renal and central nervous system complications. Older age was not related to early (p = 0.266) or late mortality (p = 0.779). There was no association between older age and longer ICU stay (p = 0.781) or total hospital stay (p = 0.985)., Conclusions: Highly selected octogenarians benefit from surgery, having a similar rate of postoperative complications and survival, as described in the literature.

Introduction: Current guidelines suggest that patients with aortic diameter over 55-60 mm should undergo ascending aorta replacement, depending on associated valve pathology and other comorbidities. Studies show that the risk of aortic rupture over 60 mm is over 30%. Even though, we still receive in our practice patients that present with aneurysms of greater dimensions. The aim of our study is to evaluate the surgical outcomes of patients presenting with ascending aorta with diameter larger than 70 mm., Methods: We performed a retrospective observational study. We collected data from patients operated on by our team between January of 2012 to September of 2017. We performed univariate logistic regression and survival analysis to construct Kaplan Meier survival curves., Results: We analysed data from 430 patients, and 31 patients fulfilled the inclusion criteria. 64.5% of the patients were male. The mean age was 67.9 ± 12.9 years. The preoperative comorbidities were hypertension (64.5%), dyslipidaemia (45.2%), aortic valve disease (35.4%), renal impairment (9.7%) and COPD (3.2%). The average diameter was 82.3 ± 18.6 mm, with values ranging from 70 to 160 millimeters. As for the procedures performed the majority was interposition of prosthetic graft (45.2%), followed by aortic valve replacement and graft interposition (35.5%), Frozen Elephant Trunk (12.9%), tube interposition and combined CABG (3.2%) and aortic root replacement with graft interposition (3.2%). 9.7% of the procedures were reoperations and 9.7% were performed as urgent. In-hospital mortality was 3.2% and 1-year survival was 83.9%. The mean survival time after surgery was 1135.9 ± 777.1 days. As for complications, 29% developed respiratory complications, 9.7% had cardiac complications, 6.5% had central nervous system complications and 3.2% developed renal and vascular complications. Greater diameter was not associated with early (p = 0.929) or late mortality (p = 0.987)., Conclusions: These results show that patients with aneurysms greater than 70 mm can be safely operated on, with no increase in complications in the postoperative period or greater mortality.