Case report
Intracardiac echocardiography-guided percutaneous mitral balloon valvuloplasty
Ecocardiografia intracardíaca – Valvuloplastia mitral percutânea conduzida por balão
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GC: guiding catheter; Kn: knot; Sh: sheath.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Nuri Ilker Akkus, Faisal Bahadur, Jai Varma" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Nuri Ilker" "apellidos" => "Akkus" ] 1 => array:2 [ "nombre" => "Faisal" "apellidos" => "Bahadur" ] 2 => array:2 [ "nombre" => "Jai" "apellidos" => "Varma" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113000450?idApp=UINPBA00004E" "url" => "/08702551/0000003200000004/v1_201308021344/S0870255113000450/v1_201308021344/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S0870255112003356" "issn" => "08702551" "doi" => "10.1016/j.repc.2012.08.008" "estado" => "S300" "fechaPublicacion" => "2013-04-01" "aid" => "230" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => 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"estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204913000597?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255112003356?idApp=UINPBA00004E" "url" => "/08702551/0000003200000004/v1_201308021344/S0870255112003356/v1_201308021344/pt/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Intracardiac echocardiography-guided percutaneous mitral balloon valvuloplasty" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "337" "paginaFinal" => "339" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Konstantinos Marmagkiolis, Mehmet Cilingiroglu" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Konstantinos" "apellidos" => "Marmagkiolis" "email" => array:1 [ 0 => "c.marmagiolis@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Mehmet" "apellidos" => "Cilingiroglu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Citizens Memorial Hospital, Bolivar, MO, United States" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, PA, United States" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Ecocardiografia intracardíaca – Valvuloplastia mitral percutânea conduzida por balão" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2788 "Ancho" => 1667 "Tamanyo" => 289830 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Left: ICE image showing tenting of the interatrial septum (large white arrow) with the Mullins catheter and Brockenbrough needle (small white arrow). LA: left atrium; RA: right atrium. Right: ICE 2-chamber view after insertion of the ICE probe into the right ventricle (RV). Visualization of the mitral valve (white arrow) prior to percutaneous mitral balloon valvuloplasty. Left atrial enlargement and left ventricular function and dimensions can be assessed. (B) Percutaneous mitral balloon valvuloplasty. Angiographic and ICE visualization of the inflated Inoue balloon (white arrow). ICE catheter probe (large black arrow) is located in the RV and the pig-tail catheter (small black arrow) in the left ventricle. (C) Post-PMBV ICE assessment. Left: two-dimension assessment. Right: Doppler evaluation of the mitral valve showing 1+ mitral regurgitation.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Percutaneous mitral balloon valvuloplasty (PMBV) was initially described by Inoue in 1984 as a novel percutaneous technique for the management of mitral stenosis.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> PMBV provides excellent immediate and mid-term results comparable to surgical mitral commissurotomy<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and is currently the standard of care for selected patients with moderate or severe mitral stenosis.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Although PMBV can be performed by a retrograde non-transeptal technique with comparable clinical results, most North American centers use the transeptal Inoue technique due to ease of use and greater experience.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Transeptal puncture is a critical and challenging step because of the distorted septal anatomy in most mitral stenosis patients. It commonly constitutes the longest part of the procedure and a failure or complication may terminate the case or place the patient at significant risk or subject to unnecessary long hospitalizations. Traditionally, transeptal puncture was performed using angiographic landmarks. The use of transesophageal echocardiography (TEE) has improved the safety and efficiency of the procedure and it is currently the preferred method in most North American institutions.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Intracardiac echocardiography was initially used in the 1980s but was not universally accepted due to its high-frequency transducers and problems with steerability and manipulation.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In the 1990s technical improvements led to more generalized use in various structural interventional procedures. The first successful balloon valvuloplasty using ICE was described in 2002 by Salem.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Case report</span><p id="par0020" class="elsevierStylePara elsevierViewall">A 31-year-old woman with known rheumatic mitral valve disease was referred for PMVB. She had been diagnosed with rheumatic heart disease four years previously after a routine transthoracic echocardiogram (TTE) and she had been asymptomatic during her recent annual clinic visits.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Over the previous three months she had noticed progressive dyspnea on exertion limiting her daily activities. The ECG showed normal sinus rhythm with left atrial enlargement. Repeat TTE revealed progressive moderate mitral stenosis with a mean valve area of 1.2 cm<span class="elsevierStyleSup">2</span> and mild mitral regurgitation, preserved left ventricular ejection fraction (LVEF), moderate left atrial enlargement and normal pulmonary artery pressure. A treadmill stress echocardiogram with a standard Bruce protocol was ordered, during which she performed 6 METS, which was less than normal for her age. She experienced significant dyspnea towards the end of the test with no associated left ventricular wall motion abnormalities but with a mean transmitral gradient increased from 8 mmHg to 17 mmHg, consistent with severe obstruction.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Elective PMBV was scheduled. Standard right heart catheterization was initially performed to invasively assess right heart pressures. Through a second right transfemoral venous access, the ICE catheter probe was advanced to the mid segment of the right atrium in order to visualize the atrial septum and guide the transeptal puncture. All septal borders were assessed before and during the tenting of the septum with the Mullin catheter (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A). After identification of the optimal interatrial septal position for puncture, the Brockenbrough needle and the sheath were advanced to the left atrium. With angiographic and ICE guidance the mitral valve balloon was advanced and inflated (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B). Immediate assessment of the post-procedural mitral valve morphology, transmitral valve gradient and mitral regurgitation were performed by fluoroscopy and ICE (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">Transeptal puncture is an important skill for interventional cardiologists. The significant decrease in the incidence of mitral stenosis in the USA and the universal acceptance of echocardiography, cardiac computed tomography (CT) and cardiac MRI as alternative accurate and safe non-invasive imaging modalities have significantly decreased the number of transeptal punctures in most cardiac catheterization labs. Today fewer centers which are involved in structural heart interventions perform routine transeptal punctures and maintain their operators’ expertise.</p><p id="par0040" class="elsevierStylePara elsevierViewall">ICE-guided structural heart disease procedures have gained increasing attention due to the ease of ICE use, the improved imaging resolution, use of Doppler and the feasibility of three-dimensional imaging applications.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Compared to plain angiography, it achieves accurate assessment of the atrial septum and the adjacent anatomic structures, improving the safety of the puncture and the operator's level of comfort with a lower radiation exposure. Compared to TEE it eliminates the need for deeper procedural sedation, patient intubation and the involvement of an additional operator, with a probable decrease of the overall procedural cost.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical disclosures</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Protection of human and animal subjects</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Confidentiality of data</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Right to privacy and informed consent</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "xres251137" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec238734" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres251136" "titulo" => "Resumo" ] 3 => array:2 [ "identificador" => "xpalclavsec238733" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:3 [ "identificador" => "sec0020" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Right to privacy and informed consent" ] ] ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-07-26" "fechaAceptado" => "2012-08-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec238734" "palabras" => array:2 [ 0 => "Intracardiac echocardiography" 1 => "Mitral balloon valvuloplasty" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec238733" "palabras" => array:2 [ 0 => "Ecocardiografia intracardíaca" 1 => "Valvuloplastia mitral percutânea por balão" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Percutaneous mitral balloon valvuloplasty (PMBV) was initially described by Inoue in 1984 as a novel percutaneous technique for the management of mitral stenosis. Intracardiac echocardiography was initially used in the 1980s but was not universally accepted due to its high-frequency transducers and problems with steerability and manipulation. In the 1990s technical improvements led to more generalized use in various structural interventional procedures. We present the case of a successful PMBV guided exclusively by ICE.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A valvuloplastia mitral percutânea por balão foi inicialmente descrita por Inoue em 1984 como uma nova técnica percutânea para o tratamento da estenose mitral. A ecocardiografia intracardíaca foi inicialmente utilizada na década de 80 sem aceitação universal devido à alta frequência dos transdutores e à sua capacidade de manobra e manuseamento problemáticos. Na década de 90 melhorias técnicas conduziram à sua utilização mais generalizada em diversos procedimentos de intervenção estrutural. Os autores apresentam um caso de uma valvuloplastia mitral percutânea conduzida por ecocardiografia intracardíaca.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2788 "Ancho" => 1667 "Tamanyo" => 289830 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Left: ICE image showing tenting of the interatrial septum (large white arrow) with the Mullins catheter and Brockenbrough needle (small white arrow). LA: left atrium; RA: right atrium. Right: ICE 2-chamber view after insertion of the ICE probe into the right ventricle (RV). Visualization of the mitral valve (white arrow) prior to percutaneous mitral balloon valvuloplasty. Left atrial enlargement and left ventricular function and dimensions can be assessed. (B) Percutaneous mitral balloon valvuloplasty. Angiographic and ICE visualization of the inflated Inoue balloon (white arrow). ICE catheter probe (large black arrow) is located in the RV and the pig-tail catheter (small black arrow) in the left ventricle. (C) Post-PMBV ICE assessment. Left: two-dimension assessment. Right: Doppler evaluation of the mitral valve showing 1+ mitral regurgitation.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical application of transvenous mitral commissurotomy by a new balloon catheter" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "K. Inoue" 1 => "T. Owaki" 2 => "T. Nakamura" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Thorac Cardiovasc Surg" "fecha" => "1984" "volumen" => "87" "paginaInicial" => "394" "paginaFinal" => "402" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6700245" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "NHLBI Balloon Valvuloplasty Registry Report on immediate and 30-day follow-up results. The National Heart, Lung, and Blood Institute Balloon Valvuloplasty Registry Participants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Multicenter experience with balloon mitral commissurotomy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "1992" "volumen" => "85" "paginaInicial" => "448" "paginaFinal" => "461" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1735143" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R.O. 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| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 10 | 5 | 15 |
| 2024 Outubro | 38 | 30 | 68 |
| 2024 Setembro | 63 | 24 | 87 |
| 2024 Agosto | 59 | 33 | 92 |
| 2024 Julho | 53 | 30 | 83 |
| 2024 Junho | 63 | 24 | 87 |
| 2024 Maio | 45 | 21 | 66 |
| 2024 Abril | 54 | 28 | 82 |
| 2024 Maro | 63 | 27 | 90 |
| 2024 Fevereiro | 79 | 35 | 114 |
| 2024 Janeiro | 49 | 34 | 83 |
| 2023 Dezembro | 32 | 27 | 59 |
| 2023 Novembro | 34 | 17 | 51 |
| 2023 Outubro | 31 | 16 | 47 |
| 2023 Setembro | 33 | 22 | 55 |
| 2023 Agosto | 27 | 18 | 45 |
| 2023 Julho | 17 | 8 | 25 |
| 2023 Junho | 35 | 19 | 54 |
| 2023 Maio | 29 | 18 | 47 |
| 2023 Abril | 23 | 1 | 24 |
| 2023 Maro | 36 | 28 | 64 |
| 2023 Fevereiro | 38 | 24 | 62 |
| 2023 Janeiro | 23 | 14 | 37 |
| 2022 Dezembro | 51 | 23 | 74 |
| 2022 Novembro | 45 | 25 | 70 |
| 2022 Outubro | 38 | 15 | 53 |
| 2022 Setembro | 21 | 30 | 51 |
| 2022 Agosto | 28 | 31 | 59 |
| 2022 Julho | 32 | 37 | 69 |
| 2022 Junho | 24 | 16 | 40 |
| 2022 Maio | 22 | 41 | 63 |
| 2022 Abril | 30 | 24 | 54 |
| 2022 Maro | 29 | 26 | 55 |
| 2022 Fevereiro | 30 | 22 | 52 |
| 2022 Janeiro | 53 | 17 | 70 |
| 2021 Dezembro | 30 | 33 | 63 |
| 2021 Novembro | 36 | 39 | 75 |
| 2021 Outubro | 41 | 50 | 91 |
| 2021 Setembro | 23 | 27 | 50 |
| 2021 Agosto | 26 | 30 | 56 |
| 2021 Julho | 17 | 27 | 44 |
| 2021 Junho | 18 | 15 | 33 |
| 2021 Maio | 21 | 30 | 51 |
| 2021 Abril | 41 | 32 | 73 |
| 2021 Maro | 72 | 26 | 98 |
| 2021 Fevereiro | 51 | 18 | 69 |
| 2021 Janeiro | 31 | 9 | 40 |
| 2020 Dezembro | 33 | 10 | 43 |
| 2020 Novembro | 46 | 20 | 66 |
| 2020 Outubro | 25 | 15 | 40 |
| 2020 Setembro | 53 | 11 | 64 |
| 2020 Agosto | 28 | 9 | 37 |
| 2020 Julho | 50 | 11 | 61 |
| 2020 Junho | 34 | 5 | 39 |
| 2020 Maio | 37 | 3 | 40 |
| 2020 Abril | 50 | 6 | 56 |
| 2020 Maro | 51 | 11 | 62 |
| 2020 Fevereiro | 45 | 23 | 68 |
| 2020 Janeiro | 30 | 11 | 41 |
| 2019 Dezembro | 35 | 10 | 45 |
| 2019 Novembro | 29 | 8 | 37 |
| 2019 Outubro | 20 | 9 | 29 |
| 2019 Setembro | 24 | 7 | 31 |
| 2019 Agosto | 21 | 9 | 30 |
| 2019 Julho | 42 | 11 | 53 |
| 2019 Junho | 28 | 10 | 38 |
| 2019 Maio | 36 | 2 | 38 |
| 2019 Abril | 19 | 18 | 37 |
| 2019 Maro | 73 | 10 | 83 |
| 2019 Fevereiro | 49 | 13 | 62 |
| 2019 Janeiro | 40 | 2 | 42 |
| 2018 Dezembro | 56 | 12 | 68 |
| 2018 Novembro | 147 | 10 | 157 |
| 2018 Outubro | 216 | 15 | 231 |
| 2018 Setembro | 37 | 9 | 46 |
| 2018 Agosto | 36 | 11 | 47 |
| 2018 Julho | 29 | 6 | 35 |
| 2018 Junho | 42 | 4 | 46 |
| 2018 Maio | 44 | 13 | 57 |
| 2018 Abril | 62 | 10 | 72 |
| 2018 Maro | 71 | 9 | 80 |
| 2018 Fevereiro | 55 | 4 | 59 |
| 2018 Janeiro | 26 | 5 | 31 |
| 2017 Dezembro | 77 | 12 | 89 |
| 2017 Novembro | 35 | 8 | 43 |
| 2017 Outubro | 26 | 14 | 40 |
| 2017 Setembro | 38 | 11 | 49 |
| 2017 Agosto | 49 | 12 | 61 |
| 2017 Julho | 29 | 6 | 35 |
| 2017 Junho | 40 | 14 | 54 |
| 2017 Maio | 43 | 9 | 52 |
| 2017 Abril | 21 | 2 | 23 |
| 2017 Maro | 31 | 1 | 32 |
| 2017 Fevereiro | 23 | 7 | 30 |
| 2017 Janeiro | 24 | 6 | 30 |
| 2016 Dezembro | 31 | 14 | 45 |
| 2016 Novembro | 25 | 8 | 33 |
| 2016 Outubro | 20 | 6 | 26 |
| 2016 Setembro | 18 | 7 | 25 |
| 2016 Agosto | 13 | 0 | 13 |
| 2016 Julho | 5 | 2 | 7 |
| 2016 Junho | 5 | 3 | 8 |
| 2016 Maio | 9 | 0 | 9 |
| 2016 Abril | 21 | 1 | 22 |
| 2016 Maro | 51 | 9 | 60 |
| 2016 Fevereiro | 84 | 16 | 100 |
| 2016 Janeiro | 55 | 15 | 70 |
| 2015 Dezembro | 60 | 7 | 67 |
| 2015 Novembro | 56 | 8 | 64 |
| 2015 Outubro | 30 | 11 | 41 |
| 2015 Setembro | 52 | 8 | 60 |
| 2015 Agosto | 61 | 16 | 77 |
| 2015 Julho | 63 | 4 | 67 |
| 2015 Junho | 41 | 8 | 49 |
| 2015 Maio | 42 | 7 | 49 |
| 2015 Abril | 62 | 10 | 72 |
| 2015 Maro | 39 | 7 | 46 |
| 2015 Fevereiro | 41 | 8 | 49 |
| 2015 Janeiro | 37 | 7 | 44 |
| 2014 Dezembro | 46 | 14 | 60 |
| 2014 Novembro | 43 | 10 | 53 |
| 2014 Outubro | 39 | 16 | 55 |
| 2014 Setembro | 46 | 10 | 56 |
| 2014 Agosto | 44 | 13 | 57 |
| 2014 Julho | 46 | 11 | 57 |
| 2014 Junho | 55 | 6 | 61 |
| 2014 Maio | 48 | 11 | 59 |
| 2014 Abril | 43 | 13 | 56 |
| 2014 Maro | 70 | 17 | 87 |
| 2014 Fevereiro | 62 | 12 | 74 |
| 2014 Janeiro | 64 | 16 | 80 |
| 2013 Dezembro | 76 | 15 | 91 |
| 2013 Novembro | 67 | 24 | 91 |
| 2013 Outubro | 78 | 15 | 93 |
| 2013 Setembro | 66 | 20 | 86 |
| 2013 Agosto | 67 | 32 | 99 |
| 2013 Julho | 83 | 36 | 119 |
| 2013 Junho | 51 | 20 | 71 |
| 2013 Maio | 82 | 44 | 126 |
| 2013 Abril | 35 | 17 | 52 |
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