Case report
Pacemaker lead-related tricuspid stenosis successfully treated with percutaneous balloon valvuloplasty guided by 3D echocardiography
Estenose tricúspide associada a electrocateter de pacemaker tratada com sucesso com valvuloplastia percutânea com balão guiada por ecocardiografia 3D
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(B) Amplatz Super Stiff guidewire across the valve; (C) balloon inflation.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0080" class="elsevierStylePara elsevierViewall">We present the case of a 52-year-old woman with a history of congenital atrioventricular block requiring pacemaker implantation at the age of 22 years, who was admitted with dyspnea and lower limb edema. Transthoracic echocardiography revealed severe tricuspid valve stenosis (gradients over 10 mmHg) secondary to fibrosis of one of the valve leaflets located over the pacemaker lead. No tricuspid regurgitation was observed.</p><p id="par0010" class="elsevierStylePara elsevierViewall">After medical and surgical assessment, it was decided that the patient was a candidate for percutaneous tricuspid valvuloplasty (PTV). This procedure was accepted by the patient, who gave her informed consent.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Before PTV, and given the fact that the patient was pacemaker-dependent, two epicardial leads were implanted in the right ventricle.</p><p id="par0020" class="elsevierStylePara elsevierViewall">PTV was performed with general anesthesia and orotracheal intubation, and was monitored with real-time three-dimensional (RT3D) transesophageal echocardiography (TEE). In mid-esophageal plane at 25° with simultaneous multiplanar visualization (x-plane mode), long- and short-axis images of the tricuspid valve were obtained. In RT3D mode of the complete volume and using the cropping tool, a view of the tricuspid valve was then obtained from the right atrium (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>). The maximum diameter of the annulus in long- and short-axis views was 30 and 20 mm, respectively.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The approach was via the right femoral vein, and the tricuspid valve was crossed by a Glidecath MP catheter (Terumo Medical Corporation) and a straight guidewire. This was replaced by a pigtail catheter, and transvalvular gradients of 15 mmHg were observed. A stiff guidewire (Amplatz Super Stiff, Boston Scientific) was placed over this catheter, and a 30 mm×4 mm balloon valvuloplasty catheter (Tyshak, Numed Inc.) was introduced. Inflation was monitored by fluoroscopy (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>) and RT3D-TEE. After inflation, a transvalvular gradient of 2.8 mmHg was measured by echocardiography. No tricuspid regurgitation was observed.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The patient was discharged after 48 hours without complications. Six months after the procedure, she was in NYHA functional class I with no clinical evidence of right heart failure. The transvalvular gradient by transthoracic echocardiography was 2 mmHg, and no tricuspid regurgitation was observed.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">The most common etiology of tricuspid stenosis is rheumatic, and in most cases it is associated with valvular regurgitation.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Interestingly, there have been reports of cases of tricuspid stenosis without associated valvular regurgitation, most of them pacemaker lead-induced.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The pathophysiology of this tricuspid stenosis includes mechanical irritation of the leaflets by the leads, leading to fibrosis, calcification, endocarditis and/or thrombus formation.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">TVR may be a therapeutic alternative to surgery in cases of pure tricuspid stenosis without other concomitant valvulopathies.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> There are few data for this option, but the reported results are favorable.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The implementation of PTV is complicated by the choice of balloon size, because the tricuspid annulus is oval in shape, but assumes a more circular shape on dilation. This makes it more difficult to assess the annulus with two-dimensional echocardiography and hence to choose a balloon for PTV.</p><p id="par0050" class="elsevierStylePara elsevierViewall">RT3D-TEE gives a clear characterization of the morphology and abnormalities of the tricuspid valve,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> as well as providing short-axis views of the valve (simultaneously viewing the three leaflets and their junction with the annulus), enabling planimetry and calculating the area and size of the annulus with high accuracy.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">RT3D-TEE may thus be a helpful tool in monitoring TVR, providing a detailed image of the tricuspid valve. With this technique, balloon size can be selected with greater accuracy and the results of its implementation can be comprehensively assessed.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Ethical disclosures</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Protection of human and animal subjects</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Confidentiality of data</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Right to privacy and informed consent</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conflicts of interest</span><p id="par0075" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "xres384005" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec362870" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres384006" "titulo" => "Resumo" ] 3 => array:2 [ "identificador" => "xpalclavsec362871" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Discussion" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Right to privacy and informed consent" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-05-12" "fechaAceptado" => "2014-06-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec362870" "palabras" => array:4 [ 0 => "Tricuspid stenosis" 1 => "Pacemaker" 2 => "Balloon valvuloplasty" 3 => "3D echocardiography" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec362871" "palabras" => array:4 [ 0 => "Estenose tricúspide" 1 => "<span class="elsevierStyleItalic">Pacemaker</span>" 2 => "Valvuloplastia com balão" 3 => "Ecocardiografia 3D" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The most common etiology of tricuspid stenosis is rheumatic, and in most cases it is associated with valvular regurgitation. Interestingly, there have been reports of tricuspid stenosis without associated valvular regurgitation, mostly related to pacemaker leads. Percutaneous tricuspid valvuloplasty may be a therapeutic alternative to surgery in cases of pure tricuspid stenosis without other concomitant valvulopathies. We report the case of a 52-year-old woman with pacemaker lead-related tricuspid stenosis successfully treated with percutaneous valvuloplasty guided by 3D echocardiography.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A causa mais comum da estenose tricúspide é reumática, e na maioria dos casos está associada com insuficiência valvular. Curiosamente, tem havido relatos de estenose tricúspide sem insuficiência associada, sendo a maioria associados com electrocateteres de <span class="elsevierStyleItalic">pacemaker</span>. A plastia da valva tricúspide pode ser uma alternativa em casos de estenose valvular tricúspide pura, sem outras valvulopatias concomitantes. Relatamos o caso de uma mulher de 52 anos com estenose tricúspide associada a electrocateter de <span class="elsevierStyleItalic">pacemaker</span> tratada com sucesso com valvuloplastia percutânea guiada por ecocardiografia 3D.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1134 "Ancho" => 1516 "Tamanyo" => 152198 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Real-time three-dimensional transesophageal echocardiography: view of the tricuspid valve in diastole from the right atrium, revealing adherence of the pacing lead to the septal leaflet (arrow).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 525 "Ancho" => 1599 "Tamanyo" => 73794 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Angiographic images of percutaneous tricuspid valvuloplasty: (A) pigtail catheter across the tricuspid valve; (B) Amplatz Super Stiff guidewire across the valve; (C) balloon inflation.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tricuspid and pulmonary valve disease evaluation and management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.M. Shah" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2010" "volumen" => "63" "paginaInicial" => "1349" "paginaFinal" => "1365" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21070730" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lead-induced tricuspid stenosis – successful management by balloon angioplasty" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Hussain" 1 => "W.B. Knight" 2 => "K.A. McLeod" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1540-8159.2009.02189.x" "Revista" => array:6 [ "tituloSerie" => "Pacing Clin Electrophysiol" "fecha" => "2009" "volumen" => "32" "paginaInicial" => "140" "paginaFinal" => "142" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19140926" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Valvuloplasty for tricuspid stenosis caused by a ventriculoatrial shunt" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Q. Akram" 1 => "D. Saravanan" 2 => "R. Levy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ccd.22745" "Revista" => array:6 [ "tituloSerie" => "Catheter Cardiovasc Interv" "fecha" => "2011" "volumen" => "77" "paginaInicial" => "722" "paginaFinal" => "725" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20824751" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Vahanian" 1 => "O. Alfieri" 2 => "F. Andreotti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ejcts/ezs455" "Revista" => array:6 [ "tituloSerie" => "Eur J Cardiothorac Surg" "fecha" => "2012" "volumen" => "42" "paginaInicial" => "S1" "paginaFinal" => "S44" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22922698" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tricuspid balloon valvuloplasty to treat tricuspid stenosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "E. Yeter" 1 => "K. Ozlem" 2 => "H. Kilic" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Heart Valve Dis" "fecha" => "2010" "volumen" => "19" "paginaInicial" => "159" "paginaFinal" => "160" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20329507" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Three-dimensional echocardiography in valvular heart disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Q. Cai" 1 => "M. Ahmad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1540-8175.2011.01523.x" "Revista" => array:6 [ "tituloSerie" => "Echocardiography" "fecha" => "2012" "volumen" => "29" "paginaInicial" => "88" "paginaFinal" => "97" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23186293" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000003300000011/v1_201411200056/S0870255114002595/v1_201411200056/en/main.assets" "Apartado" => array:4 [ "identificador" => "362" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Casos clínicos" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003300000011/v1_201411200056/S0870255114002595/v1_201411200056/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255114002595?idApp=UINPBA00004E" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 5 | 5 | 10 |
| 2024 Outubro | 49 | 32 | 81 |
| 2024 Setembro | 61 | 30 | 91 |
| 2024 Agosto | 58 | 28 | 86 |
| 2024 Julho | 38 | 40 | 78 |
| 2024 Junho | 58 | 24 | 82 |
| 2024 Maio | 51 | 28 | 79 |
| 2024 Abril | 46 | 25 | 71 |
| 2024 Maro | 37 | 34 | 71 |
| 2024 Fevereiro | 43 | 27 | 70 |
| 2024 Janeiro | 43 | 35 | 78 |
| 2023 Dezembro | 34 | 20 | 54 |
| 2023 Novembro | 42 | 23 | 65 |
| 2023 Outubro | 25 | 25 | 50 |
| 2023 Setembro | 39 | 23 | 62 |
| 2023 Agosto | 34 | 21 | 55 |
| 2023 Julho | 27 | 15 | 42 |
| 2023 Junho | 26 | 8 | 34 |
| 2023 Maio | 53 | 24 | 77 |
| 2023 Abril | 28 | 7 | 35 |
| 2023 Maro | 34 | 25 | 59 |
| 2023 Fevereiro | 36 | 19 | 55 |
| 2023 Janeiro | 18 | 16 | 34 |
| 2022 Dezembro | 39 | 24 | 63 |
| 2022 Novembro | 50 | 26 | 76 |
| 2022 Outubro | 47 | 28 | 75 |
| 2022 Setembro | 27 | 37 | 64 |
| 2022 Agosto | 38 | 32 | 70 |
| 2022 Julho | 40 | 39 | 79 |
| 2022 Junho | 22 | 24 | 46 |
| 2022 Maio | 26 | 31 | 57 |
| 2022 Abril | 41 | 30 | 71 |
| 2022 Maro | 32 | 43 | 75 |
| 2022 Fevereiro | 36 | 35 | 71 |
| 2022 Janeiro | 29 | 38 | 67 |
| 2021 Dezembro | 15 | 32 | 47 |
| 2021 Novembro | 35 | 44 | 79 |
| 2021 Outubro | 37 | 50 | 87 |
| 2021 Setembro | 22 | 28 | 50 |
| 2021 Agosto | 29 | 25 | 54 |
| 2021 Julho | 14 | 32 | 46 |
| 2021 Junho | 29 | 27 | 56 |
| 2021 Maio | 22 | 21 | 43 |
| 2021 Abril | 35 | 39 | 74 |
| 2021 Maro | 60 | 13 | 73 |
| 2021 Fevereiro | 67 | 21 | 88 |
| 2021 Janeiro | 28 | 9 | 37 |
| 2020 Dezembro | 31 | 6 | 37 |
| 2020 Novembro | 41 | 14 | 55 |
| 2020 Outubro | 22 | 9 | 31 |
| 2020 Setembro | 50 | 5 | 55 |
| 2020 Agosto | 11 | 9 | 20 |
| 2020 Julho | 69 | 6 | 75 |
| 2020 Junho | 37 | 8 | 45 |
| 2020 Maio | 50 | 3 | 53 |
| 2020 Abril | 29 | 7 | 36 |
| 2020 Maro | 27 | 5 | 32 |
| 2020 Fevereiro | 100 | 25 | 125 |
| 2020 Janeiro | 46 | 7 | 53 |
| 2019 Dezembro | 54 | 12 | 66 |
| 2019 Novembro | 54 | 7 | 61 |
| 2019 Outubro | 44 | 5 | 49 |
| 2019 Setembro | 81 | 7 | 88 |
| 2019 Agosto | 54 | 16 | 70 |
| 2019 Julho | 45 | 13 | 58 |
| 2019 Junho | 31 | 6 | 37 |
| 2019 Maio | 52 | 14 | 66 |
| 2019 Abril | 39 | 21 | 60 |
| 2019 Maro | 98 | 10 | 108 |
| 2019 Fevereiro | 109 | 12 | 121 |
| 2019 Janeiro | 66 | 16 | 82 |
| 2018 Dezembro | 62 | 19 | 81 |
| 2018 Novembro | 116 | 13 | 129 |
| 2018 Outubro | 222 | 25 | 247 |
| 2018 Setembro | 48 | 14 | 62 |
| 2018 Agosto | 32 | 11 | 43 |
| 2018 Julho | 36 | 6 | 42 |
| 2018 Junho | 77 | 5 | 82 |
| 2018 Maio | 75 | 7 | 82 |
| 2018 Abril | 80 | 0 | 80 |
| 2018 Maro | 129 | 11 | 140 |
| 2018 Fevereiro | 49 | 3 | 52 |
| 2018 Janeiro | 21 | 7 | 28 |
| 2017 Dezembro | 67 | 8 | 75 |
| 2017 Novembro | 38 | 7 | 45 |
| 2017 Outubro | 37 | 8 | 45 |
| 2017 Setembro | 46 | 8 | 54 |
| 2017 Agosto | 58 | 13 | 71 |
| 2017 Julho | 36 | 8 | 44 |
| 2017 Junho | 44 | 19 | 63 |
| 2017 Maio | 61 | 9 | 70 |
| 2017 Abril | 38 | 6 | 44 |
| 2017 Maro | 28 | 28 | 56 |
| 2017 Fevereiro | 25 | 7 | 32 |
| 2017 Janeiro | 27 | 7 | 34 |
| 2016 Dezembro | 21 | 8 | 29 |
| 2016 Novembro | 32 | 4 | 36 |
| 2016 Outubro | 28 | 12 | 40 |
| 2016 Setembro | 20 | 6 | 26 |
| 2016 Agosto | 15 | 4 | 19 |
| 2016 Julho | 12 | 4 | 16 |
| 2016 Junho | 20 | 8 | 28 |
| 2016 Maio | 6 | 7 | 13 |
| 2016 Abril | 20 | 2 | 22 |
| 2016 Maro | 32 | 11 | 43 |
| 2016 Fevereiro | 49 | 29 | 78 |
| 2016 Janeiro | 48 | 22 | 70 |
| 2015 Dezembro | 39 | 12 | 51 |
| 2015 Novembro | 42 | 10 | 52 |
| 2015 Outubro | 37 | 14 | 51 |
| 2015 Setembro | 42 | 24 | 66 |
| 2015 Agosto | 46 | 32 | 78 |
| 2015 Julho | 29 | 18 | 47 |
| 2015 Junho | 17 | 19 | 36 |
| 2015 Maio | 33 | 22 | 55 |
| 2015 Abril | 25 | 30 | 55 |
| 2015 Maro | 26 | 13 | 39 |
| 2015 Fevereiro | 27 | 11 | 38 |
| 2015 Janeiro | 26 | 33 | 59 |
| 2014 Dezembro | 97 | 60 | 157 |
| 2014 Novembro | 27 | 23 | 50 |
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