Revistas
Revista:
EUROPEAN JOURNAL OF HEART FAILURE
ISSN:
1388-9842
Año:
2023
Vol.:
25
N°:
Supl. 2
Págs.:
225 - 226
Autores:
Gómez-Bueno, M. (Autor de correspondencia); Pérez de la Sota, E.; Forteza Gil, A.; et al.
Revista:
REVISTA ESPAÑOLA DE CARDIOLOGÍA (ENGLISH ED.)
ISSN:
1885-5857
Año:
2023
Vol.:
76
N°:
4
Págs.:
227 - 237
Introduction and objectives: This report presents the clinical characteristics, outcomes and complications of all consecutive patients implanted with a long-term mechanical circulatory support device in Spain between 2007 and 2020. Methods: Analysis of the Spanish Registry of durable ventricular assist devices (REGALAD) including data form Spanish centers with a mechanical circulatory support program. Results: During the study period, 263 ventricular assist devices were implanted in 22 hospitals. The implanted device was an isolated continuous-flow left ventricular assist device in 182 patients (69%), a pulsatile-flow device (58 isolated left ventricular and 21 biventricular) in 79 (30%), and a total artificial heart in 2 patients (1%). The strategy of the implant was as bridge to heart transplant in 78 patients (30%), bridge to candidacy in 110 (42%), bridge to recovery in 3 (1%) and destination therapy in 72 patients (27%). Overall survival at 6, 12 and 24 months was 79%, 74% and 69%, respectively, and was better in continuous-flow left ventricular assist devices (84%, 80%, and 75%). The main adverse events related to this therapy were infections (37% of patients), bleeding (35%), neurological (29%), and device malfunction (17%). Conclusions: Durable ventricular assist devices have emerged in Spain in the last few years as a useful therapy for patients with advanced heart failure. As in other international registries, the current trend is to use continuous-flow intracorporeal left ventricular devices, which are associated with better results. Adverse events continue to be frequent and severe.
Autores:
Couto-Mallon, D.; Donoso-Trenado, V.; Barge-Caballero, E.; et al.
Revista:
JOURNAL OF HEART AND LUNG TRANSPLANTATION
ISSN:
1053-2498
Año:
2023
Vol.:
42
N°:
4
Págs.:
S29
Autores:
Couto-Mallon, D. (Autor de correspondencia); Almenar-Bonet, L.; Barge-Caballero, E. (Autor de correspondencia); et al.
Revista:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
ISSN:
0735-1097
Año:
2023
Vol.:
82
N°:
9
Págs.:
753 - 767
BACKGROUND The reported prevalence of donor-transmitted coronary artery disease (TCAD) in heart transplantation (HT) is variable, and its prognostic impact remains unclear. OBJECTIVES The goal of this study was to characterize TCAD in a contemporary multicentric cohort and to study its prognostic relevance. METHODS This was a retrospective study of consecutive patients >18 years old who underwent HT in 11 Spanish centers from 2008 to 2018. Only patients with a coronary angiography (c-angio) within the first 3 months after HT were studied. Significant TCAD (s-TCAD) was defined as any stenosis >= 50% in epicardial coronary arteries, and nonsignificant TCAD (ns-TCAD) as stenosis <50%. Clinical outcomes were assessed by means of Cox regression and competing risks regression. Patients were followed-up for a median period of 6.3 years after c-angio. RESULTS From a cohort of 1,918 patients, 937 underwent c-angio. TCAD was found in 172 patients (18.3%): s-TCAD in 65 (6.9%) and ns-TCAD in 107 (11.4%). Multivariable Cox regression analysis did not show a statistically significant association between s-TCAD and all-cause mortality (adjusted HR: 1.44; 95% CI: 0.89-2.35; P = 0.141); however, it was an independent predictor of cardiovascular mortality (adjusted HR: 2.25; 95% CI: 1.20-4.19; P = 0.011) and the combined event cardiovascular death or nonfatal MACE (adjusted HR: 2.42; 95% CI: 1.52-3.85; P < 0.001). No statistically significant impact of ns-TCAD on clinical outcomes was detected. The results were similar when reassessed by means of competing risks regression. CONCLUSIONS TCAD was not associated with reduced survival in patients alive and well enough to undergo post-HT angiography within the first 3 months; however, s-TCAD patients showed increased risk of cardiovascular death and MACE. (c) 2023 by the American College of Cardiology Foundation.
Autores:
Couto-Mallon, D.; Almenar Bonet, L.; Barge-Caballero, E.; et al.
Revista:
JOURNAL OF HEART AND LUNG TRANSPLANTATION
ISSN:
1053-2498
Año:
2023
Vol.:
42
N°:
4
Págs.:
S250
Autores:
Gil-Korilis, A.; Esquíroz-Patiño, C.; Llamas-Llamazares, A.; et al.
Revista:
ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN:
1137-6627
Año:
2023
Vol.:
46
N°:
3
Págs.:
e1060 - *
Background. Masses and cysts in the heart are well-known entities, but their low prevalence and non-specific symptoms makes the diagnosis difficult. We aimed to characterize the features of these entities in our environment.Methods. We carried out a search of patients who underwent surgery for tumors and cysts in the heart between 2002 and 2022 in the registry of the Department of Cardiology and Cardiac Surgery of Clinica Universidad de Navarra (Pamplona, Spain). Sociodemographic, clinical, histological, and surgical variables were collected.Results. We identified 13 patients; mean age was 63.08 +/- 15.17 years, 76.92% were female and 92.31% had at least one cardiovascular risk factor, e.g., BMI >= 25 kg/m2 and high blood pressure (61.54% and 53.85%, respectively). The most com-mon type of cardiac tumors were myxomas (69.23%). Around half (46.15%) were incidental; the most frequent symptom was dyspnea (53.85%); 30.77% of the patients were asymptomatic. The most commonly used imaging technique for the diagnosis was transthoracic Doppler echocardiography (69.23%). The agreement between the mean diameters before and after surgery was very high (ICC = 0.807, 95% CI: 0.450-0.943).Conclusions. We describe the features of masses and cysts in the heart (77% female patients) and provide information scarcely available in the literature, e.g., the most frequent cardiovascular risk factors for this population. A case of cardiac leiomyosarcoma and a case of intimal sarcoma of the pulmonary trunk are described, two extremely rare tumors for which there are few described cases.
Autores:
Couto-Mallon, D.; Lopez-Vilella, R.; Barge-Caballero, E.; et al.
Revista:
JOURNAL OF HEART AND LUNG TRANSPLANTATION
ISSN:
1053-2498
Año:
2023
Vol.:
42
N°:
4
Págs.:
S251
Autores:
Couto-Mallón, D.; Almenar-Bonet, L.; Hernández-Pérez, F. J.; et al.
Revista:
JOURNAL OF HEART AND LUNG TRANSPLANTATION
ISSN:
1053-2498
Año:
2022
Vol.:
41
N°:
4
Págs.:
S336 - S336
Autores:
Ramírez, A. (Autor de correspondencia); Sobrinos, E.; Girón, J. J.; et al.
Revista:
CIRUGIA CARDIOVASCULAR
ISSN:
1134-0096
Año:
2022
Vol.:
29
N°:
2
Págs.:
110 - 113
An anomalous origin of the coronary artery is an uncommon congenital disorder. Even though the pathology is generally asymptomatic, it can present with life-threatening symptoms. Two cases with an anomalous origin of the right coronary artery are assessed. Though both patients' arterial anomalies were alike, the surgical procedure was different in each case. The unroofing technique and coronary artery bypass grafting are compared to evaluate different surgical approaches for a personalize treatment of the pathology.
Revista:
AMERICAN JOURNAL OF ROENTGENOLOGY
ISSN:
0361-803X
Año:
2021
Vol.:
216
N°:
5
Págs.:
1216 - 1221
OBJECTIVE. This study aimed to evaluate the long-term prognostic value of coronary CTA (CCTA) in heart transplant recipients. MATERIALS AND METHODS. The records of 114 patients who had undergone a heart transplant (mean age, 61.7 +/- 11.1 [SD] years; 83.3% men) and who underwent CCTA for the surveillance of coronary allograft vasculopathy (CAV) from June 2007 to December 2017 were retrospectively evaluated for the occurrence of major adverse cardiovascular events (MACEs) (cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, coronary revascularization, cardiac arrhythmias, stroke, and retransplant). Patients were classified according to the presence of nonobstructive CAV (lumen reduction < 50%) or obstructive disease (lumen reduction >= 50%) and using a coronary segment involvement score (SIS). Differences in MACE rate between groups were compared. RESULTS. Obstructive CAV was observed in 12 heart transplant recipients (10.5%). During a mean follow-up of 67.5 +/- 41.4 months the overall rates of MACE were 50% and 14.7% in patients with obstructive and nonobstructive CAV, respectively (p < .05), resulting in an odds ratio for MACE of 6 (95% CI, 1.7-21.2). Comparison of event-free survival showed a hazard ratio (HR) of 5 (95% CI, 1.95-13; p =. 004) for patients with obstructive disease. The presence of four or more stenotic coronary segments (SIS = 4) was associated with a higher rate of events (HR, 3.46; 95% CI, 1.46-8.23). CONCLUSION. In patients who have undergone a heart transplant, CCTA offers a significant long-term prognostic impact on the prediction of MACEs.
Revista:
CIRUGIA CARDIOVASCULAR
ISSN:
1134-0096
Año:
2021
Vol.:
28
N°:
6
Págs.:
353 - 356
El tratamiento percutáneo de la estenosis aórtica severa es una opción terapéutica para paciente inoperables y para aquellos de moderado o elevado riesgo quirúrgico.
Presentamos el caso de un paciente joven inicialmente considerado inoperable, sometido a una implantación transcatéter de válvula aórtica, que comenzó a mostrar signos de degeneración tras seis años, que evolucionaron hasta requerir tratamiento quirúrgico a los ocho años del implante. Durante este tiempo, su estado de salud mejoró, por lo que fue presentado en sesión médico quirúrgica para la resección de la válvula previamente implantada y sustitución por otra bioprótesis. El procedimiento transcurrió sin complicaciones.
No obstante, la resección de estas válvulas no es un procedimiento exento de riesgo, por las densas adherencias del marco a la raíz aórtica.
Por este motivo, la expansión de esta tecnología a pacientes jóvenes y de bajo riesgo, no estaría justificada.
Revista:
EUROPEAN JOURNAL OF HEART FAILURE
ISSN:
1388-9842
Año:
2018
Vol.:
20
N°:
Supl 1
Págs.:
158 - 158
Revista:
CIRUGIA CARDIOVASCULAR
ISSN:
1134-0096
Año:
2018
Vol.:
25
N°:
4
Págs.:
208 - 211
Mitral valve aneurysms are very rare complications of bacterial endocarditis. We present the case of an 88-year-old woman with moderate aortic insufficiency and an aneurysm in the anterior leaflet of the mitral valve secondary to endocarditis. After completing a full course of antibiotic, we performed though the aortotomy, mitral leaflet aneurysm resection, repairing the defect with an autologous pericardial patch, and aortic valve replacement by a bioprosthesis. The evolution of the patient was uneventful and was discharged on the ninth postoperative day. (C) 2018 Sociedad Espanola de Cirugia Toracica-Cardiovascular. Published by Elsevier Espana, S.L.U.