Cirugia Cardiovascular最新文献

{"title":"Empleo de dispositivos de asistencia ventricular Levitronix CentriMag más de 30 días como puente al trasplante cardiaco. Experiencia en un centro","authors":"Lucía García Alcalde,&nbsp;José Aurelio Sarralde Aguayo,&nbsp;Iván García Martín,&nbsp;Juan Francisco Nistal Herrera,&nbsp;José Francisco Gutiérrez Diez,&nbsp;Mirella Fernández Gutiérrez,&nbsp;Virginia Burgos Palacios,&nbsp;Manuel Cobo Belaustegui,&nbsp;Pedro Muñoz Cacho","doi":"10.1016/j.circv.2025.02.004","DOIUrl":"10.1016/j.circv.2025.02.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Mechanical circulatory assist devices are used as a bridge to cardiac transplantation in refractory heart failure. Our objective is to assess post-transplant survival in patients with Levitronix CentriMag type ventricular assist devices for more than 30<!--> <!-->days.</div></div><div><h3>Methods</h3><div>We included patients between January 2009-December 2023 and assessed the results in terms of survival before and after heart transplant in patients with Levitronix CentriMag uni or biventricular ventricular assist device implantation. The incidence of complications and outcomes with the implant more than 30<!--> <!-->days were estimated.</div></div><div><h3>Results</h3><div>Fifty patients with a mean age of 52<!--> <!-->years; 86% were male and 14% female. Sixty percent were left ventricular assist devices and 40% were biventricular assist devices. Twenty-two percent had required ECMO prior to the Levitronix CentriMag device. The median was 41<!--> <!-->days with Levitronix until transplantation, with associated complications such as infections (62%) and hemorrhages (60%). 90% were transplanted, with a post-transplant survival of 91,1%, 78% at one year, and 44% at 5<!--> <!-->years. 14% suffered primary cardiac graft failure, with 57% of cases treated with ECMO, and with a survival rate of 85% in this group.</div></div><div><h3>Conclusions</h3><div>The use of a ventricular assist Levitronix CentriMag with more than thirty days is possible with a good result in pre- and post-transplant survival. Recovering patients from multi-organ failure provides benefits in post-transplant survival in order to make profitable the small number of donor hearts today.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 5","pages":"Pages 246-252"},"PeriodicalIF":0.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La trompa de elefante congelada para el tratamiento del síndrome aórtico agudo","authors":"Daniel Pérez-Camargo,&nbsp;Lourdes Montero-Cruces,&nbsp;Luis C. Maroto Castellanos","doi":"10.1016/j.circv.2024.04.003","DOIUrl":"10.1016/j.circv.2024.04.003","url":null,"abstract":"<div><div>Type A acute aortic syndrome involves a group of pathologies with similar clinical presentation and poor prognosis if not opportunely treated. Urgent surgery is indicated and the gold standard for intervention consists in ascending and hemiarch aortic replacement with open anastomosis under circulatory arrest. Nonetheless, in the last two decades, the frozen elephant trunk has become the treatment of choice when criteria for aortic arch replacement are present. The goal of the present article is to review the current evidence, describe the surgical technique, perioperative results and long-term outcomes.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 4","pages":"Pages 218-227"},"PeriodicalIF":0.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Credits","authors":"","doi":"10.1016/S1134-0096(26)00087-2","DOIUrl":"10.1016/S1134-0096(26)00087-2","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 4","pages":"Page i"},"PeriodicalIF":0.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148453710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The irruption of endovascular techniques in aortic repair: A personal view","authors":"Vincent Riambau","doi":"10.1016/j.circv.2024.03.003","DOIUrl":"10.1016/j.circv.2024.03.003","url":null,"abstract":"<div><div>The irruption of endovascular surgery in aortic repair has meant a paradigm shift in the way aortic pathology is approached and occupies a preferential, but not unique, place in the therapeutic algorithms of most modern hospital centres. Its emergence has shaken interprofessional relations in most healthcare settings. The most efficient and smoothest way to incorporate endovascular techniques in different centres is through the creation of an aortic team led by a vascular or cardiovascular surgeon or both. Additionally, the implementation of healthcare policies of centralisation of aortic pathology will contribute to improved outcomes and better use of resources.</div><div>However, several limitations remain to be overcome on the road to durable endovascular repair with lower re-intervention rates. There is no doubt that, with the collaboration with bioengineering, the industry involved and the creation of clinical evidence, the future of endovascular techniques, alone or in combination with open surgery, is bright and highly promising for the patients who benefit from them.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 4","pages":"Pages 212-217"},"PeriodicalIF":0.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embolization of intercostal and lumbar arteries in advance of open surgery for Type II thoracoabdominal aneurysms","authors":"Rafael Rodríguez Lecoq,&nbsp;Daniel Barnés Navarro,&nbsp;Mercedes Pérez Lafuente,&nbsp;Naoufal Zebdi,&nbsp;Remedios Rios Barrera,&nbsp;Hug Cuéllar Calabria,&nbsp;José Rodríguez Palomares,&nbsp;Fiorella Romero,&nbsp;Miriam Denadal,&nbsp;Miguel-Angel Castro Alba,&nbsp;Carlos Sureda-Barbosa,&nbsp;Mariasol Siliato,&nbsp;Neiser Palmer,&nbsp;Carlota Vigil-Escalera López,&nbsp;Pier Iorlano Mariano","doi":"10.1016/j.circv.2024.04.006","DOIUrl":"10.1016/j.circv.2024.04.006","url":null,"abstract":"<div><div>Open surgery for thoracoabdominal aortic aneurysms remains one of the most aggressive procedures, with a risk of paraplegia reaching up to 20% in some series. Preconditioning of the spinal circulation through prior embolization has been postulated to improve outcomes. We evaluate our initial experience with six patients.</div></div><div><h3>Materials and methods</h3><div>From May 2022 to June 2023, we operated on six patients with type II thoracoabdominal aortic aneurysms after prior embolization of the majority of their intercostal and lumbar arteries in 2–3 sessions separated by one month, prior to open surgery. Ethical considerations: All patients give their informed consent for the procedure and the publication of the results. Disclosures: None.</div></div><div><h3>Results</h3><div>We encountered no technical or neurological issues during the embolizations. The surgery was notably simpler due to reduced thoracic bleeding. Upon awakening, neurological assessment in all patients revealed no deficits. However, one patient, who required vasoconstrictors for sepsis postoperatively, subsequently developed paraplegia (6 days after the surgery).</div></div><div><h3>Conclusions</h3><div>Stepwise prior embolization of a significant portion of intercostal and lumbar arteries proves to be of great assistance during surgery. However, we believe it is necessary to reimplant some intercostal arteries to favor spinal cord irrigation. We do not consider indiscriminate embolization of all intercostal arteries advisable, as it significantly reduces irrigation, which can be further compromised by postoperative vasoconstrictors.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 4","pages":"Pages 208-211"},"PeriodicalIF":0.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reparación endovascular del arco aórtico con la prótesis Nexus™: experiencia inicial de un equipo de cirujanos cardiovasculares","authors":"Patric G. Callero-Hernández,&nbsp;Juan J. Otero Forero,&nbsp;Cristina Jaén Garrido,&nbsp;Miguel A. Gómez Vidal,&nbsp;José M. Vignau Cano,&nbsp;Diego Macías Rubio,&nbsp;Aníbal Bermúdez García,&nbsp;Adrián Fontaine,&nbsp;Jose A. Mamani,&nbsp;Omar Amrani,&nbsp;Tomás Daroca Martínez","doi":"10.1016/j.circv.2025.03.010","DOIUrl":"10.1016/j.circv.2025.03.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Aortic arch pathology depicts a significant challenge in cardiovascular surgery. The standard treatment is open surgery, which is highly complex and aggressive, making it inaccessible for certain patients. Therefore, less invasive therapies are needed for high-risk surgical patients. Endovascular surgery emerges as an alternative, with the Nexus™ endograft being a promising option.</div></div><div><h3>Methods</h3><div>We present our initial series of 5 patients treated with the Nexus™ endoprosthesis from June 2020 to November 2022. The intervention was performed in two stages: first, a carotid-carotid bypass, followed by the implantation of the prosthesis in a subsequent procedure.</div></div><div><h3>Results</h3><div>We achieved a 100% success rate in implantation, with one case of postoperative mortality and one case of stroke, which later showed neurological recovery. No other significant complications were observed during the follow-up period.</div></div><div><h3>Conclusions</h3><div>The Nexus™ system provides an alternative for patients considered high surgical risk or inoperable. In our center, technical success was achieved in all patients; however, the incidence of complications must be considered. A larger sample size and a longer study period would be necessary to establish definitive conclusions.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 4","pages":"Pages 181-186"},"PeriodicalIF":0.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148453712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implante de TBE™ para arco aórtico: presentación y experiencia inicial","authors":"Jose M. Villaescusa,&nbsp;Alexey Lavreshin,&nbsp;Ignacio García-Trujillo,&nbsp;Juan Oliva,&nbsp;Carla Archila,&nbsp;Carlos Porras","doi":"10.1016/j.circv.2025.06.005","DOIUrl":"10.1016/j.circv.2025.06.005","url":null,"abstract":"<div><h3>Introduction</h3><div>The Thoracic Branch Endograft (TBE™) is a type of endograft for the treatment of pathologies affecting zone<!--> <!-->2 of the aortic arch and the beginning of the descending thoracic aorta. It is the only one that currently has CE marking for this indication.</div><div>The aim of this article is to explain the advantages of this endograft and share our experience.</div></div><div><h3>Methods</h3><div>Analysis of the endovascular graft in distal arch and descending thoracic aorta in the two cases.</div></div><div><h3>Results</h3><div>Implant of two cases of TBE™. The first is a 70-year-old woman with a descending thoracic aortic aneurysm originating in zone<!--> <!-->3 requiring distal extension. The second patient is a 70-year-old man with a previous stent graft who presented an endoleak type IA and aortic wall degeneration in zone<!--> <!-->5 distal to the stent graft. Implantation in both patients was successful with no need for reintervention on short-term follow up.</div></div><div><h3>Conclusions</h3><div>The TBE™ graft is the only immediately available stent graft for the treatment in distal arch pathology with CE marking. It is an alternative to bypass surgery prior to stent graft implantation in zone<!--> <!-->2. Long-term studies are needed.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 4","pages":"Pages 194-199"},"PeriodicalIF":0.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148453711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reparación abierta retrógrada de aneurisma toracoabdominal tipo ii con injerto multirrama y reimplante de intercostales (técnica snake) en síndrome de Marfan","authors":"Iván Martín-González,&nbsp;Francisco J. Valera-Martínez,&nbsp;Alejandra Merino-Orozco,&nbsp;Claudia M. Aguirre-Ramón,&nbsp;Carlos Domínguez-Massa,&nbsp;Lorena Díez-Solorzano,&nbsp;Andrés Castelló,&nbsp;Audelio Guevara-Bonilla,&nbsp;José A. Rincón,&nbsp;Eduardo Tebar-Botí,&nbsp;Salvador Torregrosa-Puerta,&nbsp;María J. Dalmau,&nbsp;Eva M. Borrás-Parra,&nbsp;Victoria Cortés,&nbsp;María Navasquillo,&nbsp;Juan B. Martínez-León","doi":"10.1016/j.circv.2024.01.005","DOIUrl":"10.1016/j.circv.2024.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Thoracoabdominal aneurysm open repair is a high morbidity procedure, with worrisome spinal cord injury and mortality rate. The center experience, an adequate procedure planning and perioperative management are very determining factors for outcomes.</div></div><div><h3>Objective and methods</h3><div>The objective of this article is to describe, in relation to 2 recent cases of post-dissection type 2 thoracoabdominal aneurysm in Marfan, the surgical strategy for retrograde open surgical repair in our center.</div></div><div><h3>Results</h3><div>Thoraco-retroperitoneal approach with circumferential phrenotomy (partial or complete) assisted by 2 simultaneous retractors was done. Multimodal strategy for spinal cord injury protection included: distal perfusion by extracorporeal membrane oxygenator device, mild hypothermia (32-34<!--> <!-->°C), spinal cord drainage, sequential aortic clamping, neurophysiological introperative monitoring (motor and somatosensory evoked potentials) and selective intercostal arteries reattachment. A retrograde fashion repair (from distal to proximal) was performed. A home-made dacron graft with a bifurcated graft and multibranched graft was previously made. It allowed to repair the left iliac bifurcation, visceral vessels independently and segmental arteries by a parallel 10<!--> <!-->mm dacron graft (Snake technique) with multipatch reimplantation. The loss of evoked potentials during the procedure guided and changed the agressivity of intercostal arteries reattachment, with recovery of the evoked potentials.</div></div><div><h3>Conclusions</h3><div>Open repair is the first choice of therapy for thoracoabdominal aneurysms in Marfan syndrome. There are certain surgical adjuncts that could be especially useful in these cases such as retrograde fashion repair, multibranched prosthetic grafts and snake technique.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 4","pages":"Pages 200-207"},"PeriodicalIF":0.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140468003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cirugía de la aorta: realidad y futuro de una especialidad en transformación","authors":"Víctor X. Mosquera","doi":"10.1016/j.circv.2026.05.001","DOIUrl":"10.1016/j.circv.2026.05.001","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 4","pages":"Pages 179-180"},"PeriodicalIF":0.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148453713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trompa de elefante congelada a corazón latiendo: técnica quirúrgica y experiencia inicial","authors":"Francisco J. Valera-Martínez,&nbsp;Iván Martín-González,&nbsp;Claudia Aguirre-Ramón,&nbsp;Alejandra Merino-Orozco,&nbsp;Jose Alejandro Rincón-Almanza,&nbsp;Verónica Monfort-Drago,&nbsp;Carlos Domínguez-Massa,&nbsp;Eduardo Tébar-Botí,&nbsp;Manuel Pérez-Guillén,&nbsp;Tomás Heredia-Cambra,&nbsp;Audelio Guevara-Bonilla,&nbsp;Salvador Torregrosa-Puerta,&nbsp;María José Dalmau-Sorli,&nbsp;Andrés Castelló-Ginestar,&nbsp;Juan B. Martínez-León","doi":"10.1016/j.circv.2024.01.013","DOIUrl":"10.1016/j.circv.2024.01.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Aortic arch repair with hybrid prosthesis, also known as frozen elephant trunk technique, is considered the gold standard treatment for extensive arch and thoracic aortic aneurysms. By using current extracorporeal circulation as well as organ perfusion techniques, it is possible to perform the procedure while maintaining cerebral, lower body and even coronary perfusion; therefore, myocardial ischemia is avoided, and surgery can be done with lesser degree of hypothermia or even in normothermia without circulatory arrest.</div></div><div><h3>Objective and methods</h3><div>Beating heart frozen elephant trunk initial experience in two clinical cases, describing both the surgical technique and the perfusion strategy.</div></div><div><h3>Results</h3><div>The postoperative course was uneventful in both cases, without low cardiac output syndrome and no neurological events except vocal cord palsy in one case.</div></div><div><h3>Conclusions</h3><div>Beating heart frozen elephant trunk is the one-stage solution for extensive arch and thoracic aortic aneurysms, with less myocardial damage and lower risk of neurological, spinal, renal and visceral complications.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 4","pages":"Pages 187-193"},"PeriodicalIF":0.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}