Cirugia Cardiovascular最新文献

{"title":"Utilidad de la procalcitonina como biomarcador en cirugía cardiaca","authors":"Mario Castaño,&nbsp;Pasquale Maiorano,&nbsp;Laura Castillo,&nbsp;Blanca Meana,&nbsp;Belén Ramos,&nbsp;Elio Martín-Gutiérrez,&nbsp;Javier A. Gualis","doi":"10.1016/j.circv.2024.05.008","DOIUrl":"10.1016/j.circv.2024.05.008","url":null,"abstract":"<div><div>Procalcitonin is a valuable biomarker for the diagnosis and prognosis of infection and for antibiotic treatment monitoring in multiple clinical situations. Postoperative infection is a severe complication after cardiac surgery that increases morbimortality, which can be effectively reduced with early detection and appropriate treatment. Surgical trauma and cardiopulmonary bypass induced inflammation, as well as hypothermia or vasoconstrictors, stimulate the release of procalcitonin in uncomplicated postoperative patients, so its usefulness may be reduced. This review presents the state of the art regarding the predictive value of procalcitonin as a clinical biomarker for the diagnosis and prognosis of infection in various clinical contexts and the current evidence of the usefulness of this biomarker in the diagnosis and prognosis of infectious and non-infectious complications in the cardiac postoperative period.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 1","pages":"Pages 26-33"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143577","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":"Experiencia en DAC cardiaca en la Comunidad Valenciana: programa de extracción cardiaca extrahospitalaria","authors":"Audelio Guevara-Bonilla,&nbsp;Eduardo Tébar-Botí,&nbsp;Claudia Aguirre-Ramón,&nbsp;Alexandra Merino-Orozco,&nbsp;Carlos Domínguez-Massa,&nbsp;Manuel Pérez-Guillén,&nbsp;Ana Bel-Mínguez,&nbsp;Salvador Torregrosa-Puerta,&nbsp;Tomás Heredia-Cambra,&nbsp;Alejandro Rincón-Almanza,&nbsp;María J. Dalmau-Sorli,&nbsp;Iván Martín González,&nbsp;Francisco J. Valera Martínez,&nbsp;Ana Tur-Alonso,&nbsp;Juan B. Martínez León","doi":"10.1016/j.circv.2024.07.009","DOIUrl":"10.1016/j.circv.2024.07.009","url":null,"abstract":"<div><h3>Introduction</h3><div>In Spain, since 2020, hearts obtained from donation after circulatory determination of death (DCD) have been used for heart transplants. We show our experience from the beginning of the heart DCDs program. An out-of-hospital cardiac extraction protocol has been implemented within the Valencian Community.</div></div><div><h3>Materials and method</h3><div>From November 2022 to April 2024, 21 cardiac assessments have been performed in the context of DCD.</div><div>Donor inclusion criteria: donor &lt;<!--> <!-->55<!--> <!-->years old; family donation consent; functional warm ischemia time &lt;<!--> <!-->30<!--> <!-->min.</div><div>Donor exclusion criteria, additional to those of a cardiac donation: adrenaline infusion; dobutamine infusion; norepinephrine infusion &gt;<!--> <!-->0,3<!--> <!-->μg/kg/min.</div><div>This is a retrospective descriptive study.</div></div><div><h3>Results</h3><div>Of the 21 possible donors, 19 were valid hearts, 2 of them were for a hospital outside the community. The mean age of the donors was 40.4<!--> <!-->years, most of them men. In total, 17 patients were transplanted in our hospital. The mean cardiac ischemia time was 136.41<!--> <!-->min. Primary graft failure was described in 8 patients.</div></div><div><h3>Conclusions</h3><div>The cardiopulmonary bypass allowed continuous monitoring of aerobic and anaerobic metabolism, correct emptying of the cardiac chambers and the administration of cardioplegia with pressure, temperature and flow control.</div><div>Our experience highlights the possibilities of success with hearts obtained from a DCD, representing an increase in the number of donors and a decrease in the waiting time for the transplant.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 1","pages":"Pages 5-8"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143580","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":"25 años de cirugía de Ross: seguimiento y resultados en pacientes reoperados en nuestro centro","authors":"Consuelo M. Sisinni-Ganly,&nbsp;Julio C. Lugo-Adán,&nbsp;Francisco Estévez-Cid,&nbsp;Rocío Casais-Pampín,&nbsp;Juan J. Legarra-Calderón","doi":"10.1016/j.circv.2024.08.002","DOIUrl":"10.1016/j.circv.2024.08.002","url":null,"abstract":"<div><h3>Background</h3><div>Ross surgery is a relatively infrequent procedure due to its technical complexity and its long-term outcomes not being exempt from controversy. We analyzed the outcomes of our series of patients undergoing the Ross procedure and those who required reintervention due to dysfunction of the pulmonary autograft or homograft.</div></div><div><h3>Methods</h3><div>Since 1998, 108 patients underwent Ross surgery at our center, with root replacement (RR) surgical technique used in 105 of them. We retrospectively reviewed data from a subgroup of patients who underwent reintervention after Ross surgery due to dysfunction of the autograft or homograft. Their characteristics and survival were studied using Kaplan-Meier analysis.</div></div><div><h3>Results</h3><div>The mean follow-up of the patients undergoing RR was 17.5<!--> <!-->±<!--> <!-->5<!--> <!-->years (median 19<!--> <!-->years, range 0-25<!--> <!-->years). During this period, 29 patients (26.9%) required at least one reintervention: 13 patients (44.8%) due to autograft dysfunction, 7 patients (24.1%) due to homograft dysfunction, and 9 patients (31%) due to dysfunction of both autograft and homograft. The mean time to reintervention due to autograft dysfunction was 11.8<!--> <!-->±<!--> <!-->5.2<!--> <!-->years (median 12<!--> <!-->years, range 2-19<!--> <!-->years) and due to homograft dysfunction was 12.6<!--> <!-->±<!--> <!-->5<!--> <!-->years (median 13<!--> <!-->years, range 2-19<!--> <!-->years). Hospital mortality was null. The follow-up of these reintervened patients was 18.7<!--> <!-->±<!--> <!-->3.1<!--> <!-->years (median 19<!--> <!-->years, range 9-23), and the mortality during this period was 10% (n<!--> <!-->=<!--> <!-->3): two due to cardiac causes and one due to non-cardiac causes. The cumulative survival function of patients who underwent reintervention at 10<!--> <!-->years was 100%, and at 20<!--> <!-->years it was 93%.</div></div><div><h3>Conclusions</h3><div>The Ross procedure is associated with a non-negligible risk of reoperation. In our series of patients, no early mortality has been observed following reoperation due to dysfunction of the pulmonary autograft or homograft.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 1","pages":"Pages 14-20"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143576","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":"Resultados a corto y largo plazo tras trasplante cardíaco en pacientes con cardiopatías congénitas","authors":"Marta Molina ,&nbsp;Elena Roselló ,&nbsp;Manel Tauron ,&nbsp;Juan F. Tabilo ,&nbsp;Constanza Fernandez ,&nbsp;Carla Gotsens ,&nbsp;Exzequiel Pueblas ,&nbsp;José Montiel ,&nbsp;Sandra Casellas ,&nbsp;Angela Irabien ,&nbsp;Laura Corominas ,&nbsp;Laura López ,&nbsp;Sonia Mirabet ,&nbsp;Antonino Ginel","doi":"10.1016/j.circv.2024.08.001","DOIUrl":"10.1016/j.circv.2024.08.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Survival and the need for transplantation in patients with congenital heart disease have increased. This study aims to understand the perioperative characteristics and long-term survival of these patients after transplantation and to compare them with those of patients with non-congenital heart disease.</div></div><div><h3>Methods</h3><div>Patients who underwent a heart transplant at our center from 1984 to 2023 were included. A retrospective cohort study (congenital/non-congenital) with long-term follow-up was conducted. Statistical analysis was performed using Stata.</div></div><div><h3>Results</h3><div>A total of 636 transplanted patients were included, of which 37 had congenital heart disease. The number of transplanted patients with congenital heart disease has increased; 59.5% of such patients was transplanted in the last 10<!--> <!-->years. The most frequent congenital heart disease was the transposition of great arteries. Transplanted patients with congenital heart diseases were younger, had fewer comorbidities, and a higher number of previous interventions (<em>P</em> <!-->&lt;<!--> <!-->.05). There were no significant differences in extracorporeal circulation time, reoperation for bleeding, or hospital stay. The survival rates for the congenital group were 97.1%, 90.1%, 75.3%, and 52.6% at 1, 5, 10, and 20<!--> <!-->years, respectively. Compared to the non-congenital group, congenital patients had significantly higher survival rates (HR: 0.44; 95%<!--> <!-->CI: 0.22-0.9; <em>P</em> <!-->=<!--> <!-->.024).</div></div><div><h3>Conclusions</h3><div>The number of congenital heart disease patients requiring transplantation is growing sharply. Despite their greater complexity, these patients have similar surgical outcomes and better long-term survival. Team planning and preparation will be crucial.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 1","pages":"Pages 9-13"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143575","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":"Procalcitonina después de cirugía cardiaca: sí pero no, quizás","authors":"Claudia Escabia ,&nbsp;Victoria Delgado","doi":"10.1016/j.circv.2024.11.001","DOIUrl":"10.1016/j.circv.2024.11.001","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 1","pages":"Pages 3-4"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143574","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":"Treinta y seis horas de cambios eléctricos en la miocarditis fulminante","authors":"Ignacio Morales-Rey ,&nbsp;Sara Vázquez ,&nbsp;Brayan Rubio ,&nbsp;Elena Sandoval ,&nbsp;Daniel Pereda","doi":"10.1016/j.circv.2024.03.005","DOIUrl":"10.1016/j.circv.2024.03.005","url":null,"abstract":"<div><div>Fulminant myocarditis may present with a variety of EKG changes. In some cases, these changes do correlate with the severity of the disease. We present the case of a young female who was admitted with ST-segment elevation in anterior leads and evolved to an aberrant QRS complex followed by asystole in less than 48<!--> <!-->hours. Despite adequate medical therapy and mechanical circulatory support, the myocardium never recovered, and she needed an urgent heart transplant.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 1","pages":"Pages 21-22"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782274","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 clásica-abierta de las várices","authors":"","doi":"10.1016/j.circv.2024.03.002","DOIUrl":"10.1016/j.circv.2024.03.002","url":null,"abstract":"<div><div>The high prevalence of venous insufficiency has led to an important development in its treatments. Open surgery continues to be the technique of choice in many centers due to its excellent results and low recurrence rate. The use of mini-invasive techniques provides great benefits to the patient with less risk of associated complications and an immediate return to work. We will talk about the open surgery as well as its advantages and disadvantages in relation to other less invasive procedures.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 287-290"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141408416","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":"Estado actual del tratamiento de los aneurismas de la aorta abdominal","authors":"Ivan García Martín","doi":"10.1016/j.circv.2024.06.001","DOIUrl":"10.1016/j.circv.2024.06.001","url":null,"abstract":"<div><div>Abdominal aorta aneurysms present a high incidence in elderly population and are an important cause of morbi-mortality. The new endovascular aproach (EVAR) has allowed to treat an increasing number of patients, some of them not candidates for conventional surgery. Althouhg initial mortality with EVAR, in supra or infrarenal position, has been reduced, mid-term results are similar with both techniques. Larger and better registries are needed to determine the most cost/effective technique.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 247-255"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713157","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":"Revisión de cirugía vascular periférica","authors":"César A. Rodríguez Canedo,&nbsp;María Nuñez Sayar,&nbsp;Ander Ucelay Aristi,&nbsp;Alejandro Pontón Cortina","doi":"10.1016/j.circv.2024.07.001","DOIUrl":"10.1016/j.circv.2024.07.001","url":null,"abstract":"<div><div>The term peripheral arterial disease (PAD) is considered a general term that encompasses a series of non-coronary arterial syndromes caused by alterations in the structure and function of the aorta and peripheral arteries, mainly due to atherosclerosis, although there are other physiopathological processes such as smoking, diabetes, arterial hypertension and hyperlipidaemia. For its diagnosis we have non-invasive methods such as the ankle-arm index that also allows us to make a prognosis and follow-up of patients with this pathology. It is important to make the differential diagnosis through anamnesis and physical examination, with other pathologies that generate intermittent claudication such as radicular pathology or musculoskeletal pathology. In terms of medical treatment, the first step is the modification of risk factors, followed by antiplatelet and anticoagulant drugs and lipid-lowering therapy with statins.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 230-234"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573558","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":"Estudio de la insuficiencia venosa crónica","authors":"","doi":"10.1016/j.circv.2024.03.008","DOIUrl":"10.1016/j.circv.2024.03.008","url":null,"abstract":"<div><div>Venous insufficiency represents a frequent health problem in the current population, with a great impact on the patient's quality of life. Early diagnosis and early start of treatment determines the evolution and the long-term impact on the patient. That is why we consider that; an exhaustive study of this pathology can be of vital interest. In this review we will focus on data of clinical interest and relevant diagnostics. We will talk about the medical treatment of this disease and the possible invasive approaches currently available.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 256-266"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402325","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}