Cirugia Cardiovascular最新文献

{"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}

{"title":"Técnicas endovasculares en el tratamiento de la insuficiencia venosa superficial. Mecanismo de acción, procedimientos, indicaciones y efectos adversos","authors":"","doi":"10.1016/j.circv.2024.03.001","DOIUrl":"10.1016/j.circv.2024.03.001","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Chronic venous disease is the most common entity of vascular pathology and varicose veins originating in the saphenous trunks can cause significant morbidity. Endovascular treatment offers significant advantages, being at least as effective as surgery.</div></div><div><h3>Methods</h3><div>Review of thermal (laser, radiofrequency, steam and microwave) and non-thermal (cyanoacrylate, ultrasound-guided foam and mechano-chemical) endovascular techniques in the treatment of superficial venous insufficiency based on existing literature and own experience.</div></div><div><h3>Results</h3><div>Throughout the article, each of the techniques, their mechanism of action and the commercial devices available with standard use procedures are described. Likewise, the usual postoperative period for each of them, precautions, contraindications, results described in the literature, and frequent and uncommon complications are detailed. After the description of the techniques, the results of endovascular techniques are compared with conventional surgery (high ligation/stripping) and endovascular techniques with each other. Finally, a guide is provided for selecting the best treatment based on the characteristics of the patient, its indications and known limitations, according to the latest clinical guidelines and reviews.</div></div><div><h3>Conclusions</h3><div>Endovascular treatment has become the current standard. Although thermoablative techniques are the first indication, non-thermal treatments are a good alternative depending on the clinical context and some such as cyanoacrylate may become first choice therapy in the future.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 267-286"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141403561","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(24)00176-1","DOIUrl":"10.1016/S1134-0096(24)00176-1","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Page i"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573556","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":"Epidemiología, diagnóstico, clasificación e indicaciones quirúrgicas actuales de los aneurismas de la aorta toracoabdominal","authors":"","doi":"10.1016/j.circv.2023.11.030","DOIUrl":"10.1016/j.circv.2023.11.030","url":null,"abstract":"<div><div>Thoracoabdominal aortic aneurysms remain a challenge in cardiovascular surgery due to the complexity of the pathology, the invasiveness of surgical treatment required and common patient comorbidities. The prevalence, true and detected, of these aneurysms has increased due to increased life expectancy, improved diagnosis, and greater physician and patient awareness. They can trigger dissection or rupture, and half of all deaths are due to aortic rupture, even in aneurysms with diameters under 6<!--> <!-->cm. The goal of treatment is to reduce the risk of adverse aortic events, such as dissection, rupture, or aortic-related death. The timing of intervention requires careful evaluation of anatomic and risk factors for future events versus operative risks. Open surgery aims to replace the aneurysmal thoracoabdominal aortic segment with a prosthetic graft anastomosed to adjacent non-aneurysmal aortic tissues, whereas endovascular repair uses stent-grafts to exclude blood flow from the aneurysmal sac. The morbidity and mortality of open surgical repair are high, especially in patients with comorbidities, and include spinal cord ischemia and renal damage. Endovascular treatment has been developed as a less invasive alternative to open surgery, with promising results in reducing hospital mortality, but its use remains experimental. The choice of treatment requires a multidisciplinary assessment of the patient's risk factors and the anatomical characteristics of the aneurysm. Hybrid treatment, combining thoracic endovascular repair with (simultaneous or deferred) open abdominal surgery, has recently been proposed, but there is still limited experience and no robust evidence for improved outcomes.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 235-246"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140467363","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":"Estrategias en el tratamiento endovascular del aneurisma de aorta toracoabdominal","authors":"","doi":"10.1016/j.circv.2024.03.010","DOIUrl":"10.1016/j.circv.2024.03.010","url":null,"abstract":"<div><div>The thoracoabdominal segment is currently treatable by endovascular techniques, making it possible to treat patients with higher surgical risk. We expose the advantages of the different configurations with fenestrations or branches. There are prefabricated prostheses on the market suitable for most patients. Knowledge of the patient's anatomical peculiarities will allow us to select patients with an adequate result in the medium and long term, as well as choose the most appropriate prosthesis.</div><div>The application of associated spinal cord protection and nephroprotection techniques complete the comprehensive approach to the patient.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 291-294"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141413803","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":"«Special Issues» en Cirugía Cardiovascular","authors":"Rafael García Fuster","doi":"10.1016/j.circv.2024.10.001","DOIUrl":"10.1016/j.circv.2024.10.001","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Page 229"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573557","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":"Disfagia lusoria por arteria subclavia izquierda aberrante tratada mediante exclusión arterial y aortoplastia","authors":"","doi":"10.1016/j.circv.2024.02.007","DOIUrl":"10.1016/j.circv.2024.02.007","url":null,"abstract":"<div><p>Dysphagia lusoria is a rare cause of dysphagia that requires a high suspicion index to make a diagnosis and management protocol as well an understanding of the underlying physiopathological and embryological mechanisms to plan an adequate surgery for a definitive treatment. Even though there is moderate experience with the management of dysphagia lusoria in its most common variant, corresponding to that arising from an aberrant right subclavian artery, there are only a few cases of dysphagia lusoria due to an aberrant left subclavian artery. Next, we describe the case of a 45-year-old male with late onset presentation of symptoms in whom we found dysphagia lusoria with aberrant left subclavian artery.</p></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 5","pages":"Pages 222-224"},"PeriodicalIF":0.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S113400962400041X/pdfft?md5=e5bd9cc967f408cf5d3fa6b91348c754&pid=1-s2.0-S113400962400041X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268060","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 tricúspide aislada sin clampaje aórtico por minitoracotomía derecha","authors":"Walid Al Houssaini,&nbsp;María J. Mataró,&nbsp;Lorena Rubio,&nbsp;Ricardo Muñoz,&nbsp;Gemma Sanchez-Espin,&nbsp;Carlos Porras,&nbsp;José M. Melero","doi":"10.1016/j.circv.2024.05.005","DOIUrl":"10.1016/j.circv.2024.05.005","url":null,"abstract":"<div><h3>Background</h3><p>Tricuspid valve disease has been steadily increasing, raising concerns about the morbidity and mortality associated with surgery when performed via conventional sternotomy. In this context, the clinical and aesthetic advantages of isolated tricuspid surgery by right anterior mini-thoracotomy without aortic clamping are presented.</p></div><div><h3>Material and methods</h3><p>A case series of 29 patients who underwent minimally invasive isolated tricuspid valve surgery in our center, from 2014 to 2023, have been studied retrospectively. The operation was performed by right anterior mini-thoracotomy without caval exclusion and without aortic clamping to a beating heart assisted by 3<!--> <!-->D videothoracoscopy. Preoperative levosimendan was administered in patients with severe pulmonary hypertension and/or right ventricular dysfunction.</p></div><div><h3>Results</h3><p>Twenty-eight tricuspid valve replacement and one repair were performed. Average patients age was 63 years old (SD 8 years old). 18 patients (62%) had previous cardiac surgery. 22 patients (75,8%) had severe pulmonary hypertension and 12 (41,3%) had right ventricule disfunction. Average EuroSCORE II was 4,10%. In-hospital mortality was 3,4% (one patient). The average extracorporeal circulation was 109 (SD 41<!--> <!-->minutes). There was a reoperation due bleeding and a permanent pacemaker implantation (3,4%). Temporary renal replacement therapy was required in 21% (6 patients). The median length of hospital stay was 7 days.</p></div><div><h3>Conclusions</h3><p>Minimally invasive isolated tricuspid valve surgery is a safe technique as a definitive treatment of isolated tricuspid valve disease with a low mortality and morbidity.</p></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 5","pages":"Pages 207-211"},"PeriodicalIF":0.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1134009624001025/pdfft?md5=d04111d6d55a711fcbe96ab95ed54a4b&pid=1-s2.0-S1134009624001025-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240101","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":"It's not just the CROWN that makes the king, results in aortic position","authors":"German J. Chaud ,&nbsp;Joaquín Gundelach ,&nbsp;Marcos Durand ,&nbsp;Jaime Horta ,&nbsp;Rodrigo Gomez ,&nbsp;Ignacio Cuadra ,&nbsp;Sintya Provoste ,&nbsp;Yelka Tenelema ,&nbsp;Cristóbal Alvarado ,&nbsp;Gustavo Meriño","doi":"10.1016/j.circv.2024.05.003","DOIUrl":"10.1016/j.circv.2024.05.003","url":null,"abstract":"<div><h3>Introduction</h3><p>The use of biological valves in the aortic position has become more liberal in recent years due to improvements in prostheses and the possibility of performing valve-in-valve procedures, thus avoiding anticoagulation.</p></div><div><h3>Methods</h3><p>We retrospectively evaluated 246 adults in whom the Crown PRT^TM biological valve was used in the aortic position, including elective and emergency cases, isolated and combined surgeries (CS). We also evaluated mortality at 1, 3, and 5 years of follow-up.</p></div><div><h3>Results</h3><p>In this study, CS involved 94 patients (38%), while 39 patients (16%) underwent urgent or emergency procedures, which included cases of aortic dissection and endocarditis. Approximately 69% of the patients received a valve more significant than 21<!--> <!-->mm. A minimally invasive surgical approach was employed in 42 patients (17%). The in-hospital mortality for the entire patient population was 3.6% (n<!--> <!-->=<!--> <!-->9), with isolated aortic valve replacement (AVR) accounting for 3.3% (n<!--> <!-->=<!--> <!-->5) and CS for another 4.3% (n<!--> <!-->=<!--> <!-->4). The mortality for isolated AVR and CS in elective situations was n<!--> <!-->=<!--> <!-->2 (1.3%) and n<!--> <!-->=<!--> <!-->1 (1.1%), respectively. During the follow-up period, only seven patients required reoperation, with two patients (0.8%) experiencing structural valve deterioration and five other patients (2.1%) requiring reoperation due to prosthetic valve endocarditis.</p></div><div><h3>Conclusion</h3><p>The use of the Crown valve in the aortic position appears to be safe regarding postoperative morbidity and mortality. Further studies are necessary to assess its applicability in younger patients and predict its performance in the event of a valve-in-valve procedure.</p></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 5","pages":"Pages 200-206"},"PeriodicalIF":0.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1134009624001001/pdfft?md5=dec60a20f1b06288a966a37bef38abb1&pid=1-s2.0-S1134009624001001-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702834","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(24)00145-1","DOIUrl":"10.1016/S1134-0096(24)00145-1","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 5","pages":"Page i"},"PeriodicalIF":0.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1134009624001451/pdfft?md5=f28271141289a983738e9d1745832f36&pid=1-s2.0-S1134009624001451-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240099","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}