Archivos Peruanos de cardiologia y cirugia cardiovascular最新文献

{"title":"Vascular ring due to double aortic arch as a cause of stridor and dysphagia in infancy: a case report.","authors":"Diego Davila-Flores, Christie Villasante-Villalta, Renee Montesinos-Segura, Juan Zúñiga-Meza, Henry Peralta-Santos, Luis Vera-Talledo","doi":"10.47487/apcyccv.v6i4.534","DOIUrl":"10.47487/apcyccv.v6i4.534","url":null,"abstract":"<p><p>A double aortic arch is a rare congenital vascular anomaly with clinical significance in the pediatric population due to its potential to cause extrinsic compression of the trachea and esophagus. It should be suspected in infants with persistent respiratory and gastrointestinal symptoms refractory to conventional treatment. We report the case of a 2-year-7-month-old boy presenting with recurrent stridor, repeated respiratory infections, and progressive dysphagia. Cardiac CT angiography revealed a complete vascular ring causing tracheoesophageal compression. Dominance of the left aortic arch was identified, and surgical section and distal ligation of the non-dominant right arch were performed, without direct intervention on the tracheoesophageal structures. At the 12-month follow-up, there was complete resolution of symptoms and nutritional recovery. This case highlights the importance of maintaining high clinical suspicion and ensuring timely referral. Even when surgical correction is delayed, appropriate intervention can reverse symptoms and improve quality of life.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 4","pages":"253-257"},"PeriodicalIF":0.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12825437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047480","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":"Diabetic foot care and cardiovascular surgery in Peru: a looming crisis of centralism and unequal resource allocation.","authors":"W Samir Cubas","doi":"10.47487/apcyccv.v6i4.576","DOIUrl":"10.47487/apcyccv.v6i4.576","url":null,"abstract":"","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 4","pages":"274-275"},"PeriodicalIF":0.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12825436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055254","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":"Artificial intelligence and multimodal diagnostic approaches in cardiovascular disease.","authors":"Fernando A Ramos-Zaga","doi":"10.47487/apcyccv.v6i4.532","DOIUrl":"10.47487/apcyccv.v6i4.532","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the impact and clinical applicability of artificial intelligence (AI) models in cardiovascular diagnosis, assessing their potential to improve diagnostic accuracy, operational efficiency, and reliability compared with conventional methods.</p><p><strong>Materials and: </strong><b>Methods.</b> A critical review of the recent literature was conducted, encompassing retrospective studies, multicenter trials, and external validations that employed machine learning and deep learning algorithms applied to imaging modalities, electrocardiographic and phonocardiographic signals, as well as clinical and proteomic biomarkers.</p><p><strong>Results: </strong>Evidence indicates that in cardiac imaging, automated segmentation and ventricular dysfunction detection achieved accuracy metrics exceeding 90%, suggesting readiness for clinical integration. In cardiac signals, deep learning models demonstrated area under the ROC curve values of approximately 0.99 for predicting atrial fibrillation and ischemic heart disease, further supported by explainability techniques. Regarding biomarkers, ensemble models achieved diagnostic accuracies above 95%, and the integration of proteomic and clinical data substantially enhanced predictive performance. Nonetheless, decreased performance in external validations, limited generalizability to heterogeneous populations, and clinicians' reluctance due to insufficient explainability remain major barriers.</p><p><strong>Conclusion: </strong>Artificial intelligence in cardiovascular diagnostics holds transformative potential by improving accuracy, reducing interobserver variability, and expanding access in resource-limited settings. However, its consolidation into routine practice requires robust multicenter validations, seamless interoperability with clinical workflows, and strengthened explainability, prerequisites for incorporation into clinical guidelines and precision medicine strategies.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 4","pages":"230-238"},"PeriodicalIF":0.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12825441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055180","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":"Significant valvular heart disease in wild-type transthyretin amyloidosis: prevalence and impact on survival.","authors":"Santiago Decotto, Pilar Domenech, Pedro Touzas, María Adela Aguirre, Elsa Nucifora, María Lourdes Posadas-Martínez, Rocío Blanco, Mariano Falconi, Rodolfo Pizarro, Diego Pérez de Arenaza","doi":"10.47487/apcyccv.v6i3.524","DOIUrl":"10.47487/apcyccv.v6i3.524","url":null,"abstract":"<p><strong>Objective: </strong>There are limited data on the prevalence and prognostic impact of significant valvular heart disease in patients with wild-type transthyretin cardiac amyloidosis (ATTRwt). The aim of this study was to describe the prevalence of aortic stenosis (AS), mitral regurgitation (MR), and tricuspid regurgitation (TR) in this population and, secondarily, to evaluate their impact on survival.</p><p><strong>Methods: </strong>This was a retrospective, single-center cohort study including patients diagnosed with ATTRwt between 2011 and 2024. We calculated the prevalence of each significant valvular heart disease, and Kaplan-Meier survival curves were generated to estimate two-year all-cause mortality, stratified according to the presence or absence of each significant valvular disease. Finally, a multivariable Cox regression was performed to assess their association with survival.</p><p><strong>Results: </strong>We included 154 patients, with a mean age of 81 (±7) years; 85% (n=131) were male. Significant TR was the most prevalent valvular disease (27%, n=41), followed by significant MR (20%, n=30) and AS (13%, n=20). Patients with significant TR had a higher incidence of all-cause mortality compared to those without significant TR (41% vs. 16%, log-rank test, p=0.0007), whereas no differences were observed between patients with and without significant AS or MR. In multivariable Cox models, significant TR was independently associated with higher mortality, regardless of age, the presence of other valvular diseases, and NT-proBNP levels.</p><p><strong>Conclusions: </strong>Significant TR was the most prevalent valvular disease in patients with ATTRwt and was associated with lower survival in this population.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 3","pages":"112-119"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12624473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558588","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":"Single-stage repair of aortic arch hypoplasia and ventricular septal defect in a low-weight infant: a case report from a resource-limited center.","authors":"Jesús García Pinzás, Cristhian J Cueva Alvarez, Martin Crosby Barabino","doi":"10.47487/apcyccv.v6i3.498","DOIUrl":"10.47487/apcyccv.v6i3.498","url":null,"abstract":"<p><p>Aortic arch hypoplasia associated with ventricular septal defect (VSD) is a life-threatening congenital condition that demands early intervention. In low-resource settings, the lack of advanced tools complicates the safe use of selective antegrade cerebral perfusion (SACP) and innovative repair techniques such as interdigitating patch reconstruction. We describe the case of a newborn with severe aortic arch hypoplasia and a large perimembranous VSD who underwent successful one-stage surgical correction. The repair included aortic arch reconstruction using an interdigitating bovine pericardial patch and VSD closure under SACP delivered via direct brachiocephalic trunk cannulation. Despite the challenges of limited monitoring and equipment, the infant had an excellent clinical outcome. This case highlights the feasibility of adapting high-complexity cardiac techniques in resource-limited environments when surgical fundamentals and teamwork are prioritized. With strategic planning, multidisciplinary coordination, and adherence to evidence-based principles, successful single-stage repair of complex congenital heart disease is achievable even in under-resourced settings.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 3","pages":"181-185"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12624446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558617","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":"Implementation and adaptation of the Society of Thoracic Surgeons´ standardized nomenclature for congenital heart surgery in a Peruvian hospital.","authors":"Marina Huamán Robles, Samuel Y Kim, Rachel Bernier, Ruht Villarroel Villa, Carlos Carcausto Huamaní, Arnaldo Munive Méndez, Rosina Ruiz Roque, María Isabel Picón Perla, Luis Vera Talledo, Tommy Prado Gómez, Arcelia Reyes Barriga, Corina Céspedes Solano, Víctor Justo Robles Velarde, Celia Mendoza Peltroche, Miriam Gaby Escate, Gloria Bernedo Gómez, José Luis Yovera, Rodrigo López Barreda, Juan Ibla","doi":"10.47487/apcyccv.v6i3.489","DOIUrl":"10.47487/apcyccv.v6i3.489","url":null,"abstract":"<p><strong>Objective: </strong>To describe the process of implementing a congenital heart surgery database at the National Cardiovascular Institute (INCOR) in Peru, adapted to the standardized nomenclature of the Society of Thoracic Surgeons, and to present clinical-surgical outcomes in terms of morbidity and mortality within the framework of comprehensive multidisciplinary care.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted in three phases: feasibility, database construction, and prospective data collection. Variables were adapted to the institutional context, and the process included a pilot test, strategic planning, multidisciplinary training, role assignment, monitoring, and periodic statistical analysis.</p><p><strong>Results: </strong>A total of 500 consecutive patients were registered between May 2022 and July 2023. Septal defects were the most common surgical indication. The most frequent complications included cardiac dysfunction and arrhythmias. In-hospital mortality was 7.6%. The database incorporated preoperative nutritional and dental assessments. Although 27.2% of the forms were fully completed, the remainder showed limitations such as missing data and the need for additional verification of information across modules.</p><p><strong>Conclusion: </strong>The implementation of a congenital heart surgery registry in Peru is feasible even in a resource-limited setting. This system allows the identification of critical areas for improving care and optimizing clinical outcomes, establishing a foundation for future quality improvement initiatives.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 3","pages":"135-143"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12624469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558515","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":"Risk factors for postoperative acute kidney injury after cardiac surgery.","authors":"Ignacio M Piaggio, Juan F Furmento, Juan P Costabel, Daniel Navia, Francisco A Olivares, Alan Sigal, Mariano Vrancic, Fernando Piccinini, Leonardo A Seoane","doi":"10.47487/apcyccv.v6i3.491","DOIUrl":"10.47487/apcyccv.v6i3.491","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the frequency of postoperative acute kidney injury (AKI) following cardiac surgery and to analyse risk factors for its development.</p><p><strong>Materials and methods: </strong>We conducted an observational analytical cohort study using prospective data from adult patients who underwent cardiac surgery between 2003 and 2023 at a high-complexity centre in Argentina. AKI was defined according to KDIGO criteria. Risk factors were assessed using logistic regression.</p><p><strong>Results: </strong>A total of 13,215 patients were analysed, with a mean age of 64 years; most were men (75.7%). The frequency of AKI was 7.3%, with an in-hospital mortality of 4.7%. Independent risk factors included advanced age (OR: 1.05, p<0.001), urgent surgery (OR: 2.87, p<0.001), cardiopulmonary bypass (OR: 1.41, p<0.001), and comorbidities such as chronic obstructive pulmonary disease and preoperative anaemia. Asymptomatic status prior to surgery was identified as a protective factor.</p><p><strong>Conclusions: </strong>The frequency of postoperative AKI is comparable to international registries. The main predictors of risk were age, surgical urgency, and use of cardiopulmonary bypass. Identifying risk factors can improve perioperative prevention and management in cardiac surgery.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 3","pages":"129-134"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12624474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558532","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 Hospitalized Patient with Severe Aortic Stenosis].","authors":"Frank W Britto","doi":"10.47487/apcyccv.v6i3.511","DOIUrl":"10.47487/apcyccv.v6i3.511","url":null,"abstract":"","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 3","pages":"192-194"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12624460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558492","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":"[Gender and ethnic disparities in carotid artery disease: experience from a national Peruvian hospital].","authors":"Georgette Vetanzo-Sánchez, Alexander Brioso-Cevallos","doi":"10.47487/apcyccv.v6i3.526","DOIUrl":"10.47487/apcyccv.v6i3.526","url":null,"abstract":"","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 3","pages":"195-196"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12624447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558512","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":"Immune checkpoint inhibitor-induced myocarditis: a comprehensive review with clinical case insights.","authors":"María José Santa-Ana-Bayona, Camila Ponce-Acosta, Edgar Quispe-Silvestre, Gilberto H Acosta-Gutiérrez, Alfonso González-Trejo, Hugo A Valencia-Hernández, Enrique C Guerra, Pablo O Alarcón-Toxqui, Karina Martínez-Bañagas, Nilda Espinola-Zavaleta","doi":"10.47487/apcyccv.v6i3.502","DOIUrl":"10.47487/apcyccv.v6i3.502","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy by significantly improving long-term outcomes across multiple malignancies. Despite their benefits, ICIs can lead to immune-related adverse events, including rare but severe cardiovascular toxicity such as myocarditis, which can be life-threatening. This comprehensive review aims to explore and discuss the mechanisms, clinical presentation, diagnostic challenges, and management strategies of ICI-induced myocarditis, emphasizing the need for early detection and timely intervention. As the use of ICIs continues to expand, further research is essential to fully elucidate the underlying mechanisms and optimize therapeutic strategies to mitigate this potentially fatal complication while maintaining the efficacy of cancer therapy.</p>","PeriodicalId":72295,"journal":{"name":"Archivos Peruanos de cardiologia y cirugia cardiovascular","volume":"6 3","pages":"144-153"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12624509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558503","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}