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Article ; Online: Tratamiento percutáneo de un drenaje venoso pulmonar anómalo parcial con drenaje dual

Rafael González-Manzanares / Soledad Ojeda / Guisela Flores-Vergara / Javier Suárez de Lezo / Simona Espejo / Manuel Pan

REC: Interventional Cardiology, Vol 5, Iss 1, Pp 76-

2023 Volume 78

Abstract: PRESENTACIÓN DEL CASO El drenaje venoso pulmonar anómalo es una patología rara que consiste en que 1 o más venas pulmonares retornan de forma anómala a la aurícula derecha o a la circulación venosa sistémica. El tipo más frecuente en adultos es el ... ...

Abstract	PRESENTACIÓN DEL CASO El drenaje venoso pulmonar anómalo es una patología rara que consiste en que 1 o más venas pulmonares retornan de forma anómala a la aurícula derecha o a la circulación venosa sistémica. El tipo más frecuente en adultos es el drenaje de la vena pulmonar superior izquierda (VPSI) en la vena innominada izquierda. Anecdóticamente, una VPSI anómala puede presentar un drenaje doble tanto a la vena innominada izquierda como a la aurícula izquierda (AI). En ausencia de otros defectos cardiacos congénitos, el drenaje venoso pulmonar anómalo parcial suele ser un hallazgo incidental y los pacientes suelen estar asintomáticos. En este artículo se presenta el caso de un drenaje venoso pulmonar anómalo parcial con drenaje doble donde la VPSI está conectada tanto a la vena innominada izquierda como a la AI en un paciente con enfermedad coronaria y disfunción sistólica del ventrículo izquierdo. Se presenta el caso de un varón de 56 años con una historia clínica de diabetes y dislipemia derivado para valoración por cardiología tras un hallazgo incidental en una tomografía computarizada torácica solicitada por neumología como parte de un estudio diagnóstico de disnea. El paciente presentaba disnea de esfuerzo clase funcional III de la NYHA y angina durante.
Keywords	Internal medicine ; RC31-1245
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Percutaneous treatment of partial anomalous pulmonary venous connection with dual drainage. Case resolution

Rafael González-Manzanares / Soledad Ojeda / Guisela Flores-Vergara / Javier Suárez De Lezo / Simona Espejo / Manuel Pan

REC: Interventional Cardiology (English Ed.), Vol 5, Iss 1, Pp 79-

2023 Volume 82

Abstract: CASE RESOLUTION The heart team decision was to percutaneously treat both the coronary artery disease and the partial anomalous pulmonary venous connection (PAPVC). Percutaneous coronary intervention was successfully performed in the first place. ... ...

Abstract	CASE RESOLUTION The heart team decision was to percutaneously treat both the coronary artery disease and the partial anomalous pulmonary venous connection (PAPVC). Percutaneous coronary intervention was successfully performed in the first place. Treatment of the PAPVC was performed 3 months later. Since it is recommended that the diameter of the device should be 30% to 50% larger than the vessel diameter, a 22 mm Amplatzer Vascular Plug II device (AVP-II) (Abbott, United States) was selected based on the VV computed tomography measurements. The procedure was performed under local anesthesia and with fluoroscopic control. A 7-Fr introducer sheath was inserted into the right femoral vein. A 6-Fr multipurpose diagnostic catheter was advanced using a 0.035 in exchange guidewire to reach the VV through the left innominate vein (figure 1A). Angiography confirmed the presence of a left upper pulmonary vein (LUPV) with dual drainage and significant contrast flow from the LUPV to the innominate vein that filled the right chambers (left-to-right shunt) (figure 1, video 1 of the supplementary data). Using a femoral 7-Fr 90 cm Destination Guiding Sheath (Terumo, United States) the AVP-II device was placed and delivered into the VV (figure 2A, video 2 of the supplementary data). The correct position,.
Keywords	Medicine ; R
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Tratamiento percutáneo de un drenaje venoso pulmonar anómalo parcial con drenaje dual. Resolución

Rafael González-Manzanares / Soledad Ojeda / Guisela Flores-Vergara / Javier Suárez de Lezo / Simona Espejo / Manuel Pan

REC: Interventional Cardiology, Vol 5, Iss 1, Pp 79-

2023 Volume 82

Abstract: RESOLUCIÓN DEL CASO La decisión del equipo multidisciplinar fue tratar percutáneamente tanto la enfermedad coronaria como el drenaje venoso pulmonar anómalo parcial (DVPAP). En primer lugar, se realizó, con éxito, una intervención coronaria percutánea. ... ...

Abstract	RESOLUCIÓN DEL CASO La decisión del equipo multidisciplinar fue tratar percutáneamente tanto la enfermedad coronaria como el drenaje venoso pulmonar anómalo parcial (DVPAP). En primer lugar, se realizó, con éxito, una intervención coronaria percutánea. El tratamiento de la DVPAP se llevó a cabo 3 meses después. Como se recomienda que los dispositivos tengan un diámetro entre un 30 y un 50% más grande que el diámetro del vaso, se optó por emplear un dispositivo Amplatzer Vascular Plug II (AVP-II) (Abbott, Estados Unidos) de 22 mm de acuerdo con las mediciones obtenidas en la tomografía computarizada de la VV. La intervención se realizó con anestesia local y bajo control fluoroscópico. Se insertó una vaina introductora de 7 Fr en la vena femoral derecha. Posteriormente, se avanzó un catéter diagnóstico multipropósito de 6 Fr empleando una guía de intercambio de 0,035 pulgadas para llegar a la VV a través de la vena innominada izquierda (figura 1A). La angiografía confirmó la presencia de una vena pulmonar superior izquierda (VPSI) con drenaje doble y un importante flujo de contraste desde la VPSI hasta la vena innominada que rellenaba las cámaras derechas (shunt izquierda-derecha) (figura 1, vídeo 1 del material adicional). Empleando una vaina guía Destination de.
Keywords	Internal medicine ; RC31-1245
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Inhibidores selectivos de la recaptación de serotonina y riesgo hemorrágico tras ICP. Un estudio con puntuación de propensión

Rafael González-Manzanares / Soledad Ojeda / Francisco Hidalgo / Marina Ruiz-Moreno / Consuelo Fernández-Avilés / Francesco Costa / Guisela Flores-Vergara / Javier Suárez de Lezo / Luz Carmona-Artime / Manuel Pan

REC: Interventional Cardiology, Vol 4, Iss 2, Pp 115-

2022 Volume 122

Abstract: RESUMEN Introducción y objetivos: La cardiopatía isquémica y la enfermedad mental coexisten a menudo. Los inhibidores selectivos de la recaptación de serotonina (ISRS) se utilizan con frecuencia en este contexto, pero se han asociado con un incremento en ...

Abstract	RESUMEN Introducción y objetivos: La cardiopatía isquémica y la enfermedad mental coexisten a menudo. Los inhibidores selectivos de la recaptación de serotonina (ISRS) se utilizan con frecuencia en este contexto, pero se han asociado con un incremento en el riesgo hemorrágico. Los estudios previos han evaluado este fenómeno en pacientes tratados con clopidogrel, con resultados contradictorios. No hay datos sobre el uso de ISRS e inhibidores del P2Y12 potentes o triple terapia antitrombótica. El objetivo de este estudio fue examinar el impacto de los ISRS en los eventos hemorrágicos en pacientes tratados con doble (incluyendo clopidogrel, prasugrel o ticagrelor) o triple terapia antitrombótica tras una intervención coronaria percutánea (ICP). Métodos: Estudio retrospectivo en el que se incluyeron todos los pacientes tratados con ICP en un centro de alto volumen durante 2018. Los pacientes en tratamiento con ISRS fueron emparejados mediante puntaje de propensión con pacientes sin ISRS. El objetivo primario fue el sangrado mayor al año de seguimiento (BARC 3 o 5). Los objetivos secundarios fueron un combinado de sangrado mayor o menor clínicamente relevante (BARC 2, 3 o 5) y un combinado de eventos cardiovasculares adversos mayores. Resultados: De los 1.063 pacientes tratados con ICP durante el periodo del estudio, 1.002 cumplieron los criterios de selección y 139 (13,9%) recibían ISRS. Los pacientes con ISRS tenían un mayor riesgo de sangrado antes del emparejamiento (PRECISE-DAPT: 16 [10-24] frente a 13 [9-21]; p = 0,040). No hubo diferencias en el objetivo primario (2,9% frente a 2,9%; p = 0,991) ni en los objetivos secundarios de sangrado mayor o menor clínicamente relevante (2,9 frente a 7,2%; p = 0,120) y eventos cardiovasculares adversos mayores (7,9 frente a ...
Keywords	Sangrado ; Enfermedad coronaria ; Intervencionismo coronario percutáneo ; Inhibidores selectivos de la recaptación de serotonina ; Terapia antitrombótica ; Internal medicine ; RC31-1245
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Selective serotonin reuptake inhibitors and bleeding risk after PCI. A propensity score matching study

REC: Interventional Cardiology (English Ed.), Vol 4, Iss 2, Pp 115-

2022 Volume 122

Abstract: ABSTRACT Introduction and objectives: Coronary artery disease and mental health disorders are often coexistent. Selective serotonin reuptake inhibitors (SSRIs) are often used in this context but have been associated with an increased risk of bleeding due ...

Abstract	ABSTRACT Introduction and objectives: Coronary artery disease and mental health disorders are often coexistent. Selective serotonin reuptake inhibitors (SSRIs) are often used in this context but have been associated with an increased risk of bleeding due to platelet dysfunction. Previous studies have assessed this risk in patients treated with clopidogrel-based dual antiplatelet therapy (DAPT) with contradictory results. However, there is no data regarding the use of SSRIs and potent P2Y12 inhibitors or triple antithrombotic therapy after percutaneous coronary intervention (PCI). The purpose of this study was to assess the impact of SSRIs on bleeding outcomes after PCI in patients treated with clopidogrel, prasugrel or ticagrelor-based DAPT or triple antithrombotic therapy. Methods: Retrospective study including all patients undergoing PCI at a high-volume center during 2018. Patients on SSRIs were propensity-score-matched on a 1:1 ratio with patients naive to SSRIs adjusting for the baseline differences. The primary endpoint was major bleeding (BARC type 3 or 5 bleeding) at the 1-year follow-up. Secondary endpoints were a composite of major/non-major clinically relevant bleeding (BARC type 2, 3 or 5 bleeding), and a composite of major adverse cardiovascular events. Results: Out of a total of 1063 patients treated with PCI during the study period, 1002 met the selection criteria, and 139 (13.9%) were on SSRIs. The latter had a higher bleeding risk before matching [PRECISE-DAPT, 16 [10-24] vs 13 [9-21]; P = .040]. No differences were reported in major bleeding (2.9% vs 2.9%, P = .991), major/non-major clinically relevant bleeding (2.9% vs 7.2%, P = .120) or in major adverse cardiovascular events (7.9% vs 7.9%, P = .979) in patients treated with SSRIs. Conclusions: The use of SSRIs was frequent in patients treated with PCI, and although it was a marker of a higher bleeding risk at baseline, this was not associated with an additional ...
Keywords	Bleeding ; Coronary artery disease ; Percutaneous coronary intervention ; Selective serotonin reuptake inhibitors ; Antithrombotic therapy ; Medicine ; R
Subject code	610 ; 616
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Utilidad de la valoración fisiológica coronaria con iFR en la práctica diaria y en todo tipo de pacientes

Cristina Pericet-Rodríguez / Francisco José Hidalgo-Lesmes / Rafael González-Manzanares / Soledad Ojeda-Pineda / Aurora Luque-Moreno / Javier Suárez de Lezo / Miguel Ángel Romero-Moreno / Francisco Mazuelos-Bellido / José María Segura Saint-Gerons / Ana Fernández-Ruiz / María Guisela Flores-Vergara / Manuel Pan Álvarez-Ossorio

REC: Interventional Cardiology, Vol 3, Iss 3, Pp 182-

resultados inmediatos y en el seguimiento

2021 Volume 189

Abstract: RESUMEN Introducción y objetivos: El propósito del estudio fue describir nuestra experiencia con el uso del índice diastólico instantáneo sin ondas (iFR) para la evaluación fisiológica coronaria o el uso del software Syncvision/iFR (Syncvision versión 4 ... ...

Abstract	RESUMEN Introducción y objetivos: El propósito del estudio fue describir nuestra experiencia con el uso del índice diastólico instantáneo sin ondas (iFR) para la evaluación fisiológica coronaria o el uso del software Syncvision/iFR (Syncvision versión 4.1.0.5, Philips Volcano, Bélgica) en todo tipo de pacientes. Métodos: Se incluyeron todos los pacientes consecutivos a quienes, entre enero de 2017 y diciembre de 2019, se realizó en nuestro centro una evaluación fisiológica coronaria con iFR o con Syncvision/iFR. El valor de corte establecido para el iFR fue 0,89. El objetivo primario fue un compuesto de muerte cardiaca, infarto de miocardio, trombosis de stent probable o definitiva y nueva revascularización de la lesión evaluada. Resultados: Se incluyeron 277 pacientes con 433 lesiones evaluadas. La edad media fue de 65 ± 10 años y el 74% eran varones. El 41% tenía antecedente de diabetes mellitus. La presentación clínica fue angina estable en 160 pacientes (58%) y síndrome coronario agudo en 117 pacientes (42%). Se obtuvo un iFR > 0,89 en 266 lesiones (61,4%), en las cuales la intervención coronaria percutánea fue diferida. Las lesiones restantes se revascularizaron. El software Syncvision/iFR se usó en 155 lesiones (36%) para guiar la toma de decisiones, principalmente lesiones largas, difusas o secuenciales (91 lesiones, 58,7%) y lesiones intermedias (52 lesiones, 33,5%). Tras un periodo de seguimiento de 18 meses, el objetivo primario se observó en 17 pacientes (6,1%), sin diferencias en función del iFR basal (≤ 0,89 o > 0,89) (4,2 frente a 3,8%; p = 0,9) ni de la presentación ...
Keywords	Evaluación fisiológica ; Todo tipo de pacientes ; Software Syncvision/iFR ; Internal medicine ; RC31-1245
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Usefulness of physiological coronary assessment with iFR in daily practice and all-comer patients

REC: Interventional Cardiology (English Ed.), Vol 3, Iss 3, Pp 182-

immediate and follow-up results

2021 Volume 189

Abstract: ABSTRACT Introduction and objectives: The objective of this study was to describe our experience with coronary physiology assessment using the instantaneous wave-free ratio (iFR) and/or a Syncvision-guided iFR-pullback study [Syncvision version 4.1.0.5, ... ...

Abstract	ABSTRACT Introduction and objectives: The objective of this study was to describe our experience with coronary physiology assessment using the instantaneous wave-free ratio (iFR) and/or a Syncvision-guided iFR-pullback study [Syncvision version 4.1.0.5, Philips Volcano, Belgium] in all-comer patients. Methods: Consecutive patients undergoing coronary physiology assessment with the iFR (and/or a Syncvision-guided iFR-pullback study) at our center between January 2017 and December 2019 were included. The iFR cut-off value was 0.89. The primary endpoint was a composite of cardiac death, myocardial infarction, probable or definitive stent thrombosis, and target lesion revascularization. Results: A total of 277 patients with 433 lesions evaluated were included. The mean age was 65 ± 10 years and 74% were men. Personal history of diabetes mellitus was present in 41% of patients. Clinical presentation was stable angina in 160 patients (58%), and acute coronary syndrome in 117 patients (42%). iFRs > 0.89 were obtained in 266 lesions (61.4%) on which the PCI was postponed. The remaining lesions were revascularized. The Syncvision software was used to guide the iFR-pullback study in 155 lesions (36%) and the decision-making process, mainly in long, diffuse or sequential lesions (91 lesions, 58.7%), and intermediate lesions (52 lesions, 33.5%). After a median follow-up of 18 months, the primary endpoint occurred in 17 patients (6.1%) without differences regarding the baseline iFR (≤ 0.89 or > 0.89) (4.2% vs 3.8%; P = .9) or the clinical presentation (stable angina or acute coronary syndrome) (4.4% vs 8.5%; P = .1) Conclusions: The use of coronary physiology assessment with the iFR and the Syncvision-guided iFR-pullback study in the routine daily practice and in all-comer patients seems safe with a low percentage of major adverse ...
Keywords	Physiological assessment ; All-comer patients ; Syncvision-guided iFR-pullback study ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: QT Interval Monitoring with Handheld Heart Rhythm ECG Device in COVID-19 Patients

Carlos Minguito-Carazo / Julio Echarte-Morales / Tomás Benito-González / Samuel del Castillo-García / Miguel Rodríguez-Santamarta / Enrique Sánchez-Muñoz / Clea González Maniega / Rubén García-Bergel / Paula Menéndez-Suárez / Silvia Prieto-González / Carmen Palacios-Echavarren / Javier Borrego-Rodríguez / Guisela Flores-Vergara / Ignacio Iglesias-Garriz / Felipe Fernández-Vázquez

Global Heart, Vol 16, Iss

2021 Volume 1

Abstract: Background: QTc prolongation is an adverse effect of COVID-19 therapies. The use of a handheld device in this scenario has not been addressed. Objectives: To evaluate the feasibility of QTc monitoring with a smart device in COVID-19 patients receiving ... ...

Abstract	Background: QTc prolongation is an adverse effect of COVID-19 therapies. The use of a handheld device in this scenario has not been addressed. Objectives: To evaluate the feasibility of QTc monitoring with a smart device in COVID-19 patients receiving QTc-interfering therapies. Methods: Prospective study of consecutive COVID-19 patients treated with hydroxychloroquine ± azithromycin ± lopinavir-ritonavir. ECG monitoring was performed with 12-lead ECG or with KardiaMobile-6L. Both registries were also sequentially obtained in a cohort of healthy patients. We evaluated differences in QTc in COVID-19 patients between three different monitoring strategies: 12-lead ECG at baseline and follow-up (A), 12-lead ECG at baseline and follow-up with the smart device (B), and fully monitored with handheld 6-lead ECG (group C). Time needed to obtain an ECG registry was also documented. Results: One hundred and eighty-two COVID-19 patients were included (A: 119(65.4%); B: 50(27.5%); C: 13(7.1%). QTc peak during hospitalization did significantly increase in all groups. No differences were observed between the three monitoring strategies in QTc prolongation (p = 0.864). In the control group, all but one ECG registry with the smart device allowed QTc measurement and mean QTc did not differ between both techniques (p = 0.612), displaying a moderate reliability (ICC 0.56 [0.19–0.76]). Time of ECG registry was significantly longer for the 12-lead ECG than for handheld device in both cohorts (p < 0.001). Conclusion: QTc monitoring with KardiaMobile-6L in COVID-19 patients was feasible. Time of ECG registration was significantly lower with the smart device, which may offer an important advantage for prevention of virus dissemination among healthcare providers.
Keywords	covid-19 ; qtc ; ventricular arrhythmia ; kardiamobile-6l ; handheld ecg ; Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Public aspects of medicine ; RA1-1270
Subject code	610
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Ubiquity Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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