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Blasco-Turrión S, Briedis K, Estévez-Loureiro R, Sánchez-Recalde A, Cruz-González I, Pascual I, Mascherbauer J, Abdul-Jawad Altisent O, Nombela-Franco L, Pan M, Trillo R, Moreno R, Delle Karth G, Sánchez-Luna JP, Gonzalez-Gutiérrez JC, Revilla-Orodoea A, Zamorano JL, Gómez-Salvador I, Puri R, San Román JA, Amat-Santos IJ. Bicaval TricValve Implantation in Patients With Severe Symptomatic Tricuspid Regurgitation: 1-Year Follow-Up Outcomes. JACC Cardiovasc Interv 2024; 17:60-72. [PMID: 38069986 DOI: 10.1016/j.jcin.2023.10.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/09/2023] [Accepted: 10/17/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Several orthotopic transcatheter strategies have been developed to treat severe tricuspid regurgitation (TR); however, many patients are deemed unsuitable. Caval valve implantation with the TricValve system addresses this unmet need. OBJECTIVES This study sought to determine the impact of TricValve on systemic congestion and quality of life (QOL) at 1 year. METHODS The TRICUS (Safety and Efficacy of the TricValve® Transcatheter Bicaval Valves System in the Superior and Inferior Vena Cava in Patients With Severe Tricuspid Regurgitation) and TRICUS EURO studies were prospective, nonblinded, nonrandomized, single-arm trials representing the early-in-man experience of the TricValve system in NYHA functional class III or IV severe TR patients, optimally medicated and ineligible for open heart surgery, with significant caval backflow. The primary endpoint was QOL metrics and functional status. The 1-year results of the combined cohort are described here. RESULTS Forty-four patients were included. Mean age was 76.2 ± 7.5 years, 81.0% were women, and the TRISCORE (risk score model for isolated tricuspid valve surgery) was 5.3 ± 1.3. Clinical improvement at 1 year was achieved in 42 (95.5%) patients, measured by (at least 1 of) an increase in ≥15 points from baseline in 12-item Kansas City Cardiomyopathy Questionnaire score, improvement to NYHA functional class to I or II, or an increase ≥40 m in the 6-minute walk test. There were 3 (6.8%) deaths at 1-year follow-up (1 cardiovascular), and the heart failure rehospitalization rate was 29.5%. Stent fracture, conduction system disturbances, or clinically significant leaflet thrombosis were not detected. Abolished hepatic vein backflow was achieved and persisted in 63.8% of the patients, contributing towards a reduction in congestive symptoms, N-terminal pro-B-type natriuretic peptide levels (P = 0.032), and diuretic treatment. CONCLUSIONS Caval valve implantation with the TricValve system associated with meaningful 1-year clinical improvements in terms of QOL along with relatively low mortality rates. (TRICUS Study - Safety and Efficacy of the TricValve® Device; NCT03723239).
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Affiliation(s)
| | - Kasparas Briedis
- Kaunas Klinikos, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | | | - Ignacio Cruz-González
- Instituto de Investigación Biomédica de Salamanca, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Isaac Pascual
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Julia Mascherbauer
- Department of Cardiology, University Hospital Sankt Poelten, Karl Landsteiner University of Health Sciences, Krems, Austria
| | | | | | - Manuel Pan
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - Ramiro Trillo
- Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Raul Moreno
- Instituto de Investigación Hospital Universitario La Paz, Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | - Ana Revilla-Orodoea
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Jose Luis Zamorano
- Hospital Universitario Ramon y Cajal, Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Itziar Gómez-Salvador
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | | | - J Alberto San Román
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Ignacio J Amat-Santos
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain.
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Estévez-Loureiro R, Sánchez-Recalde A, Amat-Santos IJ, Cruz-González I, Baz JA, Pascual I, Mascherbauer J, Abdul-Jawad Altisent O, Nombela-Franco L, Pan M, Trillo R, Moreno R, Delle Karth G, Salido-Tahoces L, Santos-Martinez S, Núñez JC, Moris C, Goliasch G, Jimenez-Quevedo P, Ojeda S, Cid-Álvarez B, Santiago-Vacas E, Jimenez-Valero S, Serrador A, Martín-Moreiras J, Strouhal A, Hengstenberg C, Zamorano JL, Puri R, Íñiguez-Romo A. Six-Month Outcomes of the TricValve® System in Patients with Tricuspid Regurgitation: TRICUS EURO Study. JACC Cardiovasc Interv 2022; 15:1366-1377. [PMID: 35583363 DOI: 10.1016/j.jcin.2022.05.022] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Severe tricuspid regurgitation (TR) is frequently associated with significant morbidity and mortality; such patients often deemed to be at high surgical risk. Heterotopic bi-caval stenting is an emerging, attractive transcatheter solution for these patients. OBJECTIVES To evaluate the 30-day safety and 6-month efficacy outcomes of specifically designed bioprosthetic valves for the superior and inferior vena cava. METHODS TRICUS EURO is a non-blinded, non-randomized, single-arm, multicenter, prospective trial that enrolled patients from 12 European centers between December 2019 to February 2021. High risk individuals with severe symptomatic TR despite optimal medical therapy were included. Primary end point was quality of life (QOL) improvement measured by Kansas City Cardiomyopathy Questionnaire (KCCQ12) and New York Heart Association functional class (NYHA) improvement at 6-month follow-up. RESULTS 35 patients (mean age 76±6.8 years; 83% women) were treated with TricValve® system. All patients at baseline were at NYHA ≥ 3 status. At 30-days, procedural success was 94% with no procedural deaths or conversions to surgery. A significant increase in QOL at 6-months follow-up was observed (baseline and 6-month KCCQ: 42.01±22.3 vs. 59.7±23.6 respectively; p=0.004), correlating with a significant improvement in NYHA functional class with 79.4% of patients noted to be in class I or II at 6 months (p=0.0006). The 6-month all-cause mortality and heart failure hospitalization rates were 8.5% and 20%, respectively. CONCLUSIONS The dedicated bi-caval system for treating severe, symptomatic TR was associated with high procedural success rate and significant increase in both, QOL and functional improvements at 6-months follow-up.
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Affiliation(s)
| | | | | | | | - Jose A Baz
- Complejo Hospitalario Universitario Alvaro Cunqueiro, Vigo, Spain
| | - Isaac Pascual
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Julia Mascherbauer
- Division of Cardiology, Department for Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | | | - Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Manuel Pan
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - Ramiro Trillo
- Hospital Clinico Universitario de Santiago de Compostela, CIBERCV, Santiago, Spain
| | - Raul Moreno
- Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | - Jean C Núñez
- Hospital Clinico Universitario de Salamanca, CIBERCV. IBSAL. Salamanca, Spain
| | - Cesar Moris
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Georg Goliasch
- Division of Cardiology, Department for Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | | | | | - Belén Cid-Álvarez
- Hospital Clinico Universitario de Santiago de Compostela, CIBERCV, Santiago, Spain
| | | | | | - Ana Serrador
- CIBERCV. Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | | | - Christian Hengstenberg
- Division of Cardiology, Department for Internal Medicine II, Medical University of Vienna, Vienna, Austria
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Affiliation(s)
- Jorge Solano-López
- Department of Cardiology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | | | - José Luis Zamorano
- Department of Cardiology, Hospital Universitario Ramon y Cajal, Madrid, Spain
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Salido-Tahoces L, Sánchez-Recalde A, Pardo-Sanz A, Zamorano Gómez JL. Unusual presentation of acute coronary syndrome in a patient with SARS-CoV-2 infection. Eur Heart J Cardiovasc Imaging 2020; 21:1053. [PMID: 32412641 PMCID: PMC7239235 DOI: 10.1093/ehjci/jeaa147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Pascual-Tejerina V, Sánchez-Recalde A, Garzón G, Zamorano JL. A novel transcatheter technique to treat of post-coarctation aneurysm with device occlusion of the aortic arch and descending aorta in a patient with an extra-anatomic bypass. Eur Heart J 2020; 41:2412-2413. [PMID: 31562529 DOI: 10.1093/eurheartj/ehz670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/05/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Angel Sánchez-Recalde
- Cardiology Department, University Hospital Ramón y Cajal, Ctra de Colmenar Viejo Km. 9, 100, 28034 Madrid, Spain
| | - Gonzalo Garzón
- Radiology Department, University Hospital La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain
| | - José L Zamorano
- Cardiology Department, University Hospital Ramón y Cajal, Ctra de Colmenar Viejo Km. 9, 100, 28034 Madrid, Spain
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Sánchez-Recalde A. The Spanish Society of Cardiology. Eur Heart J 2020; 41:2244-2247. [DOI: 10.1093/eurheartj/ehaa384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Angel Sánchez-Recalde
- Director Interventional Cardiology Unit, Cardiology Department, University Hospital Ramón y Cajal, Associate Editor Revista Española de Cardiologia
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Pascual I, Carrasco-Chinchilla F, Benito-Gonzalez T, Li CH, Avanzas P, Nombela-Franco L, Pan M, Serrador Frutos A, Freixa X, Trillo-Nouche R, Hernández-Antolín RA, Andraka Ikazuriaga L, Cruz-Gonzalez I, López-Mínguez JR, Diez JL, Berenguer-Jofresa A, Sanchis J, Ruiz-Quevedo V, Urbano-Carrillo C, Dominguez JFO, Ortas-Nadal MR, Molina Navarro E, Carrillo X, Alonso-Briales JH, Fernández-Vázquez F, Asmarats Serra L, Hernandez-Vaquero D, Jimenez-Quevedo P, Mesa D, Rodríguez-Gabella T, Regueiro A, Martinez Monzonís A, Salido Tahoces L, Ruiz Gomez L, Trejo-Velasco B, Becerra-Muñoz VM, Garrote-Coloma C, Fernández Peregrina E, Lorca R, Agustín JAD, Romero M, Amat-Santos IJ, Sabaté M, Alvarez ABC, Hernandez-Garcia JM, Gualis J, Arzamendi D, Moris C, Tirado-Conte G, Sánchez-Recalde A, Estevez-Loureiro R. Transcatheter Mitral Repair for Functional Mitral Regurgitation According to Left Ventricular Function: A Real-Life Propensity-Score Matched Study. J Clin Med 2020; 9:E1792. [PMID: 32526978 PMCID: PMC7356666 DOI: 10.3390/jcm9061792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/24/2020] [Accepted: 06/01/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Transcatheter mitral valve repair (TMVR) could improve survival in functional mitral regurgitation (FMR), but it is necessary to consider the influence of left ventricular ejection fraction (LVEF). Therefore, we compare the outcomes after TMVR with Mitraclip® between two groups according to LVEF. METHODS In an observational registry study, we compared the outcomes in patients with FMR who underwent TMVR with and without LVEF <30%. The primary endpoint was the combined one-year all-cause mortality and unplanned hospital readmissions due to HF. The secondary end-points were New York Heart Association (NYHA) functional class and mitral regurgitation (MR) severity. Propensity-score matching was used to create two groups with the same baseline characteristics, except for baseline LVEF. RESULTS Among 535 FMR eligible patients, 144 patients with LVEF <30% (group 1) and 144 with LVEF >30% (group 2) had similar propensity scores and were included in the analyses. The primary study endpoint was significantlly higher in group 1 (33.3% vs. 9.4%, p = 0.002). There was a maintained improvement in secondary endpoints without significant differences among groups. CONCLUSION FMR patients with LVEF <30% treated with MitraClip® had higher mortality and readmissions than patients with LVEF ≥30% treated with the same device. However, both groups improved the NYHA functional class and MR severity.
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Affiliation(s)
- Isaac Pascual
- Heart Area, Asturias Central University Hospital, University of Oviedo, Instituto Investigación Sanitaria Principado de Asturias (ISPA), 33011 Oviedo, Spain; (I.P.); (P.A.); (R.L.); (C.M.)
| | - Fernando Carrasco-Chinchilla
- Cardiology Department, Virgen de la Victoria University Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, CIBERCV, 29010 Málaga, Spain; (F.C.-C.); (J.H.A.-B.); (V.M.B.-M.); (J.M.H.-G.)
| | - Tomas Benito-Gonzalez
- Cardiology Department. University Hospital of León, 24008 León, Spain; (T.B.-G.); (F.F.-V.); (C.G.-C.); (J.G.)
| | - Chi Hion Li
- Cardiology Department, Santa Creu i Sant Pau Hospital, 08041 Barcelona, Spain; (C.H.L.); (L.A.S.); (E.F.P.); (D.A.)
| | - Pablo Avanzas
- Heart Area, Asturias Central University Hospital, University of Oviedo, Instituto Investigación Sanitaria Principado de Asturias (ISPA), 33011 Oviedo, Spain; (I.P.); (P.A.); (R.L.); (C.M.)
| | - Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain; (L.N.-F.); (P.J.-Q.); (J.A.D.A.); (G.T.-C.)
| | - Manuel Pan
- Cardiology Department, Reina Sofía University Hospital, University of Córdoba (IMIBIC), 14004 Córdoba, Spain; (M.P.); (D.M.); (M.R.)
| | - Ana Serrador Frutos
- CIBERCV, Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (A.S.F.); (T.R.-G.); (I.J.A.-S.)
| | - Xavier Freixa
- Cardiology Department, Institut Clínic Cardiovascular, Hospital Clinic de Barcelona, 08036 Barcelona, Spain; (X.F.); (A.R.); (M.S.)
| | - Ramiro Trillo-Nouche
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, CIBERCV, 15706 Santiago de Compostela, Spain; (R.T.-N.); (A.M.M.); (A.B.C.A.)
| | - Rosa A. Hernández-Antolín
- Cardiology Department, Ramon y Cajal University Hospital, 28034 Madrid, Spain; (R.A.H.-A.); (L.S.T.); (A.S.-R.)
| | - Leire Andraka Ikazuriaga
- Cardiology Department, Hospital Universitario de Basurto, 48013 Bilbao, Spain; (L.A.I.); (L.R.G.)
| | - Ignacio Cruz-Gonzalez
- Cardiology Department, University Hospital of Salamanca, IBSAL, Institute of Biomedical Research of Salamanca, University of Salamanca, CIBERCV, 37007 Salamanca, Spain; (I.C.-G.); (B.T.-V.)
| | | | - Jose L. Diez
- Cardiology Department, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain;
| | | | - Juan Sanchis
- Cardiology Department, University Clinic Hospital of Valencia, University of Valencia, INCLIVA, CIBERCV, 46010 Valencia, Spain;
| | | | | | - Juan F. Oteo Dominguez
- Cardiology Department, University Hospital Puerta de Hierro/Majadahonda, 28222 Madrid, Spain;
| | - Maria R. Ortas-Nadal
- Cardiology Department, University Hospital Miguel Servet, 50009 Zaragoza, Spain;
| | | | - Xavier Carrillo
- Cardiology Department, Hospital Universitari Germans Trias i Pujol, 08916 Barcelona, Spain;
| | - Juan H. Alonso-Briales
- Cardiology Department, Virgen de la Victoria University Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, CIBERCV, 29010 Málaga, Spain; (F.C.-C.); (J.H.A.-B.); (V.M.B.-M.); (J.M.H.-G.)
| | - Felipe Fernández-Vázquez
- Cardiology Department. University Hospital of León, 24008 León, Spain; (T.B.-G.); (F.F.-V.); (C.G.-C.); (J.G.)
| | - Luis Asmarats Serra
- Cardiology Department, Santa Creu i Sant Pau Hospital, 08041 Barcelona, Spain; (C.H.L.); (L.A.S.); (E.F.P.); (D.A.)
| | - Daniel Hernandez-Vaquero
- Heart Area, Asturias Central University Hospital, University of Oviedo, Instituto Investigación Sanitaria Principado de Asturias (ISPA), 33011 Oviedo, Spain; (I.P.); (P.A.); (R.L.); (C.M.)
| | - Pilar Jimenez-Quevedo
- Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain; (L.N.-F.); (P.J.-Q.); (J.A.D.A.); (G.T.-C.)
| | - Dolores Mesa
- Cardiology Department, Reina Sofía University Hospital, University of Córdoba (IMIBIC), 14004 Córdoba, Spain; (M.P.); (D.M.); (M.R.)
| | - Tania Rodríguez-Gabella
- CIBERCV, Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (A.S.F.); (T.R.-G.); (I.J.A.-S.)
| | - Ander Regueiro
- Cardiology Department, Institut Clínic Cardiovascular, Hospital Clinic de Barcelona, 08036 Barcelona, Spain; (X.F.); (A.R.); (M.S.)
| | - Amparo Martinez Monzonís
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, CIBERCV, 15706 Santiago de Compostela, Spain; (R.T.-N.); (A.M.M.); (A.B.C.A.)
| | - Luisa Salido Tahoces
- Cardiology Department, Ramon y Cajal University Hospital, 28034 Madrid, Spain; (R.A.H.-A.); (L.S.T.); (A.S.-R.)
| | - Lara Ruiz Gomez
- Cardiology Department, Hospital Universitario de Basurto, 48013 Bilbao, Spain; (L.A.I.); (L.R.G.)
| | - Blanca Trejo-Velasco
- Cardiology Department, University Hospital of Salamanca, IBSAL, Institute of Biomedical Research of Salamanca, University of Salamanca, CIBERCV, 37007 Salamanca, Spain; (I.C.-G.); (B.T.-V.)
| | - Victor M. Becerra-Muñoz
- Cardiology Department, Virgen de la Victoria University Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, CIBERCV, 29010 Málaga, Spain; (F.C.-C.); (J.H.A.-B.); (V.M.B.-M.); (J.M.H.-G.)
| | - Carmen Garrote-Coloma
- Cardiology Department. University Hospital of León, 24008 León, Spain; (T.B.-G.); (F.F.-V.); (C.G.-C.); (J.G.)
| | | | - Rebeca Lorca
- Heart Area, Asturias Central University Hospital, University of Oviedo, Instituto Investigación Sanitaria Principado de Asturias (ISPA), 33011 Oviedo, Spain; (I.P.); (P.A.); (R.L.); (C.M.)
| | - Jose A. De Agustín
- Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain; (L.N.-F.); (P.J.-Q.); (J.A.D.A.); (G.T.-C.)
| | - Miguel Romero
- Cardiology Department, Reina Sofía University Hospital, University of Córdoba (IMIBIC), 14004 Córdoba, Spain; (M.P.); (D.M.); (M.R.)
| | - Ignacio J. Amat-Santos
- CIBERCV, Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; (A.S.F.); (T.R.-G.); (I.J.A.-S.)
| | - Manel Sabaté
- Cardiology Department, Institut Clínic Cardiovascular, Hospital Clinic de Barcelona, 08036 Barcelona, Spain; (X.F.); (A.R.); (M.S.)
| | - Ana B. Cid Alvarez
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, CIBERCV, 15706 Santiago de Compostela, Spain; (R.T.-N.); (A.M.M.); (A.B.C.A.)
| | - Jose M. Hernandez-Garcia
- Cardiology Department, Virgen de la Victoria University Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, CIBERCV, 29010 Málaga, Spain; (F.C.-C.); (J.H.A.-B.); (V.M.B.-M.); (J.M.H.-G.)
| | - Javier Gualis
- Cardiology Department. University Hospital of León, 24008 León, Spain; (T.B.-G.); (F.F.-V.); (C.G.-C.); (J.G.)
| | - Dabit Arzamendi
- Cardiology Department, Santa Creu i Sant Pau Hospital, 08041 Barcelona, Spain; (C.H.L.); (L.A.S.); (E.F.P.); (D.A.)
| | - Cesar Moris
- Heart Area, Asturias Central University Hospital, University of Oviedo, Instituto Investigación Sanitaria Principado de Asturias (ISPA), 33011 Oviedo, Spain; (I.P.); (P.A.); (R.L.); (C.M.)
| | - Gabriela Tirado-Conte
- Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain; (L.N.-F.); (P.J.-Q.); (J.A.D.A.); (G.T.-C.)
| | - Angel Sánchez-Recalde
- Cardiology Department, Ramon y Cajal University Hospital, 28034 Madrid, Spain; (R.A.H.-A.); (L.S.T.); (A.S.-R.)
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Gomez-Lara J, Salvatella N, Gonzalo N, Hernández-Hernández F, Fernandez-Nofrerias E, Sánchez-Recalde A, Bastante T, Marcano A, Romaguera R, Ferreiro JL, Roura G, Teruel L, Ariza-Solé A, Miranda-Guardiola F, Rodríguez García-Abad V, Gomez-Hospital JA, Alfonso F, Cequier A. IVUS-guided treatment strategies for definite late and very late stent thrombosis. EUROINTERVENTION 2016; 12:e1355-e1365. [DOI: 10.4244/eijy15m12_08] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Sánchez-Recalde A, Moreno R, Jiménez-Valero S, Galeote G. Trombolisis sistémica de la embolia pulmonar de alto riesgo frente al tratamiento percutáneo. Respuesta. Rev Esp Cardiol (Engl Ed) 2016. [DOI: 10.1016/j.recesp.2016.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sánchez-Recalde A, Moreno R, Jiménez-Valero S, Galeote G. Systemic Thrombolysis for High-risk Pulmonary Embolism Versus Percutaneous Transcatheter Treatment. Response. ACTA ACUST UNITED AC 2016; 69:801-2. [PMID: 27387054 DOI: 10.1016/j.rec.2016.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 05/10/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Angel Sánchez-Recalde
- Departamento de Cardiología Intervencionista, Hospital Universitario La Paz, Madrid, Spain.
| | - Raúl Moreno
- Departamento de Cardiología Intervencionista, Hospital Universitario La Paz, Madrid, Spain
| | | | - Guillermo Galeote
- Departamento de Cardiología Intervencionista, Hospital Universitario La Paz, Madrid, Spain
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Sánchez-Recalde A, Moreno R, Estebanez Flores B, Jiménez-Valero S, García de Lorenzo y Mateos A, López-Sendón JL. Tratamiento percutáneo de la tromboembolia pulmonar aguda masiva. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2015.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Arroyo-Úcar E, Moreno R, del Prado S, López T, Sánchez-Recalde A, Calvo Orbe L, Jiménez-Valero S, Galeote G, Ramírez MU, Gonzalez Davia R, Plaza I, Mesa JM, López-Sendón JL. Echogenic mobile images in intraprocedural three-dimensional transesophageal echocardiographic monitoring during percutaneous aortic valve implantation: Incidence, characteristics and clinical implications. Revista Portuguesa de Cardiologia (English Edition) 2016. [DOI: 10.1016/j.repce.2015.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sánchez-Recalde A, Moreno R, Estebanez Flores B, Jiménez-Valero S, García de Lorenzo y Mateos A, López-Sendón JL. Percutaneous Transcatheter Treatment for Massive Pulmonary Embolism. ACTA ACUST UNITED AC 2016; 69:340-2. [PMID: 26778590 DOI: 10.1016/j.rec.2015.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 11/10/2015] [Indexed: 11/29/2022]
Affiliation(s)
| | - Raúl Moreno
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
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Moreno R, Calvo L, Sánchez-Recalde A, Galeote G, Jiménez-Valero S, López T, Plaza I, González-Davia R, Ramírez U, Mesa JM, Moreno-Gomez I, López-Sendón JL. Short- and long-term need for permanent pacemaker after transcatheter implantation of the Edwards Sapien aortic valve prosthesis. Revista Portuguesa de Cardiologia (English Edition) 2015. [DOI: 10.1016/j.repce.2015.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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15
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Moreno R, Calvo L, Sánchez-Recalde A, Galeote G, Jiménez-Valero S, López T, Plaza I, González-Davia R, Ramírez U, Mesa JM, Moreno-Gomez I, López-Sendón JL. Short- and long-term need for permanent pacemaker after transcatheter implantation of the Edwards Sapien aortic valve prosthesis. Rev Port Cardiol 2015; 34:665-72. [DOI: 10.1016/j.repc.2015.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 05/06/2015] [Accepted: 05/09/2015] [Indexed: 11/29/2022] Open
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Arroyo-Úcar E, Moreno R, García E, Teles R, Rumoroso JR, Carvalho HC, Goicolea FJ, Moreu J, Mauri J, Sabaté M, Mainar V, Patricio L, Valdés M, Fernández-Vázquez F, Sánchez-Recalde A, Galeote G, Jimenez-Valero S, Almeida M, López de Sa E, Calvo L, Plaza I, Lopez-Sendón JL, Martín JLR. Drug-eluting stent thrombosis in the treatment of chronic total coronary occlusions: Incidence, presentation and related factors. Data from the CIBELES trial. Revista Portuguesa de Cardiologia (English Edition) 2015. [DOI: 10.1016/j.repce.2015.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Arroyo-Úcar E, Moreno R, García E, Teles R, Rumoroso JR, Carvalho HC, Goicolea FJ, Moreu J, Mauri J, Sabaté M, Mainar V, Patricio L, Valdés M, Fernández-Vázquez F, Sánchez-Recalde A, Galeote G, Jimenez-Valero S, Almeida M, López de Sa E, Calvo L, Plaza I, Lopez-Sendón JL, Martín JLR. Drug-eluting stent thrombosis in the treatment of chronic total coronary occlusions: incidence, presentation and related factors. Data from the CIBELES trial. Rev Port Cardiol 2015; 34:193-9. [PMID: 25686520 DOI: 10.1016/j.repc.2014.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 08/16/2014] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES The aim of this study was to analyze the incidence of drug-eluting stent thrombosis (sirolimus or everolimus) in patients with chronic total coronary occlusions (CTO) and to determine its clinical implications and related factors. METHODS Data from the 12-month follow-up of the 207 patients included in the CIBELES trial with CTO were analyzed. RESULTS Stent thrombosis occurred in three patients, two definite and one probable (overall thrombosis rate: 1.4%). However, there were no cases of death or Q-wave myocardial infarction. In univariate analysis, patients with a higher incidence of stent thrombosis were those in whom the target vessel was the left anterior descending, who had single-vessel disease, were assigned to treatment with sirolimus-eluting stents, and those with smaller minimum luminal diameter immediately after the procedure. In multivariate analysis, the only independent predictor of stent thrombosis was minimal luminal diameter immediately after the procedure. CONCLUSIONS The rate of drug-eluting stent thrombosis in patients with CTO is relatively low (1.4%). The only independent predictor of stent thrombosis in this context was minimal luminal diameter after the procedure and the clinical presentation was in all cases relatively benign.
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Affiliation(s)
| | - Raul Moreno
- Hospital Universitario La Paz, Madrid, Spain.
| | | | - Rui Teles
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | | | | | - José Moreu
- Hospital Virgen de la Salud, Toledo, Spain
| | | | - Manel Sabaté
- Hospital Santa Creu I Sant Pau, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | - Luis Calvo
- Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Jose-Luis R Martín
- Research Manager, School of Biomedical and Health Sciences, Universidad Europea de Madrid, Spain
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Carrizo S, Xie X, Peinado-Peinado R, Sánchez-Recalde A, Jiménez-Valero S, Galeote-Garcia G, Moreno R. Functional assessment of coronary artery disease by intravascular ultrasound and computational fluid dynamics simulation. Rev Port Cardiol 2014; 33:645.e1-4. [DOI: 10.1016/j.repc.2014.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 03/28/2014] [Indexed: 11/17/2022] Open
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Carrizo S, Xie X, Peinado-Peinado R, Sánchez-Recalde A, Jiménez-Valero S, Galeote-Garcia G, Moreno R. Functional assessment of coronary artery disease by intravascular ultrasound and computational fluid dynamics simulation. Revista Portuguesa de Cardiologia (English Edition) 2014. [DOI: 10.1016/j.repce.2014.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Sánchez-Recalde A, Moreno R, González A, Domínguez F, Leyra F, López-Sendón JL. Implante directo de válvula percutánea Edwards-SAPIEN en posición tricuspídea sobre bioprótesis degenerada en paciente con enfermedad de Ebstein. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2014.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sánchez-Recalde A, Moreno R, González A, Domínguez F, Leyra F, López-Sendón JL. Direct percutaneous implantation of an Edwards-SAPIEN valve in tricuspid position in a degenerated bioprosthesis in a patient with Ebstein anomaly. ACTA ACUST UNITED AC 2014; 67:770-2. [PMID: 25172078 DOI: 10.1016/j.rec.2014.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 03/29/2014] [Indexed: 10/25/2022]
Affiliation(s)
| | - Raúl Moreno
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - Ana González
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | | | - Fernando Leyra
- Servicio de Anestesia Cardiovascular, Hospital Universitario La Paz, Madrid, Spain
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Sánchez-Recalde A, Moreno R, Galeote G, Jimenez-Valero S, Calvo L, Sevillano JH, Arroyo-Ucar E, López T, Mesa JM, López-Sendón JL. Evolución inmediata y a medio plazo de las dehiscencias paravalvulares cerradas percutáneamente. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2014.01.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Sánchez-Recalde A, Moreno R, Galeote G, Jimenez-Valero S, Calvo L, Sevillano JH, Arroyo-Ucar E, López T, Mesa JM, López-Sendón JL. Immediate and mid-term clinical course after percutaneous closure of paravalvular leakage. ACTA ACUST UNITED AC 2014; 67:615-23. [PMID: 25037540 DOI: 10.1016/j.rec.2014.01.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 01/30/2014] [Indexed: 12/11/2022]
Abstract
INTRODUCTION AND OBJECTIVES Percutaneous closure of paravalvular leakage is an alternative to surgery in high-risk patients, but its use has been limited by a lack of specific devices. More appropriate devices-like the Amplatzer Vascular Plug III-have recently been developed, but information about their efficacy and safety is still scarce. The objective of the present study was to assess the mid-term results of paravalvular leakage closure with this device. METHODS We analyzed the clinical and echocardiographic course both in-hospital and mid-term (13 [9] months) in a series of 20 consecutive patients (age, 68 years; logistic EuroSCORE, 29) with paravalvular leakage and attempted percutaneous closure. RESULTS Closure was attempted for 23 leaks (17 mitral and 6 aortic) during 22 procedures in 20 patients. Implantation was successful in 87% of the leaks and the procedure was successful in 83%-with success being defined as a reduction in regurgitation of ≥ 1 degree. Survival at 1 year was 64.7% and survival free of the composite event of death/surgery was 58.8%. The degree of residual regurgitation was not associated with mortality but was associated with functional status. Survivors showed significant improvement in functional class. CONCLUSIONS Percutaneous closure of leakage with the Amplatzer Vascular Plug III is safe and efficient in the mid-term. However, mortality among high-risk patients is high independently of the degree of residual regurgitation, indicating that these procedures are performed when heart disease has reached an advanced stage.
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Affiliation(s)
| | - Raúl Moreno
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - Guillermo Galeote
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | | | - Luis Calvo
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Teresa López
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - José M Mesa
- Servicio de Cirugía Cardiovascular, Hospital Universitario La Paz, Madrid, Spain
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Costero O, Sánchez-Recalde A, Moreno R, Moreno I, Selgas R, López-Sendón JL. Pseudopheochromocytoma as a cause of resistant and paroxysmal hypertension successfully treated by percutaneous renal denervation. ACTA ACUST UNITED AC 2014; 66:227-9. [PMID: 24775462 DOI: 10.1016/j.rec.2012.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Accepted: 07/20/2012] [Indexed: 11/25/2022]
Affiliation(s)
- Olga Costero
- Servicio de Nefrología, Hospital Universitario La Paz, Madrid, Spain
| | | | - Raúl Moreno
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - Isidro Moreno
- Servicio de Anestesia Cardiaca, Hospital Universitario La Paz, Madrid, Spain
| | - Rafael Selgas
- Servicio de Nefrología, Hospital Universitario La Paz, Madrid, Spain
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Ruiz-García J, Jiménez-Valero S, Galeote G, Sánchez-Recalde A, García-Blas S, Moreno R. Neoatherosclerosis as the cause of very late bare-metal stent restenosis: optical coherence tomography evaluation. ACTA ACUST UNITED AC 2014; 66:403-5. [PMID: 24775826 DOI: 10.1016/j.rec.2012.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 09/27/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Juan Ruiz-García
- Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain.
| | - Santiago Jiménez-Valero
- Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - Guillermo Galeote
- Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - Angel Sánchez-Recalde
- Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - Sergio García-Blas
- Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - Raúl Moreno
- Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
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Sánchez-Recalde A, González-Juanatey J. Obesidad y enfermedad coronaria. ¿Asociación compleja o paradójica? Rev Clin Esp 2014; 214:137-9. [DOI: 10.1016/j.rce.2013.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 12/02/2013] [Indexed: 11/24/2022]
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Moreno R, García E, Teles R, Rumoroso JR, Cyrne Carvalho H, Goicolea FJ, Moreu J, Mauri F, Sabaté M, Mainar V, Patricio L, Valdés M, Cuellas C, Almeida M, Sánchez-Recalde A, Galeote G, Jimenez-Valero S, Calvo L, Plaza I, Lopez-Sendón JL, Martín JLR. Techniques and material used in the percutaneous treatment of chronic coronary occlusions. Data from the CIBELES study. Rev Port Cardiol 2013; 32:593-9. [PMID: 23896301 DOI: 10.1016/j.repc.2012.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 11/01/2012] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION In recent years, various specific techniques and materials have been developed for the treatment of coronary chronic total occlusions (CTO). OBJECTIVE To evaluate the current situation in the treatment of CTO (techniques and material) in our setting. METHODS We evaluated data on techniques and material used in the CIBELES (ChronIc coronary occlusion treated By EveroLimus Eluting Stent) trial, a randomized comparison of sirolimus- and everolimus-eluting stents in 207 patients with CTO in 13 centers in Spain and Portugal. RESULTS A radial approach was used in 23% of patients, and retrograde techniques were used in only 5%. A high number of balloons were used (2.2±0.9 per patient). Microcatheters were used in 33% of patients, and post-dilatation balloons in only 25%. The mean number of stents implanted per patient was 2.1±1.0, with a mean total stent length of 49±24 mm. Other devices and techniques used were: Tornus penetration catheter in 4% of patients, rotational atherectomy in 2%, and cutting balloon in 1%. Intracoronary ultrasound was used in only 6% of patients. In 34% of cases, operators used guidewires that were not specifically for CTO. Considerable variability between centers was detected in the use of different techniques, the highest and lowest variability being observed in the use of intracoronary ultrasound and the use of CTO guidewires, respectively. CONCLUSIONS In the CIBELES trial, techniques and devices specifically designed for the treatment of CTO were used in a relatively low proportion of patients. Considerable variability between centers was detected.
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Affiliation(s)
- Raul Moreno
- Interventional cardiology, University Hospital La Paz, Madrid, Spain.
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Moreno R, García E, Teles R, Rumoroso JR, Cyrne Carvalho H, Goicolea FJ, Moreu J, Mauri F, Sabaté M, Mainar V, Patricio L, Valdés M, Cuellas C, Almeida M, Sánchez-Recalde A, Galeote G, Jimenez-Valero S, Calvo L, Plaza I, Lopez-Sendón JL, Martín JLR. Techniques and material used in the percutaneous treatment of chronic coronary occlusions. Data from the CIBELES study. Revista Portuguesa de Cardiologia (English Edition) 2013. [DOI: 10.1016/j.repce.2013.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Costero O, Sánchez-Recalde A, Moreno R, Moreno I, Selgas R, López-Sendón JL. Seudofeocromocitoma como causa de hipertensión arterial refractaria y paroxística tratada con éxito mediante denervación renal percutánea. Rev Esp Cardiol 2013. [DOI: 10.1016/j.recesp.2012.07.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Moreno R, García E, Teles R, Rumoroso JR, Cyrne Carvalho H, Goicolea FJ, Moreu J, Mauri J, Sabaté M, Mainar V, Patricio L, Valdés M, Fernández Vázquez F, Sánchez-Recalde A, Galeote G, Jimenez-Valero S, Almeida M, Lopez de Sa E, Calvo L, Plaza I, Lopez-Sendón JL, Martín JLR. Randomized comparison of sirolimus-eluting and everolimus-eluting coronary stents in the treatment of total coronary occlusions: results from the chronic coronary occlusion treated by everolimus-eluting stent randomized trial. Circ Cardiovasc Interv 2013; 6:21-8. [PMID: 23403384 DOI: 10.1161/circinterventions.112.000076] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Patients with coronary total occlusions are at especially high risk for restenosis and new revascularizations. Sirolimus-eluting stents dramatically improved the clinical outcome of this subset of patients in randomized trials, but other drug-eluting stents, mainly the everolimus-eluting stent (currently the most frequently used stent), have not yet been evaluated in patients with coronary total occlusions. The objective was to compare the second-generation everolimus-eluting stent with the first-generation sirolimus-eluting stent in patients with coronary total occlusions. METHODS AND RESULTS A total of 207 patients with coronary total occlusions and estimated time since occlusion >2 weeks were randomized to everolimus- or sirolimus-eluting stent. The primary end point was in-stent late loss at 9-month angiographic follow-up (noninferiority trial). Clinical follow-up was performed at 1 and 12 months. In-stent late loss at 9 months was 0.29±0.60 versus 0.13±0.69 mm in patients allocated to sirolimus- and everolimus-eluting stent, respectively. The observed difference in in-stent late loss between both groups was -0.16 mm (95% confidence interval, 0.04 to -0.36 mm; P for noninferiority <0.01). The rate of binary angiographic restenosis was 10.8% and 9.1% in patients allocated to sirolimus- and everolimus-eluting stent, respectively (P=0.709), whereas the rate of vessel reocclusion was 3.2% and 1.1%, respectively (P=0.339). At 12 months, the rate of major adverse events was 15.9% versus 11.1% with sirolimus- and everolimus-eluting stent, respectively (P=0.335), and probable or definitive stent thrombosis occurred in 3.0% and 0.0% of patients, respectively (P=0.075). CONCLUSIONS In patients with coronary total occlusions, everolimus-eluting stent is as effective as sirolimus-eluting stent. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00793221.
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Affiliation(s)
- Raul Moreno
- Hospital Universitario La Paz, 28046 Madrid, Spain.
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Ruiz-García J, Jiménez-Valero S, Salinas P, Sánchez-Recalde A, Galeote G, Moreno R. Optical coherence tomography in spontaneous coronary dissection and in the complications following percutaneous treatment. Rev Esp Cardiol 2012; 66:72-3. [PMID: 22871349 DOI: 10.1016/j.recesp.2012.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 05/17/2012] [Indexed: 11/18/2022]
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Leal S, Galeote G, Jiménez-Valero S, Sánchez-Recalde A, Salinas P, Ruiz AS, Orbe LC, Dominguéz F, Moreno R, López-Sendón JL. Percutaneous alcohol septal ablation for hypertrophic obstructive cardiomyopathy: technical review and long-term clinical and echocardiographic outcomes. Rev Port Cardiol 2012; 31:363-71. [PMID: 22482474 DOI: 10.1016/j.repc.2011.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 11/04/2011] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Percutaneous septal ablation by alcohol-induced septal branch occlusion was introduced as a new treatment option in symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM). Our aim was to evaluate procedural and long-term clinical and echocardiographic outcomes in patients with HOCM treated by alcohol septal ablation (ASA) at our center. METHODS This single-center retrospective study included 14 consecutive HOCM patients undergoing percutaneous ASA (66.4 +/- 12.1 years, 71.4% female). At baseline all patients presented persistent symptoms despite optimized medical treatment, left ventricular outflow tract (LVOT) obstruction with a peak gradient > 50 mmHg, systolic anterior motion of the mitral valve, and ventricular septal thickness > or = 15 mm. ASA was considered successful when the LVOT pressure gradient fell to less than 50% of baseline value. All patients had echocardiographic evaluation at baseline, intraprocedure and at follow-up, and a long-term clinical follow-up (25 +/- 38 months) with evaluation of functional class and occurrence of symptoms or cardiovascular events. RESULTS Percutaneous ASA achieved a 71.4% acute and 85.7% long-term success rate. Peak LVOT gradient decreased from 104 +/- 40 mmHg at baseline to 58 +/- 30 mmHg intraprocedure (p = 0.03) and 35 +/- 26 mmHg at follow-up (p = 0.001); total gradient decrease was 75 +/- 43 mmHg. Ventricular septal thickness and mitral regurgitation also presented significant decreases during follow-up (from 24 +/- 5 mm to 18 +/- 4 mm, p = 0.02, and from grade 2.4 +/- 0.6 to 1.4 +/- 0.5, p < 0.001, respectively). A tendency for long-term improvement in NYHA functional class (from 2.6 +/- 1.1 to 1.8 +/- 1.4, p = 0.09) was observed. Procedural complications occurred in 6.7% of patients; two deaths and one transient ischemic attack occurred in-hospital, but no long-term clinical events were recorded. CONCLUSIONS Percutaneous ASA is an effective treatment for symptomatic patients with HOCM, obtaining a marked decrease in LVOT pressure gradient and symptomatic improvement. Despite the occurrence of a significant number of procedural complications, the favorable long-term outcomes underline the potential of ASA as a percutaneous alternative to surgical myectomy.
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Affiliation(s)
- Sílvio Leal
- Unidade de Intervenção Cardiovascular, Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
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Salinas P, Moreno R, Calvo L, Dobarro D, Jiménez-Valero S, Sánchez-Recalde A, Gaçeote G, Riera L, González Montalvo JI, Plaza I, Mariscal F, Gonzalez-Davia R, López T, Moreno M, Alvarez A, Cuesta E, Garzon G, Filgueiras D, Moreno-Gomez I, Mesa JM, López-Sendon JL. Implantação percutânea de próteses valvulares aórticas: resultados de uma nova opção terapêutica na estenose aórtica com alto risco cirúrgico. Rev Port Cardiol 2012; 31:143-9. [DOI: 10.1016/j.repc.2011.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 09/08/2011] [Indexed: 11/15/2022] Open
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Salinas P, Moreno R, Calvo L, Dobarro D, Jiménez-Valero S, Sánchez-Recalde A, Galeote G, Riera L, González Montalvo JI, Plaza I, Mariscal F, Gonzalez-Davia R, López T, Moreno M, Alvarez A, Cuesta E, Garzon G, Filgueiras D, Moreno-Gomez I, Mesa JM, López-Sendon JL. Transcatheter aortic valve implantation: Results of a new therapeutic option for high surgical risk aortic stenosis. Revista Portuguesa de Cardiologia (English Edition) 2012. [DOI: 10.1016/j.repce.2011.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Salinas P, Moreno R, Calvo L, Jiménez-Valero S, Galeote G, Sánchez-Recalde A, López-Fernández T, Garcia-Blas S, Iglesias D, Riera L, Moreno-Gómez I, Mesa JM, Plaza I, Ayala R, Gonzalez R, López-Sendón JL. Clinical and prognostic implications of atrial fibrillation in patients undergoing transcatheter aortic valve implantation. World J Cardiol 2012; 4:8-14. [PMID: 22279599 PMCID: PMC3262396 DOI: 10.4330/wjc.v4.i1.8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Revised: 12/20/2011] [Accepted: 12/27/2011] [Indexed: 02/06/2023] Open
Abstract
AIM To study a cohort of consecutive patients undergoing transcatheter aortic valve implantation (TAVI) and compare the outcomes of atrial fibrillation (AF) patients vs patients in sinus rhythm (SR). METHODS All consecutive patients undergoing TAVI in our hospital were included. The AF group comprised patients in AF at the time of TAVI or with history of AF, and were compared with the SR group. Procedural, echocardiographic and follow-up variables were compared. Likewise, the CHA(2)DS(2)-VASC stroke risk score and HAS-BLED bleeding risk score and antithrombotic treatment at discharge in AF patients were compared with that in SR patients. RESULTS From a total of 34 patients undergoing TAVI, 17 (50%) were allocated to the AF group, of whom 15 (88%) were under chronic oral anticoagulation. Patients in the AF group were similar to those in the SR group except for a trend (P = 0.07) for a higher logistic EuroSCORE (28% vs 19%), and a higher prevalence of hypertension (82% vs 53%) and chronic renal failure (17% vs 0%). Risk of both stroke and bleeding was high in the AF group (mean CHA(2)DS(2)-VASC 4.3, mean HAS-BLED 2.9). In the AF group, treatment at discharge included chronic oral anticoagulation in all except one case, and in association with an antiplatelet drug in 57% of patients. During a mean follow-up of 11 mo (maximum 32), there were only two strokes, none of them during the peri-procedural period: one in the AF group at 30 mo and one in the SR group at 3 mo. There were no statistical differences in procedural success, and clinical outcome (survival at 1 year 81% vs 74% in AF and SR groups, respectively, P = NS). CONCLUSION Patients in AF undergoing TAVI show a trend to a higher surgical risk. However, in our cohort, patients in AF did not have a higher stroke rate compared to the SR group, and the prognosis was similar in both groups.
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Affiliation(s)
- Pablo Salinas
- Pablo Salinas, Raúl Moreno, Luis Calvo, Santiago Jiménez-Valero, Guillermo Galeote, Angel Sánchez-Recalde, Division of Interventional Cardiology, University Hospital La Paz, 28046 Madrid, Spain
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Sánchez-Recalde A, Gutiérrez-Larraya F, Domínguez Melcón F, Mesa JM. [Closure of ventricular septal defect after surgical septal myectomy by hybrid procedure in an adult patient]. Rev Esp Cardiol 2011; 64:1067-9. [PMID: 21684662 DOI: 10.1016/j.recesp.2010.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 12/20/2010] [Indexed: 11/25/2022]
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Martín-Reyes R, Moreno R, Sánchez-Recalde A, Navarro F, Franco J, Piñero A, Sendón JLL. Comparison of the safety between first- and second-generation drug eluting stents: meta-analysis from 19 randomized trials and 16,924 patients. Int J Cardiol 2011; 160:181-6. [PMID: 21546100 DOI: 10.1016/j.ijcard.2011.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 03/21/2011] [Accepted: 04/14/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND/OBJECTIVE Despite the effectiveness of first generation drug eluting stent, DES-1 (Taxus and Cypher) in avoiding restenosis and the need for new revascularizations, a slightly increase in stent thrombosis, ST have been published. Second generation drug eluting stent, DES-2 has been developed to optimize the results of percutaneous coronary intervention in terms of efficacy and safety, for avoiding early and late ST. Our objective was to compare the risk of ST between DES-1 and DES-2. METHODS We performed a meta-analysis of 19 randomized trials. Overall 16,924 patients; 7294 were allocated to DES-1 and 9630 were allocated to DES-2. The primary endpoint was to compare the risk of overall ST during the first year. Other clinical outcomes of interest were to compare the incidence of early (<1 month) and late ST (>1 month-<1 year). RESULTS The incidence of overall ST was not increased in patients receiving DES-1 (1.13% DES-1 vs 0.75% DES-2, OR 0.79, 95% CI:0.45-1.40, p 0.43). There were no significant differences in the incidence of; early ST (0.85% DES-1 vs 0.53% DES-2, OR 0.68, 95% CI:0.31-1.51, p 0.35) and late ST (0.40% DES-1 vs 0.25% DES-2, OR 0.69, 95% CI:0.39-1.24, p 0.22). CONCLUSIONS During the first year after stent implantation, we didn't found differences in ST between DES-1 and DES-2. Most of ST was produced under appropriate anti-platelet therapy so it is possible that many other factors such as; clopidogrel resistance, procedural complications or stent malapposition were implicated. Safety after longer follow-up (>1 year) remains unclear.
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Sánchez-Recalde A, Merino JL, Moreno R, Jiménez-Valero S, Galeote G, Calvo L, López de Sá E, López-Sendón JL. [Clinical implications of intracoronary findings beyond coronary angiograms in patients with sudden death and high probability of coronary artery disease]. Rev Esp Cardiol 2011; 64:819-23. [PMID: 21501916 DOI: 10.1016/j.recesp.2010.11.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Accepted: 11/29/2010] [Indexed: 02/04/2023]
Abstract
Of 12 patients with sudden death and a high probability of coronary artery disease who underwent cardiac catheterization, 4 (25%) showed coronary arteries without significant obstructive lesions or angiographic signs of instability. The study protocol included an invasive study of coronary vasoreactivity and an intracoronary imaging study with intravascular ultrasound. The coronary reactivity study showed coronary vasospasm in 1 patient. Intravascular ultrasound showed active coronary plaques with images suggesting intraluminal thrombus in all patients. The diagnosis reached was sudden death secondary to ventricular arrhythmias in the context of acute coronary syndrome; the use of an implantable cardioverter-defibrillator was therefore not indicated. In conclusion, in patients with sudden death with a high probability of coronary artery disease but with coronary arteries lacking significant lesions, intracoronary imaging (eg, by intravascular ultrasound) may be essential to establish a diagnosis and appropriate treatment, even in patients with induced coronary vasospasm.
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Affiliation(s)
- Angel Sánchez-Recalde
- Sección de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, España.
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Cabestrero D, Polo L, Aroca A, Sánchez-Recalde A, Sartor L, Sánchez-Valenzuela D. Right pulmonary branch stent migration. Asian Cardiovasc Thorac Ann 2011; 19:177. [PMID: 21471269 DOI: 10.1177/0218492311398481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sánchez-Recalde A, González-Obeso E, Martín Reyes R, Jiménez-Valero S, Galeote G, Calvo L, Moreno R, López Sendón JL. Intravascular ultrasound and histology findings in very late bare-metal stent thrombosis. Rev Esp Cardiol 2010; 63:1492-6. [PMID: 21144414 DOI: 10.1016/s1885-5857(10)70284-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Very late thrombosis in an implanted bare-metal stent is a very uncommon event outside the context of brachytherapy and few data about its pathophysiology are available. We performed an intravascular ultrasound study during primary angioplasty in five patients with very late bare-metal stent thrombosis and carried out a histological analysis of the material removed by manual thrombectomy. The mean time from the index procedure was 7 ± 4 years. Intravascular ultrasound findings were: calcified atherosclerosis with in-stent plaque rupture, complex plaque in the distal segment of the stent, in-stent neointimal proliferation associated with underexpansion, and severe in-stent proliferation. Histological findings were consistent with the intravascular ultrasound images: recent thrombus with areas of old thrombosis in all cases and remnant atheromatous plaque and endothelium. Consequently, in-stent or distal stent atherosclerosis progression and progressive neointimal proliferation were the likely pathophysiological mechanisms.
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Affiliation(s)
- Angel Sánchez-Recalde
- Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, España.
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Martín-Reyes R, Jiménez-Valero S, Sánchez-Recalde A, Moreno R. [Initial experience with a new manual device for aspiration of intracoronary thrombus "ELIMINATE"]. Rev Clin Esp 2010; 210:594-5. [PMID: 20951374 DOI: 10.1016/j.rce.2010.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 05/11/2010] [Accepted: 05/19/2010] [Indexed: 11/18/2022]
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Sánchez-Recalde A, Oliver JM, Galeote G, González A, Calvo L, Jiménez-Valero S, Moreno R, López-Sendón JL. Atrial septal defect with severe pulmonary hypertension in elderly patients: usefulness of transient balloon occlusion. Rev Esp Cardiol 2010; 63:860-4. [PMID: 20609321 DOI: 10.1016/s1885-5857(10)70172-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In patients with an atrial septal defect and severe pulmonary hypertension, it is important to determine whether the latter is reversible before percutaneous or surgical closure. In addition to determining pulmonary resistance, one simple technique is to transiently occlude the septal defect using a balloon catheter and to evaluate the hemodynamic response. We defined a positive response as a > or = 25% reduction in mean pulmonary artery pressure during occlusion relative to the basal level, without a fall in systemic pressure or an increase in ventricular end-diastolic pressure. The study included five patients aged over 60 years with an atrial septal defect and severe pulmonary hypertension who were referred for percutaneous closure. In one patient, the test gave a negative result and closure of the atrial septal defect was not performed. In the remaining four, closure was indicated. In three patients, closure was performed percutaneously, while the fourth underwent surgery. The drop in pulmonary pressure observed during the test was maintained over the long term at a mean follow-up time of 22 months.
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Affiliation(s)
- Angel Sánchez-Recalde
- Sección de Hemodinámica y Cardiología Intervencionista, Unidad de Cardiopatías Congénitas del Adulto, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain.
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Martín-Reyes R, Galeote G, Moreno R, Sánchez-Recalde A, López De Sá E, López-Sendón JL. [Percutaneous coronary intervention in HIV infected patients with human immunodeficiency virus admitted with acute coronary syndrome: case-control study]. Med Clin (Barc) 2010; 135:691-4. [PMID: 20599234 DOI: 10.1016/j.medcli.2010.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Revised: 05/04/2010] [Accepted: 05/06/2010] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Human immunodeficiency virus (HIV) has been linked in recent years with a higher rate of cardiovascular events. The aim of our study was to analyze the main risk factors associated with the onset of an acute coronary syndrome (ACS) and in-hospital prognosis in patients with HIV, undergoing percutaneous coronary intervention (PCI). PATIENTS AND METHODS We studied the baseline clinical characteristics, angiographic findings, results of PCI and in-hospital outcome in 23 patients with HIV hospitalized for an ACS between September 2006 and March 2009. The results were compared with 60 HIV-negative patients admitted with an ACS. RESULTS HIV patients showed a lower average age and a higher rate of smoking. From a clinical point of view there were no statistically significant differences in clinical presentation, with a similar incidence of ACS with or without ST segment elevation ACS. HIV patients presented a non significant higher incidence of cardiogenic shock on admission (13% HIV vs 8% HIV negative, p 0,301). HIV-negative patients angiography showed the most calcified multivessel involvement with the highest number of diseased vessels (2.35 vs. 1.45, p<0.001). PCI results: HIV patients presented a lower rate of success (TIMI 3 final); 75% versus 85% in HIV-negative patients (p=0.105). There was no significant difference in hospital mortality (8.7 vs 1.7%, p=0.129). CONCLUSIONS HIV patients hospitalized for an ACS, despite being younger and presenting lower prevalence of traditional cardiovascular risk factors, did not present differences in terms of cardiovascular mortality compared with HIV negative patients.
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Sánchez-Recalde A, Gutiérrez-Larraya F, Aroca A, Oliver JM. Percutaneous treatment of superior vena cava obstruction after surgery for a sinus venosus atrial septal defect with partial anomalous pulmonary venous drainage. Rev Esp Cardiol 2010; 63:748-50. [PMID: 20515638 DOI: 10.1016/s1885-5857(10)70155-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Viana-Tejedor A, Sánchez-Recalde A, Oliver J, Maté I, Sobrino J, Bret M, López de Sá y Areses E, Lopez Sendon J. Infective endocarditis of unusual location following surgical correction of a complex congenital heart disease. Clin Cardiol 2010; 32:E85-7. [PMID: 19353677 DOI: 10.1002/clc.20382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A 40-year-old woman from Ecuador diagnosed with a complex congenital heart disease was admitted complaining of fever chills, night sweats, and productive cough 6 months after surgical correction of the anomalies. An echocardiography showed vegetations located on the interatrial pericardium patch. To the best of our knowledge, this is the first reported case of postoperative infective endocarditis on this location.
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Affiliation(s)
- Ana Viana-Tejedor
- Department of Cardiology, Hospital La Paz, Paseo de la Casellana, Madrid, Spain
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Díaz-Caraballo E, González-García AE, Reñones M, Sánchez-Recalde A, García-Río F, Oliver-Ruiz JM. Long-term bosentan treatment of complex congenital heart disease and Eisenmenger's syndrome. Rev Esp Cardiol 2010; 62:1046-9. [PMID: 19712626 DOI: 10.1016/s1885-5857(09)73271-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The BREATHE-5 study demonstrated that bosentan, an oral endothelin receptor antagonist, provides clinical benefits in patients with Eisenmenger's syndrome. As a result, the European Medicines Agency (EMEA) approved its use for this indication. However, follow-up in that study was limited to 16 weeks and patients with complex congenital heart disease were excluded. We assessed the effect of long-term bosentan treatment in 10 patients with complex congenital heart disease and Eisenmenger's syndrome. In the mean clinical follow-up period of 25 months, all patients reached the target dose without developing side effects and without experiencing a change in arterial oxygen consumption at either rest or maximal exercise. Moreover, there were significant changes in clinical parameters: NYHA functional class improved from 3.3+/-0.7 to 2.5+/-0.9 (P=.002) and the 6-minute walk distance increased from 266+/-161 m to 347+/-133 m (P=.015).
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Affiliation(s)
- Eva Díaz-Caraballo
- Servicio de Cardiología, Hospital Universitario de Guadalajara, Guadalajara, España
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Viana-Tejedor A, Oliver JM, Sánchez-Recalde A, López-Sendón J. Development of dyspnea over several months in a young man. Rev Esp Cardiol 2010; 63:117-119. [PMID: 20089238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Aroca Peinado A, Polo López L, González Rocafort A, Bret Zurita M, Cabestrero Alonso D, Ruiz Cantador J, Sartor L, Oliver Ruiz J, Sánchez-Recalde A, González García A, Villagrá Blanco F. 225. Cirugía cavopulmonar en la situación de ventrículo único durante la edad adulta. Resultados quirúrgicos y seguimiento. Cirugía Cardiovascular 2010. [DOI: 10.1016/s1134-0096(10)70728-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Jiménez-Valero S, Moreno R, Sánchez-Recalde A. Very late drug-eluting stent thrombosis related to incomplete stent endothelialization: in-vivo demonstration by optical coherence tomography. J Invasive Cardiol 2009; 21:488-490. [PMID: 19726825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Very late drug-eluting stent (DES) thrombosis is a rare but potentially life-threatening event that has become a major cause of concern. Delayed arterial healing with incomplete endothelialization is probably a pivotal factor related with DES thrombosis. Optical coherence tomography (OCT) is a new high-resolution intracoronary imaging technique that allows detailed evaluation of stent neointimal coverage. We present a case of very late DES thrombosis that was evaluated with OCT, demonstrating incomplete endothelialization as the probable main mechanism of stent thrombosis. This case illustrates the ability of OCT for in-vivo identification of stent coverage and its potential role in the evaluation of stent thrombosis mechanisms.
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Affiliation(s)
- Santiago Jiménez-Valero
- Interventional Cardiology Unit, Cardiology Department, La Paz University Hospital, Avda. Castellana 261, Madrid 28046, Spain.
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Dobarro D, Moreno R, Filgueiras D, Calvo L, López-Fernández T, Sánchez-Recalde A, Jiménez-Valero S, Galeote G, Gómez-Rubín MDC, Moreno-Gómez I, Mesa JM, Plaza I, López-Sendón JL. [Implantation of aortic valvular prosthesis via transfemoral catheter. Evaluation of candidates undergoing the procedure]. Med Clin (Barc) 2009; 133:414-21. [PMID: 19674759 DOI: 10.1016/j.medcli.2009.05.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Accepted: 05/26/2009] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVE In recent years, techniques for implantation of aortic prosthesis via catheter have been developed as a therapeutic alternative in patients with severe aortic stenosis rejected for surgery. The correct selection of candidates is one of the more complex aspects of this treatment. We analyzed the acceptance rate in our environment for transcatheter aortic valve implantation in patients referred to our hospital for evaluation as possible candidates, describing the exclusion reasons. PATIENTS AND METHOD 30 patients with severe aortic stenosis and rejected for surgical aortic valve replacement were referred to our hospital to evaluate transcatheter aortic valve implantation. The patients first underwent clinical evaluation and were studied with echocardiography, angiography and computed tomography. RESULTS Of the 30 patients, 18 were rejected for the procedure (60%): 4 patients with non-severe aortic stenosis, 2 asymptomatic patients, 2 patients who finally underwent surgery because of a low-surgical-risk, 5 patients with contraindications for the procedure, 2 patients who finally did not want to undergo the procedure and 3 patients were further rejected because the vascular access was inappropriate. Of the remaining 12 patients initially accepted, 3 died before the procedure was performed. Finally, only 9 patients (30%) underwent transcatheter aortic valve implantation. CONCLUSIONS Of the patients referred for transcatheter aortic valve implantation, only 40% were accepted. The mortality rate during the evaluation process of this procedure is high, showing that these patients are terminally ill.
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Affiliation(s)
- David Dobarro
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, España
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