ABSTRACT
OBJECTIVES: We sought to identify predictors of in-hospital and long-term (> 1 year) mortality and major adverse cardiac events (MACE) in elderly patients referred for percutaneous coronary intervention (PCI). METHODS: Seventy-three patients (> or = 80 years) were included. Clinical and interventional characteristics were collected retrospectively. Primary end points were in-hospital and long-term mortality, and a composite of non-fatal myocardial infarction, target vessel revascularization, urgent coronary artery bypass graft surgery, and death (MACE). RESULTS: Eighty-three percent of the patients had acute coronary syndromes, 43% three-vessel disease, and 42% heart failure. In-hospital mortality and MACE were 16.4% and 19%, respectively. Long-term mortality and MACE were 11.3% and 16.4%, respectively. Univariate characteristics associated with in-hospital mortality and MACE were: Killip Class III-IV, heart failure, cardiogenic shock, TIMI 0-2 flow prior and after intervention, diabetes mellitus, contrast nephropathy, and presence of A-V block or atrial fibrillation (AF). Long term predictors for mortality were the presence of heart failure, cardiogenic shock, diabetes mellitus, TIMI flow 0-2 before and after intervention, and A-V block or AF. CONCLUSION: The identification of the factors previously mentioned may help to predict complications in elderly patients.
Subject(s)
Aged, 80 and over , Female , Humans , Male , Angioplasty, Balloon, Coronary/adverse effects , Angioplasty, Balloon, Coronary/mortality , Cardiovascular Diseases , Cardiovascular Diseases/mortality , Prognosis , Retrospective Studies , Risk FactorsSubject(s)
Humans , Child , Adolescent , Adult , Middle Aged , Male , Female , Heart Valve Diseases/diagnosis , Heart Valve Diseases/etiology , Heart Valve Diseases/therapy , Heart Valve Prosthesis/classification , Heart Valve Prosthesis/mortality , Heart Valve Prosthesis/standards , Heart Valves/abnormalitiesABSTRACT
Se presenta un caso de leiomiosarcoma de útero que produjo cuatro prolongaciones que crecieron lenta y progressivamente dentro de la cava y de las cuales una terminaba a nivel de la vena renal derecha, dos llegaban a la aurícula izquierda y la cuarta atravesaba la tricúspide y terminaba a nivel de las sigmoideas pulmonares emitiendo una pequeña prolongación en el tronco de la arteria pulmonar. Las manifestaciones clínicas simularon una estenosis pulmonar valvular congénita y tromboembolias pulmonares reiteradas. El diagnóstico preciso no se logró a pesar de métodos especiales como cardioangiografía y centelleograma. Se revisan casos semejantes que existen en la literatura mundial y se comparan con el presente. También se hace una revisión de otros tumores que pueden alcanzar las cavidades cardiacas derechas por crecimiento lento y progresivo intravenoso y no por metástasis. Se discute la operabilidad de estos tumores y el mecanismo de crecimiento intravenoso