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1.
Rev. méd. Chile ; 148(4): 548-552, abr. 2020. graf
Artículo en Español | LILACS | ID: biblio-1127095

RESUMEN

Transcatheter aortic valve implantation (TAVI) has a lower perioperative risk than traditional surgery mostly when the transfemoral access is used. Some patients have anatomical conditions that contraindicate the use of this route. Lithoplasty is a novel technique that fractures calcium in coronary and peripheral arteries using pulsatile waves transmitted through an angioplasty balloon. We report an 83 year-old male with an aortic stenosis requiring TAVI, with severe calcification of his femoral and aortic arteries. A balloon lithoplasty of the right iliac-femoral tract was carried out, which allowed the use of the transfemoral route to install the aortic prosthesis. The patient had a good subsequent evolution.


Asunto(s)
Humanos , Estenosis de la Válvula Aórtica , Prótesis Valvulares Cardíacas , Reemplazo de la Válvula Aórtica Transcatéter , Fluoroscopía , Cateterismo Cardíaco , Resultado del Tratamiento
2.
Rev. méd. Chile ; 148(3): 409-413, mar. 2020. graf
Artículo en Español | LILACS | ID: biblio-1115807

RESUMEN

We report a 55-year-old woman with a history of hypothyroidism and type 2 diabetes mellitus who consulted at the emergency room because of intermittent oppressive chest discomfort. At admission, electrocardiogram showed a complete atrioventricular block. A transthoracic echocardiogram disclosed severe left ventricular dysfunction. The patient developed cardiogenic shock that required the installation of the Impella system. An emergency coronary angiography showed an ostial occlusion of the anterior descending artery. Despite successful primary angioplasty, she persisted with refractory shock and progressive hypoxemia. A concomitant connection to the extracorporeal membrane oxygenation system (ECMO) was decided. The support of both devices allowed the stabilization of the patient and the improvement of perfusion parameters.


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Choque Cardiogénico/terapia , Corazón Auxiliar , Disfunción Ventricular Izquierda , Oxigenación por Membrana Extracorpórea , Diabetes Mellitus Tipo 2
3.
Rev. chil. cardiol ; 38(3): 204-209, dic. 2019. graf, ilus
Artículo en Español | LILACS | ID: biblio-1058064

RESUMEN

RESUMEN:TAVI transfemoral en una paciente con obesidad extrema y estenosis aórtica severa. Una mujer extremadamente obesa (IMC 62.5 Kg/M2) con estenosis aórtica severa fue descartada para cirugía bariátrica y reemplazo valvular aórtico. Se efectuó una TAVI por vía transfemoral, sin anestesia general. Se describen cuidadosas técnicas para efectuar la punción femoral y su sellado posterior. La paciente se recuperó sin incidentes, la gradiente transvalvular aórtica se redujo significativamente y hubo mínima insuficiencia valvular.


ABSTRACT: An extremely obese woman (BMI 62.5 Kg/M2) with severe symptomatic aortic stenosis was discarded for bariatric surgery or aortic valve replacement. A transfemoral TAVI was performed, without general anesthesia. Careful techniques to perform and seal the transfemoral puncture are described. The patient recovered uneventfully with a significant decrease in aortic valve gradient and minimal aortic insufficiency.


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Válvula Aórtica/diagnóstico por imagen , Reemplazo de la Válvula Aórtica Transcatéter , Estenosis de la Válvula Aórtica , Angiografía , Ultrasonografía , Arteria Femoral/cirugía , Arteria Femoral/diagnóstico por imagen , Obesidad
4.
Rev. méd. Chile ; 147(10): 1350-1354, oct. 2019. graf
Artículo en Español | LILACS | ID: biblio-1058605

RESUMEN

We report a 65-years old woman with a history of permanent atrial fibrillation with high risk for ischemic and bleeding events. She developed a heart failure with severely impaired left ventricular ejection fraction and severe secondary mitral regurgitation. Given her high surgical risk, using transesophageal echocardiography guidance, a concomitant deployment of two MitraClip devices using a high-posterior septal puncture and a left atrial appendage closure with an Amplatzer Amulet occluder were performed through the same access.


Asunto(s)
Humanos , Femenino , Anciano , Fibrilación Atrial/cirugía , Implantación de Prótesis de Válvulas Cardíacas/métodos , Apéndice Atrial/cirugía , Dispositivo Oclusor Septal , Insuficiencia de la Válvula Mitral/cirugía , Índice de Severidad de la Enfermedad , Angiografía/métodos , Factores de Riesgo , Resultado del Tratamiento , Ecocardiografía Transesofágica
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