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1.
Rev Esp Cardiol (Engl Ed) ; 76(4): 253-260, 2023 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35691552

RESUMO

INTRODUCTION AND OBJECTIVES: Transfemoral access is the most frequently used vascular approach in chronic total occlusion percutaneous coronary interventions (CTO-PCI). The aim of this study was to evaluate the safety and feasibility of a transradial access CTO-PCI program and its impact on angiographic and clinical results and length of hospital stay. METHODS: Retrospective multicenter cohort study including 2550 consecutive CTO-PCI procedures included in a multicenter registry with accurate information on vascular access. A total of 896 procedures were performed as radial-only access while 1654 were performed through at least 1 femoral puncture. Clinical and angiographic data were collected. RESULTS: The mean age was 66.3± 11.4 years. The mean Japan-chronic total occlusion score (2.7±0.3) was similar in the 2 groups. Successful revascularization was achieved in 2009 (79.6%) cases, 78.2% and 82.1% in the femoral and radial access cohorts, respectively (P=.002). Periprocedural in-hospital complications were observed in 5.1% and 2.3% (P=.02), with fewer access site-dependant vascular complications in the transradial cohort (2.3% vs 0.2%; P=.009). The mean length of hospital stay was significantly shorter in the transradial access group (0.89±1.4 vs 2.2±3.2 days, P<.001). CONCLUSIONS: A transradial program for CTO-PCI is safe and effective in most CTO lesions. The transradial strategy has fewer vascular complications and shorter length of hospital stay without compromising the success rate.


Assuntos
Doenças Cardiovasculares , Oclusão Coronária , Intervenção Coronária Percutânea , Humanos , Pessoa de Meia-Idade , Idoso , Intervenção Coronária Percutânea/métodos , Oclusão Coronária/diagnóstico , Oclusão Coronária/cirurgia , Estudos de Viabilidade , Estudos de Coortes , Artéria Radial/cirurgia , Artéria Femoral/cirurgia , Resultado do Tratamento , Angiografia Coronária , Sistema de Registros , Doença Crônica
3.
Med Intensiva ; 33(1): 50-3, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19232209

RESUMO

Interventricular septum rupture following blunt chest trauma is a rare cardiac injury that sometimes is difficult to diagnose. It has a high mortality rate, especially when in cases of hemodynamic instability requiring early surgical repair. We report the case of an 18-year old man who suffered blunt thoracoabdominal trauma and hemorrhagic shock who required emergency abdominal surgery on three occasions. He was diagnosed of traumatic rupture of interventricular septum that had not been detected in the initial echocardiography, but was suspected after the right heart catheterism. Urgent cardiac surgery was performed 72 hours later because of hemodynamic instability.


Assuntos
Traumatismos Cardíacos/etiologia , Septos Cardíacos/lesões , Ferimentos não Penetrantes/complicações , Traumatismos Abdominais , Acidentes de Trânsito , Adolescente , Cateterismo Cardíaco , Reações Falso-Negativas , Traumatismos Cardíacos/sangue , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/diagnóstico por imagem , Traumatismos Cardíacos/cirurgia , Septos Cardíacos/diagnóstico por imagem , Septos Cardíacos/cirurgia , Humanos , Hipóxia/etiologia , Masculino , Traumatismo Múltiplo , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Polietilenotereftalatos , Próteses e Implantes , Taquicardia Sinusal/etiologia , Traumatismos Torácicos , Ultrassonografia
4.
Med. intensiva (Madr., Ed. impr.) ; 33(1): 50-53, feb. 2009. ilus
Artigo em Es | IBECS | ID: ibc-71772

RESUMO

La rotura del septo interventricular por traumatismo cerrado de tórax es una rara lesión cardíaca cuyo diagnóstico puede ser pasado por alto y que muestra una elevada mortalidad en los casos con inestabilidad hemodinámica que requieren cirugía correctora precoz. Presentamos el caso de un joven de 18 años con traumatismo toracoabdominal cerrado y shock hemorrágico que precisó cirugía abdominal urgente en tres ocasiones. Fue diagnosticado de rotura traumática del septo interventricular no detectada en el ecocardiograma inicial, que se sospechó tras cateterismo cardíaco derecho y se intervino quirúrgicamente de urgencia a las 72 h de su ingreso


We report the case of an 18-year old man who suffered blunt thoracoabdominal trauma and hemorrhagic shock who required emergency abdominal surgery on three occasions. He was diagnosed of traumatic rupture of interventricular septum that had not been detected in the initial echocardiography, but was suspected after the right heart catheterism. Urgent cardiac surgery was performed 72 hours later because of hemodynamic instability


Assuntos
Humanos , Masculino , Adolescente , Traumatismos Torácicos/complicações , Fraturas Fechadas/complicações , Ruptura do Septo Ventricular/diagnóstico , Ruptura do Septo Ventricular/etiologia , Ruptura do Septo Ventricular/cirurgia
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