[Guidelines of the Spanish Society of Cardiology on requirements and equipment in hemodynamic and interventional cardiology]. / Guías de práctica clínica de la Sociedad Española de Cardiología sobre requerimientos y equipamiento en hemodinámica y cardiología intervencionista.

In the last 20 years the work performed in catheterization laboratories has changed greatly, and while also taking the diagnostic aspects also into account, interventional cardiology has acquired an important role. Work in the catheterisation laboratory has evolved from only diagnostic studies of cardiac anatomy and function, and evaluation of potential surgical candidates, to interventional procedures mainly based on catheters techniques. As new diagnostic and interventional procedures are now available, human and technical requirements of the catheterization laboratory have changed. The aim of this report is to make an update of the requirements needed to perform diagnostic and interventional procedures in the cardiac catheterization laboratory.

Aneurisma de arteria coronaria e infarto agudo de miocardio secundario a traumatismo torácico / Coronary artery aneurysm and acute myocardial infarction after chest trauma

El aneurisma coronario secundario a traumatismo torácico no penetrante es extremadamente raro. Describimos el caso de un varón de 29 años que sufrió un infarto agudo de miocardio (IAM) traumático asintomático tras accidente de tráfico. El electrocardiograma (ECG) mostró un IAM antero-lateral transmural y la coronariografía demostró la existencia de un aneurisma sacular postraumático de la arteria coronaria descendente anterior. En los pacientes con traumatismo torácico y cambios ECG y enzimáticos sugestivos de IAM puede estar indicado realizar una angiografía coronaria para descartar un aneurisma coronario. (AU)

[The performance of coronary angioplasties at centers without cardiac surgery. The recommendations of the Sociedad Española de Cardiología]. / Realización de angioplastias coronarias en centros sin cirugía cardíaca. Recomendaciones de la Sociedad Española de Cardiología.

During the early years of coronary interventions a rigorous on-site surgical stand-by was mandatory. The increased experience in coronary angioplasty both on total number of procedures and the experience gained by each operator, together with the technical improvements, namely since the introduction of stents has induced an evolution in the stand-by strategy, with new concepts such as "next available operating room" or coronary interventions "without on site" surgical facilities, are gaining widespread acceptance. With the aim of defining the requirements to perform coronary interventions at hospitals without coronary surgery, the following aspects are reviewed: a) complications following coronary angioplasty that require coronary surgery; b) the current status of coronary angioplasty without surgical stand-by in different countries. All this information allows us to advance some recommendations concerning the performance of coronary interventions at hospitals without on-site cardiac surgery. Different issues including hospital characteristics, operator and cardiac catheterization laboratory requirements, as well as lesion characteristics and the type of informed consent, should be taken into account.

[Endomyocardial biopsy in heart transplantation]. / La biopsia endomiocárdica en el trasplante cardíaco.

From October 1984 to June 1991, 1,549 endomyocardial biopsies (EMB) were performed on 122 patients submitted to a Cardiac Transplant procedure (CT) at the Hospital Puerta de Hierro in Madrid. All biopsies were performed with the long sheath technique and the King bioptome. A total of 8,707 specimens were obtained, of which 7,311 (83.97%) were considered adequate for pathological examination. We did not find significant differences between the internal jugular (83.21%) and the femoral vein (84.82%) approaches. About 20% of the samples were not adequate for pathological evaluation after the fifth procedure performed on the same patient. There has been no deaths in our group. One patient (0.06%) had right ventricular perforation with tamponade that required surgical treatment. Two patients (2.98%) presented coronary fistulae related to EMB. The percent of other minor complications was less than 0.5%. EMB is mandatory for the control of rejection in the first year after cardiac transplantation, and has shown to be a reliable and safe method in experienced hands.