Assuntos
Estenose da Valva Aórtica/diagnóstico por imagem , Valva Aórtica/diagnóstico por imagem , Ecocardiografia sob Estresse , Teste de Esforço , Idoso , Idoso de 80 Anos ou mais , Valva Aórtica/fisiopatologia , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/fisiopatologia , Estenose da Valva Aórtica/cirurgia , Doenças Assintomáticas , Tomada de Decisão Clínica , Feminino , Implante de Prótese de Valva Cardíaca , Humanos , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores de TempoRESUMO
The aims of this study were to determine the incidence of coronary artery perforation by intracoronary guide wires during angioplasty, to identify associated factors, and to assess outcomes. The retrospective analysis covered 4,353 consecutive procedures, corresponding to a total 6,994 lesions treated over a period of 8 years. Coronary artery perforation by guide wires occurred in 15 cases (0.35%). Perforation was associated with the number of hydrophilic wires used (odds ratio=2.33; 95% confidence interval, 1.34-4.05) and treatment of chronic occlusions (odds ratio=3.31; 95% confidence interval, 1.05-10.46). Cardiac tamponade occurred in seven cases (46.7%), six of which were subacute. Three cases were resolved by pericardiocentesis, while four required surgical drainage. Cardiac tamponade was associated with the number of guide wires used (P=.039) and the use of abciximab (P=.016). No death occurred.
Assuntos
Angioplastia Coronária com Balão/instrumentação , Vasos Coronários/lesões , Idoso , Angioplastia Coronária com Balão/efeitos adversos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de RiscoRESUMO
En el presente estudio se valora la incidencia, los parámetros relacionados y la evolución de la perforación coronaria por guía intracoronaria durante la realización de angioplastia. Se analizaron retrospectivamente 4.353 procedimientos consecutivos, correspondientes a 6.994 lesiones tratadas en 8 años. Se detectó perforación coronaria por guía en 15 casos (0,35%). Ésta se relacionó con el número de guías hidrófilas usadas (odds ratio [OR] = 2,33; intervalo de confianza [IC] del 95%, 1,34-4,05) y el tratamiento de oclusiones crónicas (OR = 3,31; IC del 95%, 1,05-10,46). En 7 casos (46,7%) hubo taponamiento cardiaco, 6 de manera subaguda; 3 se solucionaron con pericardiocentesis y 4 requirieron drenaje quirúrgico. El taponamiento se relacionó con el número de guías utilizadas (p = 0,039) y el uso de abciximab (p = 0,016). No se produjeron muertes (AU)
The aims of this study were to determine the incidence of coronary artery perforation by intracoronary guide wires during angioplasty, to identify associated factors, and to assess outcomes. The retrospective analysis covered 4,353 consecutive procedures, corresponding to a total 6,994 lesions treated over a period of 8 years. Coronary artery perforation by guide wires occurred in 15 cases (0.35%). Perforation was associated with the number of hydrophilic wires used (odds ratio=2.33; 95% confidence interval, 1.34-4.05) and treatment of chronic occlusions (odds ratio=3.31; 95% confidence interval, 1.05-10.46). Cardiac tamponade occurred in seven cases (46.7%), six of which were subacute. Three cases were resolved by pericardiocentesis, while four required surgical drainage. Cardiac tamponade was associated with the number of guide wires used (P=.039) and the use of abciximab (P=.016). No death occurred (AU)
