Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 2 de 2
Filtrar
Más filtros












Base de datos
Intervalo de año de publicación
1.
Interact Cardiovasc Thorac Surg ; 20(4): 499-503, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25564579

RESUMEN

OBJECTIVES: Valuable treatment modalities for branch pulmonary artery (BPA) stenoses are surgical patch angioplasty, percutaneous BPA stenting and hybrid stent placement. The purpose of this study was to report our institutional experience with hybrid stent placement to relieve BPA stenoses. METHODS: Between August 2007 and May 2014, 7 adults (5 females) with congenital heart disease (CHD) had elective intraoperative BPA stent placement. All 7 patients had undergone previous surgery [6 tetralogy of Fallot repairs and 1 arterial switch operation for transposition of the great arteries (TGAs)]. A total of 7 stents (4 right pulmonary artery, 3 left pulmonary artery) were implanted under direct vision, concomitant with a pulmonary homograft implantation (tetralogy of Fallot patients), or because percutaneous stenting was not feasible (TGA patient). Retrospective analysis of clinical data, procedural details and outcomes was performed. RESULTS: Overall, the mean age was 35 ± 7.2 years. Stent implantation was successful in all procedures. The mean postinflation stent diameter was 13.3 ± 2.0 mm. No stent migration, fracture, stent thrombosis, reintervention or deaths occurred. In 1 case the procedure was complicated by a right pulmonary artery tear just distal to the stent which was repaired by surgical patch angioplasty. At a mean follow-up of 55.6 ± 26 months no patient required catheter reintervention or surgery. Echocardiography (mean follow-up 47.1 ± 22 months), MRI (mean follow-up 43.8 ± 37 months) and CT data (mean follow-up 14.8 ± 10 months) demonstrate a BPA diameter increment from a mean 5.57 ± 2.29 to 10.71 ± 2.56 mm. CONCLUSIONS: Hybrid intraoperative BPA stent placement is safe and effective and can be used as an alternative for surgical patch angioplasty or if percutaneous BPA stenting is not feasible. Short- to mid-term results are good.


Asunto(s)
Angioplastia de Balón/instrumentación , Arteriopatías Oclusivas/terapia , Implantación de Prótesis Vascular , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Cardiopatías Congénitas/cirugía , Arteria Pulmonar/cirugía , Stents , Adulto , Angioplastia de Balón/efectos adversos , Arteriopatías Oclusivas/diagnóstico , Arteriopatías Oclusivas/etiología , Arteriopatías Oclusivas/fisiopatología , Implantación de Prótesis Vascular/efectos adversos , Constricción Patológica , Ecocardiografía Transesofágica , Femenino , Cardiopatías Congénitas/diagnóstico , Cardiopatías Congénitas/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/fisiopatología , Reoperación , Estudios Retrospectivos , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Adulto Joven
2.
Radiother Oncol ; 114(1): 91-5, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25630429

RESUMEN

BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation (nCRT) followed by surgery is considered curative intent treatment for patients with resectable esophageal cancer. The aim was to establish hemodynamic aspects of changes in heart volume and to explore whether changes in heart volume resulted in clinically relevant changes in the dose distribution of radiotherapy. METHODS: A prospective study was conducted in patients who were treated with nCRT consisting of carboplatin and paclitaxel concomitant with radiotherapy (41.4 Gy/1.8 Gy per fraction). Physical parameters, cardiac volume on CT and Cone beam CT, cardiac blood markers and cardiac ultrasound were obtained. RESULTS: In 23 patients a significant decrease of 55.3 ml in heart volume was detected (95% CI 36.7-73.8 ml, p<0.001). There was a decrease in both systolic (mean decrease 18 mmHg, 95% CI 11-26 mmHg, p<0.001) and diastolic blood pressure (mean decrease 8 mmHg, 95% CI 2-14 mmHg, p=0.008) and an increase in heart rate with 6 beats/min (95% CI 1-11 beats/min, p=0.021). Except for Troponin T, no change in other cardiac markers and echocardiography parameters were observed. The change in heart volume did not result in a clinically relevant change in radiation dose distribution. CONCLUSION: Heart volume was significantly reduced, but was not accompanied by overt cardiac dysfunction. All observed changes in hemodynamic parameters are consistent with volume depletion. Adaptation of the treatment plan during the course of radiotherapy is not advocated.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Volumen Cardíaco/efectos de la radiación , Quimioradioterapia Adyuvante/métodos , Neoplasias Esofágicas/terapia , Anciano , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/efectos de la radiación , Carboplatino/administración & dosificación , Volumen Cardíaco/efectos de los fármacos , Neoplasias Esofágicas/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante , Paclitaxel/administración & dosificación , Estudios Prospectivos , Dosis de Radiación , Dosificación Radioterapéutica
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...