ABSTRACT
The treatment of refractory terminal heart failure has been heart transplantation. However, there are limitations with regard to clinical conditions of the recipient and availability of donors, and ventricular support has therefore been alternatively used as destination therapy. We describe the case is of a female patient with ischemic cardiomyopathy-associated heart failure who had a left ventricular assist device successfully implanted and at eight months of the procedure was at functional class I, with no complications.
El tratamiento de la falla cardiaca terminal avanzada ha sido el trasplante de corazón, sin embargo, hay limitantes en cuanto a las características del receptor y disponibilidad de donadores, por lo que se ha utilizado alternativamente el soporte ventricular como tratamiento de destino. Se describe a una paciente con falla cardiaca terminal por cardiomiopatía isquémica en quien se implantó exitosamente un sistema de soporte ventricular izquierdo y a ocho meses del procedimiento se encontraba en clase funcional I, sin complicaciones.
Subject(s)
Heart Failure/surgery , Heart-Assist Devices , Myocardial Ischemia/surgery , Aged , Female , Follow-Up Studies , Humans , Myocardial Ischemia/complications , Prosthesis Implantation/methodsABSTRACT
Resumen El tratamiento de la falla cardiaca terminal avanzada ha sido el trasplante de corazón, sin embargo, hay limitantes en cuanto a las características del receptor y disponibilidad de donadores, por lo que se ha utilizado alternativamente el soporte ventricular como tratamiento de destino. Se describe a una paciente con falla cardiaca terminal por cardiomiopatía isquémica en quien se implantó exitosamente un sistema de soporte ventricular izquierdo y a ocho meses del procedimiento se encontraba en clase funcional I, sin complicaciones.
Abstract The treatment of refractory terminal heart failure has been heart transplantation. However, there are limitations with regard to clinical conditions of the recipient and availability of donors, and ventricular support has therefore been alternatively used as destination therapy. We describe the case is of a female patient with ischemic cardiomyopathy-associated heart failure who had a left ventricular assist device successfully implanted and at eight months of the procedure was at functional class I, with no complications.
Subject(s)
Humans , Female , Aged , Heart-Assist Devices , Myocardial Ischemia/surgery , Heart Failure/surgery , Follow-Up Studies , Myocardial Ischemia/complications , Prosthesis Implantation/methodsABSTRACT
BACKGROUND: Myocardial noncompaction of the left ventricle is a congenital cardiomyopathy characterised by left ventricular hypertrabeculation and prominent intertrabecular recesses. The incidence ranges from 0.15% to 2.2%. Clinical manifestations include heart failure, arrhythmias, and stroke. Prognosis is fatal in most cases. Heart transplantation is a therapeutic option for this cardiomyopathy, and few had been made worldwide. CLINICAL CASE: The case is presented of a 20 year-old male with noncompacted myocardium of the left ventricle, who had clinical signs of heart failure. His functional class was IV on the New York Heart Association scale. He was successfully transplanted. Its survival to 15 months is optimal in class I New York Heart Association, and endomyocardial biopsies have been reported without evidence of acute rejection. CONCLUSION: It is concluded that heart transplantation modified the natural history and improved survival in patients with this congenital heart disease.
Subject(s)
Heart Transplantation , Isolated Noncompaction of the Ventricular Myocardium/surgery , Cardiovascular Agents/therapeutic use , Combined Modality Therapy , Echocardiography , Humans , Isolated Noncompaction of the Ventricular Myocardium/diagnostic imaging , Isolated Noncompaction of the Ventricular Myocardium/drug therapy , Isolated Noncompaction of the Ventricular Myocardium/epidemiology , Male , Mexico/epidemiology , Young AdultABSTRACT
BACKGROUND: Aortic stenosis is a frequent disease in the elderly, and is associated with other systemic pathologies that may contraindicate the surgical procedure. Another option for these patients is percutaneous aortic valve implantation, which is less invasive. We present our initial experience with this procedure. MATERIAL AND METHODS: Patients with aortic stenosis were included once selection criteria were accomplished. Under general anaesthesia and echocardiographic and fluosocopic control, a transcatheter aortic valve was implanted following s valvuloplasty. Once concluded the procedure, angiographic and pressure control was realized in order to confirm the valve function. RESULTS: Between November 2014 and May 2015, 6 patients were treated (4 males and 2 females), with a mean age of 78.83±5.66 years-old. The preoperative transvalvular gradient was 90.16±28.53mmHg and posterior to valve implant was 3.33±2.92mmHg (P<.05). Two patients had concomitant coronary artery disease which had been treated previously. One patient presented with acute right coronary artery occlusion which was immediately treated. However due to previous renal failure, postoperative sepsis and respiratory failure, the patient died one month later. CONCLUSION: It was concluded that our preliminary results showed that in selected patients percutaneous aortic valve implantation is a safe procedure with clinical improvement for treated patients.
Subject(s)
Aortic Valve Stenosis/surgery , Transcatheter Aortic Valve Replacement , Aged , Aged, 80 and over , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/physiopathology , Female , Humans , Male , Patient Selection , Radiology, Interventional , Retrospective Studies , Transcatheter Aortic Valve Replacement/statistics & numerical data , Treatment OutcomeABSTRACT
Se describe la utilización de transfusión autóloga por depósito previo (TADP) en 75 pacientes con comuniación interauricular o interventricular que requirieron cirugía entre julio de 1992 y septiembre de 1996 en el Centro Médico La Raza. La mayoría correspondió al sexo femenino (93.3 por ciento), la edad promedio fue de 29 años y 64 por ciento perteneció al grupo sanguíneo O factor Rh positivo; 8 por ciento no requirió unidad de TADP, 2.6 por ciento requirió una 2.6 necesitó dos y 86.8 por ciento requirió tres. En 10.6 por ciento se utilizó sangre homóloga adicional. No existieron complicaciones atribuibles a la TADP. El objetivo de evitar la utilización de sangre homóloga se alcanzó en 89.4 por ciento de los casos
