[Sequential percutaneous surgical treatment in a woman with severe aortic stenosis and hypertrophic obstructive cardiomyopathy]. / Abordaje percutáneo secuencial en una paciente diagnosticada de estenosis aórtica severa y miocardiopatia hipertrófica obstructiva.

Quality of life is seriously compromised in both severe aortic stenosis and in hypertrophic obstructive cardiomyopathy. At advanced stages of disease, symptoms become incapacitating. Surgical correction is extremely effective, reducing symptoms and improving functional capacity. Percutaneous surgical techniques facilitate the treatment of patients in high-risk categories for whom conventional surgery is not an option. We report the case of a woman with severe symptomatic aortic stenosis and hypertrophic obstructive cardiomyopathy with associated mitral regurgitation. An aortic valve was implanted percutaneously. Later septal ablation was also performed percutaneously. The postoperative course was slow and the hospital stay was long. Percutaneous procedures provide a useful alternative way to treat severe symptomatic aortic stenosis and hypertrophic obstructive cardiomyopathy with mitral regurgitation, particularly when patients are at high risk for conventional surgery. These procedures are not without risk, however.

Abordaje percutáneo secuencial en una paciente diagnosticada de estenosis aórtica severa y miocardiopatía hipertrófica obstructiva / Sequential percutaneous surgical treatment in a woman with severe aortic stenosis and hypertrophic obstructive cardiomyopathy

Tanto la estenosis aórtica severa como la miocardiopatía hipertrófica obstructiva son enfermedades que condicionan de manera importante la calidad de vida del paciente y sus síntomas son incapacitantes en sus fases más avanzadas. Su corrección anatómica mediante cirugía es extraordinariamente eficaz, reduciendo las manifestaciones clínicas y mejorando la capacidad funcional del enfermo. El desarrollo de las técnicas percutáneas permite tratar a los enfermos con índices de riesgo elevados, que son rechazados para cirugía convencional. Presentamos el caso de una paciente con estenosis aórtica severa sintomática y miocardiopatía hipertrófica obstructiva con insuficiencia mitral asociada, tratada mediante implante valvular aórtico percutáneo y, posteriormente, con ablación septal percutánea. El postoperatorio fue tórpido y la estancia hospitalaria larga. El intervencionismo percutáneo en la estenosis aórtica severa sintomática asociada con miocardiopatía e insuficiencia mitral, es una alternativa útil de tratamiento, especialmente en pacientes de alto riesgo para cirugía convencional, si bien no exenta de complicaciones(AU)

Quality of life is seriously compromised in both severe aortic stenosis and in hypertrophic obstructive cardiomyopathy. At advanced stages of disease, symptoms become incapacitating. Surgical correction is extremely effective, reducing symptoms and improving functional capacity. Percutaneous surgical techniques facilitate the treatment of patients in high-risk categories for whom conventional surgery is not an option. We report the case of a woman with severe symptomatic aortic stenosis and hypertrophic obstructive cardiomyopathy with associated mitral regurgitation. An aortic valve was implanted percutaneously. Later septal ablation was also performed percutaneously. The postoperative course was slow and the hospital stay was long. Percutaneous procedures provide a useful alternative way to treat severe symptomatic aortic stenosis and hypertrophic obstructive cardiomyopathy with mitral regurgitation, particularly when patients are at high risk for conventional surgery. These procedures are not without risk, however(AU)

Electroacupuntura en un caso de neuralgia postherpética con afectación de la rama oftálmica del V par craneal / Electroacupuncture in a case of postherpetic neuralgia with involvement of the ophthalmic branch of the trigeminal nerve

Neuralgia postherpética: cuadro de dolor neuropático crónico que aparece como complicación de una infección por el virus de la varicela zóster. La clínica se caracteriza por un dolor intenso y episódico. El tratamiento de elección es farmacológico, pero en un porcentaje de pacientes no se consigue una adecuada respuesta terapéutica, bien por intolerancia a los fármacos bien por inadecuado control del dolor. Se presenta el caso clínico de una paciente con una neuralgia postherpética que afecta a la rama oftálmica izquierda del V par craneal, en la cual no conseguimos un adecuado manejo del cuadro doloroso tras probar diferentes pautas farmacológicas. Ante esta situación, se inició sesiones de electroacupuntura combinadas con fármacos. Se obtuvo una mejoría progresiva de las crisis dolorosas en intensidad y frecuencia, lo que permitió la supresión del tratamiento farmacológico. Alternativa terapéutica a pacientes que no toleran los tratamientos farmacológicos para su dolor neuropático o cuando éstos son ineficaces (AU)

Postherpetic neuralgia consists of chronic neuropathic pain that appears as a complication of varicella-zoster virus infection and is characterized by intense and episodic pain. The treatment of choice is pharmacological but adequate therapeutic response is not always achieved, either due to drug intolerance or to inadequate pain control. Were port the case of a woman with postherpetic neuralgia affecting the left ophthalmic branch of the trigeminal nerve, in whom distinct drug treatments failed to achieve adequate pain control. Given this situation, electro-acupuncture sessions were started, combined with pharmacological therapy. The frequency and intensity of the pain exacerbations progressively diminished, allowing drug treatment to be discontinued. Electroacupuncture can constitute a therapeutic alternative in patients with drug intolerance or inadequate control of neuropathic pain with pharmacological treatment (AU)