Percutaneous treatment of an early complication after endocarditis surgery with Cabrol type repair.

We present a 70-year-old man with rheumatic mitral valve disease who had undergone 3 previous open-heart surgeries, the last of which was a new mitral valve replacement for a mechanical prosthesis due to early bioprosthetic endocarditis.

Experiencia unicéntrica en el tratamiento percutáneo con stent de la coartación de aorta en niños y adolescentes / Unicentric experience in percutaneous stent treatment of aortic coarctation in children and teenagers

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Experiencia en angioplastia percutánea de recoartación de aorta en un solo centro. Resultados a corto, medio y largo plazo / Experience in percutaneous angioplasty of aortic recoartation in a single centre. Short, medium and long-term outcomes

Resumen Introducción: La angioplastia con balón es una técnica que ofrece buenos resultados, especialmente en los casos de recoartación tras cirugía correctora. Objetivo: Analizar los resultados de un centro hospitalario a partir de la introducción de la técnica. Método: Se analizaron 73 pacientes con una edad media de 3.3 años; el 74% eran menores de 1 año y el 72.6% estaban por debajo de 10 kg de peso. Todos los pacientes incluidos fueron casos de recoartación tras cirugía correctora. Resultados: Se observó un resultado efectivo en el 93.1% de los casos, con gradiente residual < 20 mmHg. Durante el seguimiento, el 20.5% precisaron reintervención, la cual fue más frecuente en caso de angioplastia sobre el arco, lesiones asociadas y menores de 1 año. Solo se objetivó una complicación grave relacionada con el procedimiento, que correspondió a una rotura aórtica que no pudo ser solventada con implante de stent cubierto. Conclusiones: La angioplastia percutánea de recoartación de aorta es una técnica segura y efectiva, en especial en los casos de recoartación tras cirugía correctora de lesiones circunscritas al istmo.

Abstract Introduction: Balloon angioplasty is a technique with good outcomes, specially in cases aortic recoartation after correcting surgery. Objective: To analyze our centre results since the introduction of the technique. Method: We analyzed 73 patients with medium age of 3,3 years; 74% were under 1 years old and 72,6% under 10 kg weight. All patients included were cases of recoartation after surgery. Results: Effective results was achieved in 93,1%, obtaining residual gradient less than 20 mmHg. During the following up 20,5% of patients required reintervention, being more frequent in case of aortic arch hypoplasia, associated lesions or patients under 1 year. Only a severe complication was referred, a case of aortic rupture that couldn’t be solved with a covered stent. Conclusions: Percutaneous angioplasty of aortic recoartation is a safe and effective technique, specially in discrete istmic lesions after correcting surgery.

Percutaneous treatment of a splenorenal shunt with an atrial septal closure device.

We present the case of a 70-year-old female who underwent liver transplantation in 2011 due to enolic cirrhosis with a normofunction graft and no portal hypertension. During the last months, recurrent hospitalization was needed due to hepatic encephalopathy, in spite of treatment with lactulose and rifaximin. An abdominal computed tomography (CT) showed a large varicose dilatation of the splenic vein up to 14-16 mm, descending by the left abdominal side, communicating with the renal vein with direct drainage into inferior cava vein (ICV).

Long-term follow-up after recanalisation of aortic arch atresia.

AIMS: Aortic arch atresia (AAA) is one of the rarest obstructive defects. The presence of this anomaly in adult age is uncommon. The typical anatomic feature consists of a complete occlusion of the membranous obstruction resulting in an acquired atresia without flow continuity between the proximal and distal segments. This feature is important in determining the feasibility of percutaneous intervention. The aim of the present study was to share long-term follow-up data of adult patients with AAA requiring percutaneous interventions for the management of this rare anomaly involving five different centres. METHODS AND RESULTS: Retrospective data of 19 patients (12 males, 63.2%, mean age 32.2±18.9 years) diagnosed with AAA treated in five different centres between 1999 and 2017 were collected. All patients underwent percutaneous recanalisation by (1) radiofrequency (RF) system (five patients, 26.3%), (2) extra-stiff guidewire (12 patients, 63.2%), and (3) transseptal needle (two patients, 10.5%). All procedures were subsequently followed by covered stent implantation. Two patients developed complications during the procedure and one of them died. Over a median follow-up of 4.94 years, four (21%) patients were able to be weaned from medications for hypertension. All the patients underwent reassessment for recurrence or restenosis during the follow-up. Seven (36.8%) patients underwent successful stent dilatation with a balloon. After the intervention, one patient experienced a late complication; however, one patient died due to an unknown cause believed to be unrelated to the previous recanalisation procedure. CONCLUSIONS: Percutaneous treatment of AAA is feasible with good long-term survival. This study reports the largest case series so far available in the literature.

Tratamiento percutáneo en un solo procedimiento de coartación y estenosis aórtica / One-step percutaneous procedure to treat an aortic coarctation and aortic stenosis

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Experiencia en la intervención coronaria percutánea en población pediátrica y adolescente en un centro de referencia de cardiopatías congénitas / Experience of percutaneous coronary intervention in the pediatric and adolescent population in a referral center for congenital heart disease

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Perforación esofágica tardía por dispositivo Amplatzer en síndrome de la cimitarra / Late esophageal perforation due to an Amplatzer device in scimitar syndrome

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