IAM por trombosis de aneurisma del seno de Valsalva / Thrombosis of a Valsalva sinus aneurysm causing AMI

No disponible

Drug-eluting vs. conventional balloon for side branch dilation in coronary bifurcations treated by provisional T stenting.

OBJECTIVE: The origin of the side branch (SB) is the most common site for restenosis in coronary bifurcations. The end-point is to compare the results of SB dilation with drug-eluting balloon (DEB group) versus conventional balloon (BAL group) in bifurcations treated with provisional T stenting. METHODS AND RESULTS: Each group included 50 patients. In DEB, the origin of SB was dilated with a Sequent(®) Please balloon. In both groups, a Taxus Liberté(®) stent was implanted in the main vessel, with kissing balloon postdilation. If the outcome for the SB was suboptimal, a Taxus stent was implanted in BAL and a bare stent in DEB group. An angiographic follow-up and IVUS were scheduled for 12 months later. Adverse events (MACE) were 24% in BAL versus 11% in DEB (P = 0.11), with greater revascularization (TLR) in the BAL group (22% vs. 12%, P = 0.16). At angiographic follow-up, there was a lower percentage of SB restenosis in the DEB group (20% vs. 7%, P = 0.08), with less late loss (0.40 mm vs. 0.09 mm, P = 0.01). CONCLUSION: Side branch dilation with a drug-eluting balloon resulted in better angiographic outcomes than with a conventional balloon, with less late loss and restenosis at the 12-month follow-up.

Comparison of zotarolimus- versus everolimus-eluting stents in the treatment of coronary bifurcation lesions.

OBJECTIVES: To compare zotarolimus-eluting stent (Endeavor Sprint®; ZES-S) and the everolimus-eluting stent (Xience V®; EES) in the treatment of coronary bifurcation lesions. BACKGROUND: Both these stents have demonstrated good outcomes in the treatment of coronary lesions. However, the outcomes with respect to treatment of bifurcation lesions have yet to be conclusively demonstrated. METHODS: In this single centered, nonrandomized, open label study, we treated, between August 2006 and December 2008, 110 bifurcations with ZES-S and, in a second stage of the study, 129 bifurcations with EES. The primary end point was to compare the rate of major adverse cardiac events (MACE) (death, myocardial infarction, and new target lesion revascularization) in-hospital and at 12 months of follow-up. Provisional T stenting was the strategy used in the majority of cases. Angiographic follow-up was performed only in patients who presented signs or symptoms suggestive of angina or ischemia. RESULTS: There were no significant differences in in-hospital MACE between the groups (ZES-S: 8.1%; EES: 6.2%; P = 0.5). At 12 months, the ZES-S group had significantly more MACE than the EES group (23.1% vs. 4.5%; P < 0.001) and an elevated index of new revascularization of the bifurcation (17.5% vs. 3.2%; P < 0.001). There were no significant differences in mortality (four patients in ZES-S vs. one in EES; P = 0.14). CONCLUSION: The treatment of coronary bifurcation lesions using everolimus-eluting stents results in better outcomes at 12 months of follow-up than zotarolimus-eluting stents.

[Percutaneous transcatheter closure of ventricular septal defects using an Amplatz device]. / Cierre percutáneo de comunicación interventricular congénita mediante el dispositivo de Amplatz.

We carried out an analysis of our initial experience with using an Amplatz device for percutaneous closure of ventricular septal defects in 15 patients. The patient's ages ranged in from 1 to 44 years. Seven were infants with heart failure. In 4 patients, the ventricular septal defect was located in the muscular portion of the ventricular septum; in 11 patients, it was in the perimembraneous portion. The mean size of the Amplatz device selected was 11.2 (3.0) mm. Successful device implantation was achieved in 12 patients. In the other 3, stable occlusion could not be achieved, and the device was retrieved without complications. Immediate complete closure occurred in 11 of the 12 patients who underwent successful implantation. No complications were observed, either immediately or during follow-up. After a mean follow-up period of 9.2 (3.6) months, all patients remained free of symptoms. Follow-up Doppler echocardiography demonstrated complete closure in all patients.

Cierre percutáneo de comunicación interventricular congénita mediante el dispositivo de Amplatz / Percutaneous transcatheter closure of ventricular septal defects using an amplatz device

El presente estudio analiza nuestra experiencia inicial en 15 pacientes con comunicación interventricular (CIV) en los que se intentó el cierre percutáneo mediante la implantación de un dispositivo de Amplatz. La edad media fue de 14 ± 14 años. Siete eran lactantes con síntomas de insuficiencia cardiaca. Cuatro pacientes presentaban un defecto muscular y 11 perimembranoso. El tamaño medio del dispositivo seleccionado fue de 11,2 ± 3,0 mm. Se consiguió la implantación correcta del dispositivo en 12 pacientes; en los 3 restantes no se pudo estabilizar el oclusor y fue retirado sin incidencias. Se produjo un cierre completo inicial de la CIV en 11 de los 12 pacientes con éxito en la implantación. No hubo complicaciones mayores inmediatas ni en el seguimiento. A los 9,2 ± 3,6 meses de seguimiento clínico todos los pacientes permanecieron libres de síntomas y no hubo incidencia de endocarditis o embolismo. El estudio eco-Doppler al seguimiento mostró cierre completo en todos los pacientes (AU)

We carried out an analysis of our initial experience with using an Amplatz device for percutaneous closure of ventricular septal defects in 15 patients. The patient's ages ranged in from 1 to 44 years. Seven were infants with heart failure. In 4 patients, the ventricular septal defect was located in the muscular portion of the ventricular septum; in 11 patients, it was in the perimembraneous portion. The mean size of the Amplatz device selected was 11.2 (3.0) mm. Successful device implantation was achieved in 12 patients. In the other 3, stable occlusion could not be achieved, and the device was retrieved without complications. Immediate complete closure occurred in 11 of the 12 patients who underwent successful implantation. No complications were observed, either immediately or during follow-up. After a mean follow-up period of 9.2 (3.6) months, all patients remained free of symptoms. Follow-up Doppler echocardiography demonstrated complete closure in all patients (AU)