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Cruz-González I, Antúnez-Muiños P, López-Tejero S, Arnold L, Oldroyd KG. Patient-Specific Commissural Alignment With a Self-Expanding Transcatheter Heart Valve. JACC Case Rep 2024; 29:102190. [PMID: 38379652 PMCID: PMC10874896 DOI: 10.1016/j.jaccas.2023.102190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 02/22/2024]
Abstract
A simple and reproducible technique to achieve commissural alignment during transcatheter aortic valve replacement with the Allegra valve is described. Slight rotation of the system before system insertion is necessary. Moreover, thanks to its permaflow system (Biosensors) and its radiopaque markings, small adjustments before valve deployment can be made to reassess correct alignment.
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Affiliation(s)
- Ignacio Cruz-González
- Cardiology Department, Hospital Universitario de Salamanca, Salamanca, Spain
- Biomedical Research Institute of Salamanca, Salamanca, Spain
- Centro de Investigación Biomédica En Red. Enfermedades Cardiovasculares (CIBER-CV), Salamanca, Spain
| | - Pablo Antúnez-Muiños
- Cardiology Department, Hospital Universitario de Salamanca, Salamanca, Spain
- Biomedical Research Institute of Salamanca, Salamanca, Spain
- Centro de Investigación Biomédica En Red. Enfermedades Cardiovasculares (CIBER-CV), Salamanca, Spain
| | - Sergio López-Tejero
- Cardiology Department, Hospital Universitario de Salamanca, Salamanca, Spain
- Biomedical Research Institute of Salamanca, Salamanca, Spain
- Centro de Investigación Biomédica En Red. Enfermedades Cardiovasculares (CIBER-CV), Salamanca, Spain
| | - Lars Arnold
- Biosensors International, Singapore, Singapore
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Armario X, Carron J, Simpkin AJ, Elhadi M, Kennedy C, Abdel-Wahab M, Bleiziffer S, Lefèvre T, Wolf A, Pilgrim T, Villablanca PA, Blackman DJ, Van Mieghem NM, Hengstenberg C, Swaans MJ, Prendergast BD, Patterson T, Barbanti M, Webb JG, Behan M, Resar J, Chen M, Hildick-Smith D, Spence MS, Zweiker D, Bagur R, Teles R, Ribichini FL, Jagielak D, Park DW, Kornowski R, Wykrzykowska JJ, Bunc M, Estévez-Loureiro R, Poon K, Götberg M, Jeger RV, Ince H, Packer EJS, Angelillis M, Nombela-Franco L, Guo Y, Savontaus M, Al-Moghairi AM, Parasca CA, Kliger C, Roy D, Molnár L, Silva M, White J, Yamamoto M, Carrilho-Ferreira P, Toggweiler S, Voudris V, Ohno Y, Rodrigues I, Parma R, Ojeda S, Toutouzas K, Regueiro A, Grygier M, AlMerri K, Cruz-González I, Fridrich V, de la Torre Hernández JM, Noble S, Kala P, Asmarats L, Kurt IH, Bosmans J, Erglis M, Casserly I, Iskandarani D, Bhindi R, Kefer J, Yin WH, Rosseel L, Kim HS, O'Connor S, Hellig F, Sztejfman M, Mendiz O, Pineda AM, Seth A, Pllaha E, de Brito FS, Bajoras V, Balghith MA, Lee M, Eid-Lidt G, Vandeloo B, Vaz VD, Alasnag M, Ussia GP, Tay E, Mayol J, Gunasekaran S, Sardella G, Buddhari W, Kao HL, Dager A, Tzikas A, Gudmundsdottir IJ, Edris A, Gutiérrez Jaikel LA, Arias EA, Al-Hijji M, Ertürk M, Conde-Vela C, Boljević D, Ferrero Guadagnoli A, Hermlin T, ElGuindy AM, Lima-Filho MDO, de Moura Santos L, Perez L, Maluenda G, Akyüz AR, Alhaddad IA, Amin H, So CY, Al Nooryani AA, Vaca C, Albistur J, Nguyen QN, Arzamendi D, Grube E, Modine T, Tchétché D, Hayashida K, Latib A, Makkar RR, Piazza N, Søndergaard L, McEvoy JW, Mylotte D. Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study. JACC Cardiovasc Interv 2024; 17:374-387. [PMID: 38180419 DOI: 10.1016/j.jcin.2023.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays. OBJECTIVES This study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity. METHODS This international registry reported monthly TAVR case volume in participating institutions prior to and during the COVID-19 pandemic (January 2018 to December 2021). Hospital-level information on public vs private, urban vs rural, and TAVR volume was collected, as was country-level information on socioeconomic status, COVID-19 incidence, and governmental public health responses. RESULTS We included 130 centers from 61 countries, including 65,980 TAVR procedures. The first and second pandemic waves were associated with a significant reduction of 15% (P < 0.001) and 7% (P < 0.001) in monthly TAVR case volume, respectively, compared with the prepandemic period. The third pandemic wave was not associated with reduced TAVR activity. A greater reduction in TAVR activity was observed in Africa (-52%; P = 0.001), Central-South America (-33%; P < 0.001), and Asia (-29%; P < 0.001). Private hospitals (P = 0.005), urban areas (P = 0.011), low-volume centers (P = 0.002), countries with lower development (P < 0.001) and economic status (P < 0.001), higher COVID-19 incidence (P < 0.001), and more stringent public health restrictions (P < 0.001) experienced a greater reduction in TAVR activity. CONCLUSIONS TAVR procedural volume declined substantially during the first and second waves of the COVID-19 pandemic, especially in Africa, Central-South America, and Asia. National socioeconomic status, COVID-19 incidence, and public health responses were associated with treatment delays. This information should inform public health policy in case of future global health crises.
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Affiliation(s)
- Xavier Armario
- Department of Cardiology, Galway University Hospital, Galway, Ireland; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jennifer Carron
- Department of Cardiology, Galway University Hospital, Galway, Ireland
| | - Andrew J Simpkin
- School of Mathematical and Statistical Sciences, University of Galway, Galway, Ireland
| | - Mohamed Elhadi
- Department of Cardiology, Galway University Hospital, Galway, Ireland
| | - Ciara Kennedy
- Department of Cardiology, Galway University Hospital, Galway, Ireland
| | | | - Sabine Bleiziffer
- Heart and Diabetes Center Northrhine-Westfalia, Clinic for Thoracic and Cardiovascular Surgery, Bad Oeynhausen, Germany
| | | | | | | | | | | | | | | | | | | | | | | | - John G Webb
- St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Miles Behan
- Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Jon Resar
- John Hopkins Hospital, Baltimore, Maryland, USA
| | - Mao Chen
- West China Hospital, Sichuan University, Chengdu, China
| | | | | | | | - Rodrigo Bagur
- University Hospital, London Health Sciences Center, London, Ontario, Canada
| | - Rui Teles
- Hospital de Santa Cruz, CHLO, Nova Medical School, CEDOC, Lisbon, Portugal
| | | | | | | | | | | | - Matjaz Bunc
- Ljubljana University Medical Center, Ljubljana, Slovenia
| | | | - Karl Poon
- The Prince Charles Hospital, Brisbane, Australia
| | - Matthias Götberg
- Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden
| | | | | | | | | | | | - Yingqiang Guo
- West China Hospital, Sichuan University, Chengdu, China
| | | | | | | | - Chad Kliger
- Lenox Hill/Northwell Health, New York, New York, USA
| | - David Roy
- St. Vincent's Hospital, Sydney, Australia
| | - Levente Molnár
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Mariana Silva
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | | | - Masanori Yamamoto
- Toyohashi Heart Center, Toyohashi, Japan; Nagoya Heart Center, Nagoya, Japan; Gifu Heart Center, Gifu, Japan
| | | | | | | | - Yohei Ohno
- Tokai University School of Medicine, Isehara, Japan
| | | | | | - Soledad Ojeda
- Hospital Universitario Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain
| | | | | | - Marek Grygier
- Poznan University School of Medical Sciences, Poznan, Poland
| | | | | | - Viliam Fridrich
- National Institute of Cardiovascular Diseases, Bratislava, Slovakia
| | | | | | - Petr Kala
- Centrum Kardiovaskulární a Transplantační Chirurgie, Brno, Czechia
| | | | | | | | | | - Ivan Casserly
- Mater Misericordiae University Hospital, Dublin, Ireland; Mater Private Hospital, Dublin, Ireland
| | | | | | - Joelle Kefer
- Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | | | - Hyo-Soo Kim
- Seoul National University Hospital, Seoul, South Korea
| | | | | | | | | | - Andres M Pineda
- University of Florida College of Medicine Jacksonville, Jacksonville, Florida, USA
| | - Ashok Seth
- Fortis Escorts Heart Institute, New Delhi, India
| | | | | | - Vilhelmas Bajoras
- Division of Cardiology and Vascular Diseases, Vilnius University Hospital Santaros Clinics, Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | - Michael Lee
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - Guering Eid-Lidt
- Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Bert Vandeloo
- Department of Cardiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Belgium
| | | | | | - Gian Paolo Ussia
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Edgar Tay
- National University Heart Center, Singapore, Singapore
| | | | | | | | | | - Hsien-Li Kao
- National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | | - Ahmad Edris
- Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | | | | | - Mehmet Ertürk
- Istanbul Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | | | | | | | | | | | - Moysés de Oliveira Lima-Filho
- Hospital das Clínicas de Ribeirão Preto, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | - Luis Perez
- Hospital Clínico Regional Guillermo Grant Benavente, Concepción, Chile
| | - Gabriel Maluenda
- Hospital San Borja Arriaran, Santiago, Chile; Clínica Alemana, Santiago, Chile
| | - Ali Rıza Akyüz
- Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Health Sciences University, Trabzon, Turkey
| | | | - Haitham Amin
- Mohammed Bin Khalifa Cardiac Center, Royal Medical Services, Awali, Bahrain
| | - Chak-Yu So
- Prince of Wales Hospital, Hong Kong, Hong Kong
| | | | - Carlos Vaca
- Instituto de Cardiología Intervencionista Cardiovida SRL, Santa Cruz, Bolivia
| | - Juan Albistur
- Hospital de Clínicas Dr Manuel Quintela, Montevideo, Uruguay
| | | | | | | | | | | | | | - Azeem Latib
- Montefiore Medical Center, Bronx, New York, USA
| | - Raj R Makkar
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nicolo Piazza
- McGill University Health Center, Montréal, Quebec, Canada
| | | | - John William McEvoy
- Department of Cardiology, Galway University Hospital, Galway, Ireland; School of Medicine, University of Galway, Galway, Ireland
| | - Darren Mylotte
- Department of Cardiology, Galway University Hospital, Galway, Ireland; School of Medicine, University of Galway, Galway, Ireland.
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López-Tejero S, Antúnez-Muiños P, Fraile-Gómez P, Sousa GBD, Rodríguez-Collado J, Herrero-Garibi J, Blanco-Fernández F, Diego-Nieto A, Delgado-Lapeira GC, Del Villar-Moro MCP, Martín-Moreiras J, Sánchez-Fernández PL, Cruz-González I. Left atrial appendage occlusion in patients suffering from advanced chronic kidney disease (stage 4 and 5). Long-term follow-up. Catheter Cardiovasc Interv 2024; 103:499-510. [PMID: 38168895 DOI: 10.1002/ccd.30946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION AND OBJECTIVES Advanced chronic kidney disease (A-CKD) combined with atrial fibrillation increases the risk of both thrombogenic and bleeding events. Left atrial appendage occlusion (LAAO) may be an alternative to oral anticoagulation to prevent thromboembolic events. We aimed to evaluate the outcomes of LAAO in patients with A-CKD. METHODS Comparison at long-term follow-up of patients diagnosed with and without A-CKD (eGFR<30 mL/min/1.73 m2 ) who underwent LAAO between 2009 and May 2022. RESULTS Five hundred seventy-three patients were included. Eighty-one (14%) were diagnosed with A-CKD. There were no differences in sex, age, and cardiovascular risk factors, except for diabetes which was more frequent in patients with A-CKD. The control group had higher rates of stroke, both ischemic and hemorrhagic. There were no differences in the CHA2 DS2 -VASc score, although A-CKD patients had a higher bleeding risk according to the HASBLED scale. Global procedural success was 99.1%. At follow-up, there were no differences in stroke rate: at 1-year (HR: 1.22, IC-95%: 0.14-10.42, p = 0.861); at 5-years (HR: 0.60, IC-95%: 0.08-4.58, p = 0.594). Although bleeding events were higher in the A-CKD group, no differences were found in major bleeding (defined BARC ≥ 3) at 1-year (HR: 1.34, IC-95%: 0.63-2.88, p = 0.464) or at 5-years follow-up (HR: 1.30, IC-95%: 0.69-2.48, p = 0.434). Mortality rate at 5 years was higher in the A-CKD patients (HR: 1.84, IC-95%: 1.18-2.87, p = 0.012). CONCLUSIONS LAAO is an effective and safe treatment in A-CKD patients to prevent ischemic events and bleeding. This strategy could be an alternative to oral anticoagulation in this high-risk group of patients.
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Affiliation(s)
- Sergio López-Tejero
- Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Spain
| | - Pablo Antúnez-Muiños
- Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Spain
| | - Pilar Fraile-Gómez
- Department of Nephrology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
| | - Gilles Barreira-de Sousa
- Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Spain
| | - Javier Rodríguez-Collado
- Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Spain
| | - Jesús Herrero-Garibi
- Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Spain
| | - Fabián Blanco-Fernández
- Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Spain
| | - Alejandro Diego-Nieto
- Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Spain
| | | | - M Candelas Pérez Del Villar-Moro
- Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Spain
| | - Javier Martín-Moreiras
- Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Spain
| | - Pedro L Sánchez-Fernández
- Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Spain
| | - Ignacio Cruz-González
- Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Spain
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Blasco-Turrión S, Briedis K, Estévez-Loureiro R, Sánchez-Recalde A, Cruz-González I, Pascual I, Mascherbauer J, Abdul-Jawad Altisent O, Nombela-Franco L, Pan M, Trillo R, Moreno R, Delle Karth G, Sánchez-Luna JP, Gonzalez-Gutiérrez JC, Revilla-Orodoea A, Zamorano JL, Gómez-Salvador I, Puri R, San Román JA, Amat-Santos IJ. Bicaval TricValve Implantation in Patients With Severe Symptomatic Tricuspid Regurgitation: 1-Year Follow-Up Outcomes. JACC Cardiovasc Interv 2024; 17:60-72. [PMID: 38069986 DOI: 10.1016/j.jcin.2023.10.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/09/2023] [Accepted: 10/17/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Several orthotopic transcatheter strategies have been developed to treat severe tricuspid regurgitation (TR); however, many patients are deemed unsuitable. Caval valve implantation with the TricValve system addresses this unmet need. OBJECTIVES This study sought to determine the impact of TricValve on systemic congestion and quality of life (QOL) at 1 year. METHODS The TRICUS (Safety and Efficacy of the TricValve® Transcatheter Bicaval Valves System in the Superior and Inferior Vena Cava in Patients With Severe Tricuspid Regurgitation) and TRICUS EURO studies were prospective, nonblinded, nonrandomized, single-arm trials representing the early-in-man experience of the TricValve system in NYHA functional class III or IV severe TR patients, optimally medicated and ineligible for open heart surgery, with significant caval backflow. The primary endpoint was QOL metrics and functional status. The 1-year results of the combined cohort are described here. RESULTS Forty-four patients were included. Mean age was 76.2 ± 7.5 years, 81.0% were women, and the TRISCORE (risk score model for isolated tricuspid valve surgery) was 5.3 ± 1.3. Clinical improvement at 1 year was achieved in 42 (95.5%) patients, measured by (at least 1 of) an increase in ≥15 points from baseline in 12-item Kansas City Cardiomyopathy Questionnaire score, improvement to NYHA functional class to I or II, or an increase ≥40 m in the 6-minute walk test. There were 3 (6.8%) deaths at 1-year follow-up (1 cardiovascular), and the heart failure rehospitalization rate was 29.5%. Stent fracture, conduction system disturbances, or clinically significant leaflet thrombosis were not detected. Abolished hepatic vein backflow was achieved and persisted in 63.8% of the patients, contributing towards a reduction in congestive symptoms, N-terminal pro-B-type natriuretic peptide levels (P = 0.032), and diuretic treatment. CONCLUSIONS Caval valve implantation with the TricValve system associated with meaningful 1-year clinical improvements in terms of QOL along with relatively low mortality rates. (TRICUS Study - Safety and Efficacy of the TricValve® Device; NCT03723239).
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Affiliation(s)
| | - Kasparas Briedis
- Kaunas Klinikos, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | | | - Ignacio Cruz-González
- Instituto de Investigación Biomédica de Salamanca, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Isaac Pascual
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Julia Mascherbauer
- Department of Cardiology, University Hospital Sankt Poelten, Karl Landsteiner University of Health Sciences, Krems, Austria
| | | | | | - Manuel Pan
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - Ramiro Trillo
- Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Raul Moreno
- Instituto de Investigación Hospital Universitario La Paz, Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | - Ana Revilla-Orodoea
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Jose Luis Zamorano
- Hospital Universitario Ramon y Cajal, Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Itziar Gómez-Salvador
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | | | - J Alberto San Román
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Ignacio J Amat-Santos
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain.
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5
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Jurado-Román A, Freixa X, Cid B, Cruz-González I, Sarnago Cebada F, Baz JA, Lozano Í, Sabaté M, Jiménez J, Íñigo García LA, Subinas Elorriaga A, Berenguer Jofresa A, Novo García E, Pérez Vizcayno MJ, Carrillo Suárez X, Pinar Bermúdez E, Calviño Santos R, Álvarez Antón S, Trillo Nouche R, Ruíz Arroyo JR, Fernández Cisnal A, Amat-Santos IJ, Jerez Valero M, Rama Merchán JC, Vaquerizo B, Tejada Ponce D, Ruiz Nodar JM, Sánchez Pérez I, Tejedor P, Elizaga J, Jiménez Cabrera FM, Bullones Ramírez JA, Sánchez Aquino R, Portero Pérez MP, Roura G, Mohandes M, Sáez Moreno R, Avanzas P, Caballero J, Torres Bosco AM, Merchán Herrera A, Robles Alonso J, Bosa Ojeda F, García San Román K, Agudelo VH, Martin Lorenzo P, Fernández JC, Pérez de Prado A, Ruiz Quevedo V, Cruz González I, Moreu Burgos J, Ruiz García J, Sánchez Burguillos FJ, Núñez Pernas D, Baello Monge P, Hernando Marrupe L, Franco Peláez JA, Jurado Román A, Pomar Domingo F, Fuertes Ferre G, Pimienta González R, Morales Ponce FJ, Sánchez Recalde Á, Ojeda Pineda S, Frutos Garcia A, Millán Segovia R, Fajardo Molina R, Díez Gil JL, Guisado Rasco A, Gómez Menchero AE, Bosch E, Oteo Domínguez JF, Gutiérrez-Barrios A, Cascón Pérez JD, Casanova Sandoval JM, Fernández Portales J, Rivero Crespo F, Gonzalez Caballero E, Ocaranza Sánchez R, Zueco J, García Del Blanco B, Alonso Briales JH, Sánchez Gila J, Vizcaino Arellano M, Carballo Garrido J, Andraka L, Gómez Jaume A, Merino Otermin Á, Artaiz Urdaci M, Arellano Serrano C, Íñigo García LA, García E, Unzué L, Ruiz Nodar JM, Arzamendi D, Freixa X, Mainar V, Usón M, Palazuelos Molinero J, López Palop R, Bethencourt A, Alegría Barrero E, Camacho Freire SJ, Peña G, Vázquez Álvarez ME, Muñoz Camacho JF, Ramírez Moreno A, Larman Tellechea M, García de la Borbolla Fernández R. Spanish cardiac catheterization and coronary intervention registry. 32nd official report of the Interventional Cardiology Association of the Spanish Society of Cardiology (1990-2022). Rev Esp Cardiol (Engl Ed) 2023; 76:1021-1031. [PMID: 37863184 DOI: 10.1016/j.rec.2023.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/26/2023] [Indexed: 10/22/2023]
Abstract
INTRODUCTION AND OBJECTIVES This article presents the annual activity report of the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) for the year 2022. METHODS All Spanish centers with catheterization laboratories were invited to participate. Data were collected online and were analyzed by an external company in collaboration with the members of the board of the ACI-SEC. RESULTS A total of 111 centers participated. The number of diagnostic studies increased by 4.8% compared with 2021, while that of percutaneous coronary interventions (PCI) remained stable. PCIs on the left main coronary artery increased by 22%. The radial approach continued to be preferred for PCI (94.9%). There was an upsurge in the use of drug-eluting balloons, as well as in intracoronary imaging techniques, which were used in 14.7% of PCIs. The use of pressure wires also increased (6.3% vs 2021) as did plaque modification techniques. Primary PCI continued to grow and was the most frequent treatment (97%) in ST-segment elevation myocardial infarction. Most noncoronary procedures maintained their upward trend, particularly percutaneous aortic valve implantation, atrial appendage closure, mitral/tricuspid edge-to-edge therapy, renal denervation, and percutaneous treatment of pulmonary arterial disease. CONCLUSIONS The Spanish cardiac catheterization and coronary intervention registry for 2022 reveals a rise in the complexity of coronary disease, along with a notable growth in procedures for valvular and nonvalvular structural heart disease.
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Affiliation(s)
| | - Xavier Freixa
- Servicio de Cardiología, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Belén Cid
- Servicio de Cardiología, Hospital Clínico de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Ignacio Cruz-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ángel Sánchez Recalde
- Hospital Universitario Ramón y Cajal, Hospital Universitario Sanitas La Moraleja, Hospital Universitario Sanitas Zarzuela
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6
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Vij V, Cruz-González I, Galea R, Piayda K, Nelles D, Vogt L, Gloekler S, Fürholz M, Meier B, Räber L, O'Hara G, Arzamendi D, Agudelo V, Asmarats L, Freixa X, Flores-Umanzor E, De Backer O, Sondergaard L, Nombela-Franco L, McInerney A, Salinas P, Korsholm K, Nielsen-Kudsk JE, Afzal S, Zeus T, Operhalski F, Schmidt B, Montalescot G, Guedeney P, Iriart X, Miton N, Saw J, Gilhofer T, Fauchier L, Veliqi E, Meincke F, Petri N, Nordbeck P, Gonzalez-Ferreiro R, Bhatt DL, Laricchia A, Mangieri A, Omran H, Schrickel JW, Rodes-Cabau J, Nickenig G, Sievert H, Sedaghat A. Symptomatic vs. non-symptomatic device-related thrombus after LAAC: a sub-analysis from the multicenter EUROC-DRT registry. Clin Res Cardiol 2023; 112:1790-1799. [PMID: 37294311 PMCID: PMC10697873 DOI: 10.1007/s00392-023-02237-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/23/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Device-related thrombus (DRT) after left atrial appendage closure (LAAC) is associated with adverse outcomes, i.e. ischemic stroke or systemic embolism (SE). Data on predictors of stroke/SE in the context of DRT are limited. AIMS This study aimed to identify predisposing factors for stroke/SE in DRT patients. In addition, the temporal connection of stroke/SE to DRT diagnosis was analyzed. METHODS The EUROC-DRT registry included 176 patients, in whom DRT after LAAC were diagnosed. Patients with symptomatic DRT, defined as stroke/SE in the context of DRT diagnosis, were compared against patients with non-symptomatic DRT. Baseline characteristics, anti-thrombotic regimens, device position, and timing of stroke/SE were compared. RESULTS Stroke/SE occurred in 25/176 (14.2%) patients diagnosed with DRT (symptomatic DRT). Stroke/SE occurred after a median of 198 days (IQR 37-558) after LAAC. In 45.8% stroke/SE occurred within one month before/after DRT diagnosis (DRT-related stroke). Patients with symptomatic DRT had lower left ventricular ejection fractions (50.0 ± 9.1% vs. 54.2 ± 11.0%, p = 0.03) and higher rates of non-paroxysmal atrial fibrillation (84.0% vs. 64.9%, p = 0.06). Other baseline parameters and device positions were not different. Most ischemic events occurred among patients with single antiplatelet therapy (50%), however, stroke/SE was also observed under dual antiplatelet therapy (25%) or oral anticoagulation (20%). CONCLUSION Stroke/SE are documented in 14.2% and occur both in close temporal relation to the DRT finding and chronologically independently therefrom. Identification of risk factors remains cumbersome, putting all DRT patients at substantial risk for stroke/SE. Further studies are necessary to minimize the risk of DRT and ischemic events.
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Affiliation(s)
- Vivian Vij
- Department of Cardiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | | | | | | | - Dominik Nelles
- Department of Cardiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Lara Vogt
- Department of Cardiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | | | | | | | | | - Gilles O'Hara
- Quebec Heart and Lung Institute, Laval University, Quebec City, Canada
| | | | | | - Lluis Asmarats
- Quebec Heart and Lung Institute, Laval University, Quebec City, Canada
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Ole De Backer
- Rigshospitalet, University Hospital Copenhagen, Copenhagen, Denmark
| | - Lars Sondergaard
- Rigshospitalet, University Hospital Copenhagen, Copenhagen, Denmark
| | | | | | | | | | | | - Shazia Afzal
- University Hospital Düsseldorf, Düsseldorf, Germany
| | - Tobias Zeus
- University Hospital Düsseldorf, Düsseldorf, Germany
| | | | - Boris Schmidt
- Agaplesion Bethanien Krankenhaus, CBB, Frankfurt, Germany
| | - Gilles Montalescot
- ACTION Study Group, Pitié-Salpêtrière Hospital (AP-HP), Sorbonne University, Paris, France
| | - Paul Guedeney
- ACTION Study Group, Pitié-Salpêtrière Hospital (AP-HP), Sorbonne University, Paris, France
| | | | | | | | | | | | | | | | - Nils Petri
- University Hospital Würzburg, Würzburg, Germany
| | | | | | | | - Alessandra Laricchia
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Humanitas Research Hospital IRCCS, Rozzano, Italy
| | - Antonio Mangieri
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Humanitas Research Hospital IRCCS, Rozzano, Italy
| | | | - Jan Wilko Schrickel
- Department of Cardiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Josep Rodes-Cabau
- Quebec Heart and Lung Institute, Laval University, Quebec City, Canada
| | - Georg Nickenig
- Department of Cardiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | | | - Alexander Sedaghat
- Department of Cardiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
- Rhein-Ahr-Cardio, Bad Neuenahr-Ahrweiler, Germany.
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Blanco-Fernández F, Antúnez-Muiños PJ, Núñez-García JC, López-Tejero S, Barreira-de Sousa GJ, García-Monsalvo M, Antúnez-Ballesteros M, Maree A, González-Calle D, Rodríguez-Collado J, Barreiro-Pérez M, Díaz-Peláez E, Pérez del Villar-Moro MC, Sánchez-Fernández PL, Cruz-González I. Effectiveness and Safety of an Outpatient Program for Percutaneous Left Atrial Appendage Occlusion. J Clin Med 2023; 12:6728. [PMID: 37959194 PMCID: PMC10648316 DOI: 10.3390/jcm12216728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/07/2023] [Accepted: 10/08/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Left atrial appendage occlusion (LAAO) is a safe and effective alternative to oral anticoagulation for thromboprophylaxis in patients with nonvalvular atrial fibrillation. Technological development in devices and imaging techniques, as well as accumulated experience, have increased procedural success rates and decreased complications. Same-day discharge protocols have been proposed in the field of structural heart disease, but this approach has not been studied in detail for the LAAO procedure. AIM The aim of this study is to assess the safety and efficacy of an outpatient program for LAAO when compared to the conventional treatment approach. METHODS We present a retrospective, non-randomized single-center study of 262 consecutive patients undergoing LAAO. Patients were divided into two groups, the first (n = 131) followed a conventional protocol (CP), and the second (n = 131) an outpatient protocol (OP). The primary composite endpoint comprised MACCE (death, stroke, and bleeding), cardiac tamponade, vascular complication, or attendance in the emergency department after hospital discharge at 30 days. RESULTS The overall success rate was 99.6%, with a periprocedural complication rate of 2.29%. With regards to the CP versus OP group, there were no differences between incidences of the primary composite endpoint (6.1% PC vs. 3.0% PA, p = 0.24), or after an analysis, with propensity score matching. No differences were observed in the individual endpoints. There was a decrease in hospital length of stay in the same-day discharge group (p < 0.01). CONCLUSIONS A same-day discharge LAAO program is safe, effective, and feasible when compared to the conventional strategy. Moreover, it reduces hospital length of stay, which might have clinical and economic benefits.
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Affiliation(s)
- Fabián Blanco-Fernández
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
| | - Pablo J. Antúnez-Muiños
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
| | | | - Sergio López-Tejero
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
| | - Gilles J. Barreira-de Sousa
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
| | - Mónica García-Monsalvo
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
| | - Milena Antúnez-Ballesteros
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
| | | | - David González-Calle
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
| | - Javier Rodríguez-Collado
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
| | | | - Elena Díaz-Peláez
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
| | - María C. Pérez del Villar-Moro
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
| | - Pedro L. Sánchez-Fernández
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
| | - Ignacio Cruz-González
- Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain (G.J.B.-d.S.)
- Instituto de Investigación Biomédica de Salamanca, 37007 Salamanca, Spain
- Centro de Ivestigación Biomédica en Red—Enfermedades Cardiovasculares (CIBER-CV), 37007 Salamanca, Spain
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Aminian A, Freixa X, Swaans MJ, Ben Yedder M, Cruz-González I. Reply: Miniaturized Procedural Imaging for Left Atrial Appendage Closure: A Mode or Fad-Time Will Tell. JACC Cardiovasc Interv 2023; 16:2575. [PMID: 37879814 DOI: 10.1016/j.jcin.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 10/27/2023]
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9
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Salinas P, García-Camarero T, Jimenez-Kockar M, Regueiro A, García-Blas S, Gomez-Menchero AE, Ojeda S, Vilchez-Tschischke JP, Amat-Santos I, Díez-Gil JL, Rondán J, Lozano Ruiz-Poveda F, de Miguel Castro A, Manzano MC, Pascual-Tejerina V, Cruz-González I, García Perez-Velasco J, Fernández-Diaz JA, Escaned J. Myocardial revascularization failure among patients requiring cardiac catheterization and secondary revascularization in contemporary clinical practice: Results of the REVASEC multicenter registry. Catheter Cardiovasc Interv 2023; 102:608-619. [PMID: 37582340 DOI: 10.1002/ccd.30804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 06/30/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Myocardial revascularization failure (MRF) and Secondary revascularization (SR) are contemporary interventional cardiology challenges. AIM To investigate the characteristics, management, and prognosis of patients with myocardial revascularization failure (MRF) and need for secondary revascularization (SR) in contemporary practice. METHODS The REVASEC study is a prospective registry (NCT03349385), which recruited patients with prior revascularization referred for coronary angiography at 19 centers. The primary endpoint is a patient-oriented composite (POCE) at 1 year, including death, myocardial infarction, or repeat revascularization. RESULTS A total of 869 patients previously revascularized by percutaneous intervention (83%) or surgery (17%) were recruited. MRF was found in 83.7% (41.1% stent/graft failure, 32.1% progression of coronary disease, and 10.5% residual disease). SR was performed in 70.1%, preferably by percutaneous intervention (95%). The POCE rate at 1 year was 14% in the overall cohort, with 6.4% all-cause death. In the multivariate analysis, lower POCE rates were found in the groups without MRF (9.4%) and with disease progression (11%) compared with graft/stent failure (17%) and residual disease (18%), hazard ratio 0.67 (95% confidence interval: 0.45-0.99), p = 0.043. At 1 year, the SR group had less chronic persistent angina (19% vs. 34%, p < 0.001), but a higher rate of repeat revascularization (9% vs. 2.9%, p < 0.001). CONCLUSION MRF was found in 84% of patients with prior revascularization referred for coronary angiography. Stent/graft failure and residual coronary disease were associated with a worse prognosis. SR provided better symptom control at the expense of a higher rate of new revascularization.
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Affiliation(s)
- Pablo Salinas
- Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | | | | | - Sergio García-Blas
- Instituto de Investigación Sanitaria INCLIVA, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | | | - Soledad Ojeda
- Hospital Universitario Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | | | | | | | | | | | | | | | | | | | | | | | - Javier Escaned
- Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Cepas-Guillén P, Flores-Umanzor E, Leduc N, Bajoras V, Perrin N, Farjat-Pasos J, McInerney A, Lafond A, Millán X, Zendjebil S, O'Hara G, Ibrahim R, de Backer O, Cruz-González I, Arzamendi D, Sanchis L, Garot P, Nielsen-Kudsk JE, Nombela-Franco L, Aminian A, Rodés-Cabau J, Freixa X. Impact of Device Implant Depth After Left Atrial Appendage Occlusion. JACC Cardiovasc Interv 2023; 16:2139-2149. [PMID: 37565966 DOI: 10.1016/j.jcin.2023.05.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Device-related thrombus (DRT) remains one of the main concerns after left atrial appendage occlusion (LAAO). Several risk factors have been proposed, but most cannot be modulated. A modifiable factor such as device implantation depth is a potential target to adjust the risk for DRT. OBJECTIVES The aim of this study was to assess the impact of LAAO device implantation depth as a predisposing factor for DRT. METHODS The study included patients who underwent successful LAAO at 9 centers in Europe and Canada. Patients were classified into 2 groups: proximal device implantation (covered pulmonary ridge [PR] in the lobe and disc cohort or <5 mm from the PR in the single-lobe cohort) and distal device implantation (uncovered PR in the disc and lobe cohort and ≥5 mm in the single-lobe cohort). RESULTS A total of 1,317 patients were included. Among these, proximal and distal device implantation was achieved in 732 (55%) and 585 (45%) patients, respectively. No differences in procedural outcomes were observed between the groups. At follow-up, patients with proximal implantation had a lower incidence of DRT (2.3%) than those with distal implantation (12.2%) (P < 0.001). Deeper device implantation and a larger uncovered left atrial appendage area were associated with a higher incidence of DRT (P < 0.001), regardless of device type. In multivariable analysis, distal implant (HR: 5.92; 95% CI: 3.39-10.36) and no or single antiplatelet therapy (HR: 1.62; 95% CI: 0.99-2.62) emerged as independent predictors of DRT. CONCLUSIONS LAAO device implantation depth is an independent risk factor for DRT. Deeper device implantation and larger uncovered left atrial appendage areas were associated with a higher incidence of DRT.
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Affiliation(s)
- Pedro Cepas-Guillén
- Institut Clinic Cardiovascular, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | | | - Nina Leduc
- Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Vilhemas Bajoras
- Rigshospitalet, Copenhagen, Denmark; Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Department of Interventional Cardiology, Division of Cardiology and Vascular Diseases, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania
| | - Nils Perrin
- Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
| | - Julio Farjat-Pasos
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | | | - Ana Lafond
- Hospital Universitario de Salamanca, Salamanca, Spain
| | - Xavi Millán
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Sandra Zendjebil
- Institut Cardiovasculaire Paris-Sud, Hôpital Jacques Cartier, Ramsay-Santé, Massy, France
| | - Gilles O'Hara
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Reda Ibrahim
- Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
| | | | | | | | - Laura Sanchis
- Institut Clinic Cardiovascular, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Philippe Garot
- Institut Cardiovasculaire Paris-Sud, Hôpital Jacques Cartier, Ramsay-Santé, Massy, France
| | | | | | - Adel Aminian
- Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Josep Rodés-Cabau
- Institut Clinic Cardiovascular, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain; Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Xavier Freixa
- Institut Clinic Cardiovascular, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain.
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Cruz-González I, Martín-Moreiras J, López-Tejero S. Trillium: a new treatment for severe tricuspid regurgitation. Rev Esp Cardiol (Engl Ed) 2023; 76:750. [PMID: 36587759 DOI: 10.1016/j.rec.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Ignacio Cruz-González
- Sección de Hemodinámica e Intervencionismo Estructural, Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Spain
| | - Javier Martín-Moreiras
- Sección de Hemodinámica e Intervencionismo Estructural, Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Spain
| | - Sergio López-Tejero
- Sección de Hemodinámica e Intervencionismo Estructural, Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Spain.
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12
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Aminian A, Leduc N, Freixa X, Swaans MJ, Ben Yedder M, Maarse M, Sanchis L, Cepas-Guillen P, Cruz-González I, Blanco-Fernandez F, Eschalier R, Boersma LVA. Left Atrial Appendage Occlusion Under Miniaturized Transesophageal Echocardiographic Guidance and Conscious Sedation: Multicenter European Experience. JACC Cardiovasc Interv 2023; 16:1889-1898. [PMID: 37587597 DOI: 10.1016/j.jcin.2023.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/29/2023] [Accepted: 06/13/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Left atrial appendage occlusion (LAAO) procedures are widely guided by standard transesophageal echocardiography (TEE) probes, requiring general anesthesia in most patients. The use of miniaturized TEE probes allows for LAAO guidance under local anesthesia and offers an attractive imaging alternative to standard TEE probes. OBJECTIVES The aim of this study was to assess the safety and efficacy of miniaturized TEE probes for procedural guidance of LAAO. METHODS Multicenter retrospective observational study of LAAO procedures performed under miniaturized TEE guidance and conscious sedation. The primary efficacy endpoint was technical success. The secondary efficacy endpoint was procedural success (technical success without major periprocedural complications). The safety outcome was a composite of major periprocedural complications. RESULTS A total of 546 consecutive LAAO procedures were performed in 5 European centers. Technical success was achieved in 534 (98.0%) patients. Sixteen major periprocedural complications occurred in 15 (2.9%) patients, yielding a procedural success rate of 97.0%. Conversion to general anesthesia was required in 4 (0.7%) patients. Short-term imaging follow-up was available in 422 patients with an incidence of major (>5 mm) TEE-detected residual leaks of 0.7%, complete LAA occlusion of 82.2% on cardiac computed tomography, and device-related thrombus of 5%. As compared with procedural 2-dimensional imaging for device sizing, preprocedural assessment by 3-dimensional imaging resulted in improved technical success (100% vs 95.0%; P < 0.001). CONCLUSIONS LAAO under conscious sedation and miniaturized TEE guidance is safe and feasible with a high rate of technical success and a low rate of periprocedural complications.
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Affiliation(s)
- Adel Aminian
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium.
| | - Nina Leduc
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | | | - Martin J Swaans
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Mohamed Ben Yedder
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Moniek Maarse
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands
| | | | | | - Ignacio Cruz-González
- Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, University Hospital Salamanca, Salamanca, Spain
| | - Fabian Blanco-Fernandez
- Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, University Hospital Salamanca, Salamanca, Spain
| | - Romain Eschalier
- Department of Cardiology, Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Lucas V A Boersma
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands
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13
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Amat-Santos IJ, Estevez-Loureiro R, Sánchez-Recalde Á, Cruz-González I, Pascual I, Mascherbauer J, Abdul-Jawad Altisent O, Nombela-Franco L, Pan M, Trillo R, Moreno R, Delle Karth G, Blasco-Turrión S, Sanchez-Luna JP, Revilla-Orodoea A, Redondo A, Zamorano JL, Puri R, Íñiguez-Romo A, San Román A. Right heart remodelling after bicaval TricValve implantation in patients with severe tricuspid regurgitation. EUROINTERVENTION 2023; 19:e450-e452. [PMID: 37083622 PMCID: PMC10397665 DOI: 10.4244/eij-d-23-00077] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/19/2023] [Indexed: 04/22/2023]
Affiliation(s)
- Ignacio J Amat-Santos
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | | | - Ignacio Cruz-González
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- IBSAL, Hospital Clinico Universitario de Salamanca, Salamanca, Spain
| | - Isaac Pascual
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Julia Mascherbauer
- Department of Cardiology, University Hospital Sankt Poelten, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Omar Abdul-Jawad Altisent
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Hospital Clinic, Barcelona, Spain
| | - Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clinico Universitario San Carlos, Madrid, Spain
| | - Manuel Pan
- Hospital Universitario Reina Sofia (IMIBIC), Córdoba, Spain
| | - Ramiro Trillo
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Hospital Clinico Universitario de Santiago de Compostela, Santiago, Spain
| | - Raul Moreno
- IdiPAZ, Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | - Ana Revilla-Orodoea
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Alfredo Redondo
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Jose Luis Zamorano
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Hospital Universitario Ramon y Cajal, Madrid, Spain
| | | | - Andrés Íñiguez-Romo
- Hospital Alvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Alberto San Román
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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14
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Tirado-Conte G, Rodés-Cabau J, Oteo JF, Pan M, Muñoz E, Witberg G, Cheema AN, Alpieri A, Lopez D, Amat-Santos IJ, Akodad M, Ojeda S, Serra V, Garcia-Blas S, Alfonso F, de Backer O, Asmarats L, Muñoz A, Hamdan A, Toggweiler S, Del Valle R, Salido L, Cruz-González I, Estevez-Loureiro R, Martin Alfaro LE, Gheorge L, Dabrowski M, Berenguer A, Arzamendi D, Saia F, Webb JG, Sondergaard L, Nombela-Franco L. Transcatheter aortic valve implantation in patients with extra-small aortic annuli. EUROINTERVENTION 2023:EIJ-D-23-00011. [PMID: 37334654 DOI: 10.4244/eij-d-23-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND A small aortic annulus (SAA) is a risk factor for prosthesis-patient mismatch (PPM) in patients undergoing surgical or transcatheter aortic valve implantation (TAVI). Data regarding TAVI in patients with extra-SAA is scarce. AIMS The aim of this study was to analyse the safety and efficacy of TAVI in patients with extra-SAA. METHODS A multicentre registry study including patients with extra-SAA (defined as an aortic annulus area <280 mm2 and/or perimeter <60 mm) undergoing TAVI was established. Primary efficacy and safety endpoints were defined as device success and early safety at 30 days, respectively, using the Valve Academic Research Consortium-3 criteria, and were analysed according to valve type: self-expanding (SEV) versus balloon-expandable (BEV). RESULTS A total of 150 patients were included, of which 139 (92.7%) were women, and 110 (73.3%) received an SEV. Intraprocedural technical success was 91.3%, with a higher rate in patients receiving an SEV (96.4% vs 77.5% with BEV; p=0.001). Overall, 30-day device success was 81.3%, (85.5% with SEV vs 70.0% with BEV; p=0.032). The primary safety endpoint occurred in 72.0% of patients (with no difference between groups; p=0.118). Severe PPM occurred in 12% (9.0% with SEV and 24.0% with BEV; p=0.039), with no impact on all-cause mortality, cardiovascular mortality, or heart failure readmission at 2-year follow-up. CONCLUSIONS TAVI is a safe and feasible treatment in patients with extra-SAA with a high rate of technical success. The use of SEV was associated with a lower rate of intraprocedural complications, higher device success at 30 days and better haemodynamic outcomes compared to BEV.
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Affiliation(s)
| | - Josep Rodés-Cabau
- Quebec Heart and Lung Institute, Laval University, Quebec, QC, Canada
| | - Juan F Oteo
- Department of Cardiology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Manuel Pan
- Hospital Universitario Reina Sofia, Córdoba, Spain and Universidad de Cordoba (IMIBIC), Córdoba, Spain
| | - Erika Muñoz
- CIBERCV Cardiology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Guy Witberg
- Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel and The Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asim N Cheema
- St Michael's Hospital, Toronto, ON, Canada
- Division of Cardiology, Southlake Regional Health Centre, Newmarket, ON, Canada
| | - Alberto Alpieri
- Quebec Heart and Lung Institute, Laval University, Quebec, QC, Canada
| | - Diego Lopez
- Hospital Clínico Universitario de Santiago, CIBERCV, Santiago, Spain
| | - Ignacio J Amat-Santos
- CIBERCV, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Soledad Ojeda
- Hospital Universitario Reina Sofia, Córdoba, Spain and Universidad de Cordoba (IMIBIC), Córdoba, Spain
| | | | - Sergio Garcia-Blas
- Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de Valencia, INCLIVA, CIBERCV, Valencia, Spain
| | - Fernando Alfonso
- Department of Cardiology, Hospital Universitario La Princesa, IIS-IP, CIBERCV, Madrid, Spain
| | - Ole de Backer
- Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Antonio Muñoz
- CIBERCV Cardiology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Ashraf Hamdan
- Cardiology Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel and The Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | - Luisa Salido
- Cardiology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - Ignacio Cruz-González
- Department of Cardiology, Complejo Asistencial Universitario Salamanca, CIBERCV, IBSAL, Salamanca, Spain
| | | | | | | | - Maciec Dabrowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland
| | - Alberto Berenguer
- Cardiology Department, Hospital General Universitario de Valencia, Valencia, Spain
| | - Dabit Arzamendi
- Department of Cardiology, Hospital Universitario La Princesa, IIS-IP, CIBERCV, Madrid, Spain
| | - Francesco Saia
- Cardiology Unit, Cardio-Thoracic-Vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - John G Webb
- CIBERCV, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Lars Sondergaard
- Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark
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15
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Ojeda S, González-Manzanares R, Jiménez-Quevedo P, Piñón P, Asmarats L, Amat-Santos I, Fernández-Nofrerias E, Valle RD, Muñoz-García E, Ferrer-Gracia MC, María de la Torre J, Ruiz-Quevedo V, Regueiro A, Sanmiguel D, García-Blas S, Elízaga J, Baz JA, Romaguera R, Cruz-González I, Moreu J, Gheorghe LL, Salido L, Moreno R, Urbano C, Serra V, Pan M. Coronary Obstruction After Transcatheter Aortic Valve Replacement: Insights From the Spanish TAVI Registry. JACC Cardiovasc Interv 2023; 16:1208-1217. [PMID: 37225292 DOI: 10.1016/j.jcin.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/01/2023] [Accepted: 03/14/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Coronary obstruction (CO) following transcatheter aortic valve replacement (TAVR) is a life-threatening complication, scarcely studied. OBJECTIVES The authors analyzed the incidence of CO after TAVR, presentation, management, and in-hospital and 1-year clinical outcomes in a large series of patients undergoing TAVR. METHODS Patients from the Spanish TAVI (Transcatheter Aortic Valve Implantation) registry who presented with CO in the procedure, during hospitalization or at follow-up were included. Computed tomography (CT) risk factors were assessed. In-hospital, 30-day, and 1-year all-cause mortality rates were analyzed and compared with patients without CO using logistic regression models in the overall cohort and in a propensity score-matched cohort. RESULTS Of 13,675 patients undergoing TAVR, 115 (0.80%) presented with a CO, mainly during the procedure (83.5%). The incidence of CO was stable throughout the study period (2009-2021), with a median annual rate of 0.8% (range 0.3%-1.3%). Preimplantation CT scans were available in 105 patients (91.3%). A combination of at least 2 CT-based risk factors was less frequent in native than in valve-in-valve patients (31.7% vs 78.3%; P < 0.01). Percutaneous coronary intervention was the treatment of choice in 100 patients (86.9%), with a technical success of 78.0%. In-hospital, 30-day, and 1-year mortality rates were higher in CO patients than in those without CO (37.4% vs 4.1%, 38.3% vs 4.3%, and 39.1% vs 9.1%, respectively; P < 0.001). CONCLUSIONS In this large, nationwide TAVR registry, CO was a rare, but often fatal, complication that did not decrease over time. The lack of identifiable predisposing factors in a subset of patients and the frequently challenging treatment when established may partly explain these findings.
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Affiliation(s)
- Soledad Ojeda
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Universidad de Córdoba, Córdoba, Spain.
| | - Rafael González-Manzanares
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Pilar Jiménez-Quevedo
- Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Pablo Piñón
- Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Lluis Asmarats
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ignacio Amat-Santos
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | | | - Raquel Del Valle
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Erika Muñoz-García
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | | | - Jose María de la Torre
- Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain; Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | | | - Ander Regueiro
- Servicio de Cardiología, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Dario Sanmiguel
- Servicio de Cardiología, Hospital General Universitario de Valencia, Valencia, Spain
| | - Sergio García-Blas
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain; Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
| | - Jaime Elízaga
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón; Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
| | - Jose Antonio Baz
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro,Vigo, Pontevedra, Spain
| | - Rafael Romaguera
- Servicio de Cardiología, Hospital de Bellvitge, Barcelona, Spain; Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ignacio Cruz-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario de Salamanca, Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - José Moreu
- Servicio de Cardiología, Hospital Universitario de Toledo, Toledo, Spain
| | - Livia L Gheorghe
- Servicio de Cardiología, Hospital Universitario Puerta del Mar Hospital, Cádiz, Spain
| | - Luisa Salido
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Raúl Moreno
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Hospital Universitario La Paz (IDIPAZ), Madrid, Spain
| | - Cristóbal Urbano
- Servicio de Cardiología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Vicenc Serra
- Servicio de Cardiología, Hospital Vall d'Hebron, Barcelona, Spain
| | - Manuel Pan
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Universidad de Córdoba, Córdoba, Spain
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16
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Flores-Umanzor E, Nogic J, Cepas-Guillén P, Hascoet S, Pysz P, Baz JA, Cruz-González I, Amat-Santos IJ, Antúnez-Muiños P, González JC, Ruíz-Quevedo V, Estévez-Loureiro R, Gerardin B, Millan X, Santaló-Corcoy M, Regueiro A, Ibrahim R, Arzamendi D, Onorato EM, Rodés-Cabau J, Horlick E, Calvert PA, Freixa X. Percutaneous paravalvular leak closure after transcatheter aortic valve implantation: the international PLUGinTAVI Registry. EUROINTERVENTION 2023:EIJ-D-22-01110. [PMID: 37128805 PMCID: PMC10397666 DOI: 10.4244/eij-d-22-01110] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Data regarding the safety and long-term effectiveness of percutaneous closure of paravalvular leak (PVL) after transcatheter aortic valve implantation (TAVI) are scarce. AIMS This study aims to present a large multicentre international experience of percutaneous post-TAVI PVL closure. METHODS All patients who underwent percutaneous post-TAVI PVL closure in 14 hospitals across Europe and North America between January 2018 and October 2022 were included. RESULTS Overall, 45 patients (64% male) were enrolled. The median age was 80 years (75-84). Among them, 67% and 33% had self-expanding and balloon-expandable valve implantations, respectively. Baseline post-TAVI PVL was severe in 67% of cases and moderate in the rest. The time from index TAVI to PVL closure procedure was 16.1 (8.7-34.8) months. Most patients were in NYHA Class III and IV (73%) before the procedure, and 40% had referred hospitalisations for heart failure between TAVI and the PVL closure procedure. Successful PVL closure was achieved in 94%, reducing regurgitation to ≤mild in 91% and moderate in the rest. The Amplatzer Valvular Plug III was the most frequently used device (27 cases), followed by the Amplatzer Valvular Plug 4. The incidence of severe adverse events was 11%. None of the patients died during the index hospitalisation. During long-term follow-up (21.7±16.2 months), the all-cause mortality rate was 14%, and patients presented improvement in functional status and a significant reduction in the rate of hospitalisation for heart failure (from 40% to 6%). CONCLUSIONS Percutaneous PVL closure is a feasible and safe option for treating post-TAVI leaks. Successful PVL reduction to mild or less could be associated with acute and long-lasting improvements in clinical outcomes.
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Affiliation(s)
- Eduardo Flores-Umanzor
- Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network (UHN), Toronto, ON, Canada
| | - Jason Nogic
- Department of Cardiology, Royal Papworth Hospital, Cambridge, UK
| | - Pedro Cepas-Guillén
- Hospital Clinic de Barcelona, Institut Clinic Cardiovascular, IDIBAPS, Barcelona, Spain
| | - Sebastian Hascoet
- Marie Lannelongue Hospital, Department of Congenital Heart Diseases, M3C Network, INSERM UMR-S 999, Paris-Saclay University, Plessis-Robinson, Paris, France
| | - Piotr Pysz
- Medical University of Silesia, Katowice, Poland
| | - Jose Antonio Baz
- Cardiovascular Research Group, Department of Cardiology, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saude, University of Vigo, Vigo, Spain
| | | | - Ignacio J Amat-Santos
- Hospital Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | | | | | | | - Rodrigo Estévez-Loureiro
- Cardiovascular Research Group, Department of Cardiology, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saude, University of Vigo, Vigo, Spain
| | - Benoit Gerardin
- Marie Lannelongue Hospital, Department of Congenital Heart Diseases, M3C Network, INSERM UMR-S 999, Paris-Saclay University, Plessis-Robinson, Paris, France
| | | | | | - Ander Regueiro
- Hospital Clinic de Barcelona, Institut Clinic Cardiovascular, IDIBAPS, Barcelona, Spain
| | | | | | | | - Josep Rodés-Cabau
- Quebec Heart and Lung Institute, Laval University, Quebec City, QC, Canada
| | - Eric Horlick
- Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network (UHN), Toronto, ON, Canada
| | | | - Xavier Freixa
- Hospital Clinic de Barcelona, Institut Clinic Cardiovascular, IDIBAPS, Barcelona, Spain
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17
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López-Tejero S, Antúnez-Muiños P, Cruz-González I. CAVI in CAVI to resolve prosthesis migration. Rev Esp Cardiol (Engl Ed) 2023; 76:390. [PMID: 36202318 DOI: 10.1016/j.rec.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/19/2022] [Indexed: 04/29/2023]
Affiliation(s)
- Sergio López-Tejero
- Sección de Hemodinámica e Intervencionismo Estructural, Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
| | - Pablo Antúnez-Muiños
- Sección de Hemodinámica e Intervencionismo Estructural, Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Ignacio Cruz-González
- Sección de Hemodinámica e Intervencionismo Estructural, Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
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González-Calle D, Laffond A, López-Tejero S, Sánchez PL, Cruz-González I. Impact of Peridevice Leak Outcomes After Left Atrial Appendage Closure: Does Size No Longer Matter? J Am Coll Cardiol 2023; 81:e79. [PMID: 36889881 DOI: 10.1016/j.jacc.2022.08.815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 03/08/2023]
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Rodríguez-Leor O, Cid-Álvarez AB, Moreno R, Rosselló X, Ojeda S, Serrador A, López-Palop R, Martín-Moreiras J, Ramón Rumoroso J, Cequier Á, Ibáñez B, Cruz-González I, Romaguera R, Raposeiras y S, de Prado AP. Diferencias regionales en la atenci�n al IAMCEST en Espa�a. Datos del Registro de C�digo Infarto ACI-SEC. RECIC 2023. [DOI: 10.24875/recic.m22000360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Li CHP, Estévez-Loureiro R, Freixa X, Teles R, Molina-Ramos AI, Pan M, Nombela-Franco L, Melica B, Amat-Santos IJ, Cruz-González I, Asmarats L, Alarcón R, Sanchis L, Fernández-Peregrina E, Baz JA, Millán X, Menduiña I, Arzamendi D. Iberian experience with PASCAL transcatheter edge-to-edge repair for mitral valve regurgitation. Rev Esp Cardiol (Engl Ed) 2023; 76:25-31. [PMID: 35691867 DOI: 10.1016/j.rec.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/26/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION AND OBJECTIVES The PASCAL system is a novel device for transcatheter mitral valve repair based on the edge-to-edge concept. The unique features of this device might have a relevant impact on the repair outcomes. There are few data on clinical outcomes in real-life registries. The aim of this study was to report the early Iberian experience (Spain and Portugal) of the PASCAL system. METHODS Procedural and 30-day outcomes were investigated in consecutive patients with symptomatic severe mitral regurgitation (MR) treated with the PASCAL system at 10 centers. Primary efficacy endpoints were technical success and degree of residual MR at discharge. The primary safety endpoint was the rate of major adverse events (MAE) at 30 days. RESULTS We included 68 patients (age, 75 [68-81] years; 38% women; EuroSCORE II 4.5%). MR etiology was degenerative in 25%, functional in 65%, and mixed in 10%. A total of 71% of patients were in New York Heart Association (NYHA) functional class≥III. Technical success was achieved in 96% and independent capture was used in 73% of procedures. In the treated population, MR at discharge was≤2+ in 100%, with no in-hospital deaths. At 30 days, the MAE rate was 5.9%, the all-cause mortality rate was 1.6%, 98% were in NYHA functional class≤II, and 95% had MR≤2+ (P<.001). CONCLUSIONS Transcatheter mitral valve repair with the PASCAL system was safe and effective, with high procedural success and low rates of MAE. At 30 days, MR was significantly reduced, with a significant improvement in functional status.
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Affiliation(s)
- Chi-Hion Pedro Li
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain; Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Valladolid, Spain.
| | | | - Xavier Freixa
- Servicio de Cardiología, Hospital Clínic de Barcelona, Institut Clínic Cardiovascular, Barcelona, Spain
| | - Rui Teles
- Serviço de Cardiologia, Hospital de Santa Cruz, Lisboa, Portugal
| | - Ana I Molina-Ramos
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Valladolid, Spain; Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Manuel Pan
- Servicio de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain
| | - Luis Nombela-Franco
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Bruno Melica
- Serviço de Cardiologia, Centro Hospitalar Vila Nova de Gaia, Vila Nova de Gaia, Portugal
| | - Ignacio J Amat-Santos
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Valladolid, Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Ignacio Cruz-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Valladolid, Spain; Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Lluís Asmarats
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Valladolid, Spain
| | - Robert Alarcón
- Servicio de Cardiología, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain
| | - Laura Sanchis
- Servicio de Cardiología, Hospital Clínic de Barcelona, Institut Clínic Cardiovascular, Barcelona, Spain
| | - Estefanía Fernández-Peregrina
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Valladolid, Spain
| | - José Antonio Baz
- Servicio de Cardiología, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain
| | - Xavier Millán
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Valladolid, Spain
| | - Irene Menduiña
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Valladolid, Spain
| | - Dabit Arzamendi
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain; Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Valladolid, Spain
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Antúnez-Muiños PJ, López-Tejero S, Herrero Garibi J, Díaz Peláez E, Fernández y PLS, Cruz-González I. Implante percut�neo de v�lvula a�rtica mediante co-registro FEops HEARTguide. RECIC 2022. [DOI: 10.24875/recic.m22000346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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22
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Freixa X, Jurado-Román A, Cid B, Cruz-González I. Spanish cardiac catheterization and coronary intervention registry. 31st official report of the Interventional Cardiology Association of the Spanish Society of Cardiology (1990-2021). Rev Esp Cardiol (Engl Ed) 2022; 75:1040-1049. [PMID: 36241156 DOI: 10.1016/j.rec.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/12/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION AND OBJECTIVES The Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) presents its annual activity report for 2021. METHODS All Spanish centers with catheterization laboratories were invited to participate. Data were collected online and were analyzed by an external company, together with the members of the ACI-SEC. RESULTS A total of 121 centers participated (83 public and 38 private). Compared to 2020, both diagnostic coronary angiograms and percutaneous coronary interventions (PCI) increased by 11,4% and 10,3%, respectively. The radial approach was the most used access (92,8%). Primary PCI also increased by 6.2% whereas rescue PCI (1,8%) and facilitated PCI (2,4%) were less frequently conducted. Transcatheter aortic valve implantation was one of the interventions with the most relevant increase. A total of 5720 transcatheter aortic valve implantation procedures were conducted with an increase of 34,9% compared to 2020 (120 per million in 2021 and 89,4 per million in 2020). Other structural interventions like transcatheter mitral or tricuspid repair, left atrial appendage occlusion and patent foramen oval closure also experienced a significant increase. CONCLUSIONS The 2021 registry demonstrates a clear recovery of the activity both in coronary and structural interventions showing a relevant increase compared to 2020, the year of the COVID-19 pandemic.
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Affiliation(s)
- Xavier Freixa
- Servicio de Cardiología, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
| | | | - Belén Cid
- Servicio de Cardiología, Hospital Clínico de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Ignacio Cruz-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
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23
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Barrero A, Carrasco-Chinchilla F, Benito-González T, Pascual I, Arzamendi D, Estévez-Loureiro R, Nombela-Franco L, Pan M, Freixa X, Trillo-Nouche R, Sánchez-Recalde Á, Andraka L, Cruz-González I, López-Mínguez JR, Diez Gil JL, Urbano-Carrillo C, Sanmiguel Cervera D, Sanchis J, Bosa F, Ruiz V, Del Trigo M, Molina E, Serrador AM, Alonso-Briales JH, Garrote C, Avanzas P, Li CH, Baz JA, Jiménez-Quevedo P, Mesa D, Regueiro A, Cid B, Carrasco-Moraleja M, Rodríguez-Gabella T, Hernández-García JM, Fernández-Vázquez F, Amat-Santos IJ. Temporal trend and potential impact of angiotensin receptor neprilysin inhibitors on transcatheter edge-to-edge mitral valve repair. Rev Esp Cardiol (Engl Ed) 2022; 75:1001-1010. [PMID: 35272968 DOI: 10.1016/j.rec.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION AND OBJECTIVES Transcatheter edge-to-edge repair (TEER) should be considered in patients with heart failure and secondary mitral regurgitation (MR). Angiotensin receptor-neprilysin inhibitors (ARNIs) have been demonstrated to improve prognosis in heart failure. We aimed to evaluate the impact ARNIs on patient selection and outcomes. METHODS The population of the Spanish TEER prospective registry (March 2012 to January 2021) was divided into 2 groups: a) TEER before the ARNI era (n=450) and b) TEER after the recommendation of ARNIs by European Guidelines (n=639), with further analysis according to intake (n=52) or not (n=587) of ARNIs. RESULTS A total of 1089 consecutive patients underwent TEER for secondary MR. In the ARNI era, there was a reduction in left ventricle dilation (82mL vs 100mL, P=.025), and better function (35% vs 38%, P=.011). At 2 years of follow-up, mortality (10.6% vs 17.3%, P <.001) and heart failure readmissions (16.6% vs 27.8%, P <.001) were lower in the ARNI era, but not recurrent MR. In the ARNI era, 1- and 2-year mortality were similar irrespective of ARNI intake but patients on ARNIs had a lower risk of readmission+mortality at 2 years (OR, 0.369; 95%CI, 0.137-0.992; P=.048), better NYHA class, and lower recurrence of MR III-IV (1.9% vs 14.3%, P=.011). CONCLUSIONS Better patient selection for TEER has been achieved in the last few years with a parallel improvement in outcomes. The use of ARNIs was associated with a significant reduction in overall events, better NYHA class, and lower MR recurrence.
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Affiliation(s)
- Alejandro Barrero
- Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Fernando Carrasco-Chinchilla
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Virgen de la Victoria, Málaga, Spain
| | - Tomás Benito-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Clínico Universitario, León, Spain
| | - Isaac Pascual
- Departamento de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Dabit Arzamendi
- Departamento de Cardiología, Hospital Sant Pau, Barcelona, Spain
| | | | | | - Manuel Pan
- Departamento de Cardiología, Hospital Reina Sofía, Córdoba, Spain
| | - Xavier Freixa
- Departamento de Cardiología, Hospital Clinic, Barcelona, Spain
| | - Ramiro Trillo-Nouche
- Departamento de Cardiología, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | | | - Leire Andraka
- Departamento de Cardiología, Hospital Civil de Basurto, Bilbao, Vizcaya, Spain
| | - Ignacio Cruz-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Clínico de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | | | - José Luis Diez Gil
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | | | - Juan Sanchis
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Clínico Universitario, INCLIVA, Valencia, Spain
| | - Francisco Bosa
- Departamento de Cardiología, Hospital Universitario, Canarias, Spain
| | - Valeriano Ruiz
- Departamento de Cardiología, Complejo Hospitalario, Navarra, Spain
| | - María Del Trigo
- Departamento de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Eduardo Molina
- Departamento de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Ana M Serrador
- Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Juan H Alonso-Briales
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Virgen de la Victoria, Málaga, Spain
| | - Carmen Garrote
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Clínico Universitario, León, Spain
| | - Pablo Avanzas
- Departamento de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Chi Hion Li
- Departamento de Cardiología, Hospital Sant Pau, Barcelona, Spain
| | - José Antonio Baz
- Departamento de Cardiología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | | | - Dolores Mesa
- Departamento de Cardiología, Hospital Reina Sofía, Córdoba, Spain
| | - Ander Regueiro
- Departamento de Cardiología, Hospital Clinic, Barcelona, Spain
| | - Belén Cid
- Departamento de Cardiología, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Manuel Carrasco-Moraleja
- Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Tania Rodríguez-Gabella
- Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - José M Hernández-García
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Virgen de la Victoria, Málaga, Spain
| | - Felipe Fernández-Vázquez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Cardiología, Hospital Clínico Universitario, León, Spain
| | - Ignacio J Amat-Santos
- Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
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Cruz-González I, Estévez-Loureiro R, Barreiro-Pérez M, Aguilera-Saborido A, Olmos-Blanco C, Rincón LM, Gómez-Polo JC, Arzamendi D, Borreguero L, Vilacosta I, Gámez JM, Martínez-Monzonis A. Mitral and tricuspid valve disease: diagnosis and management. Consensus document of the Section on Valvular Heart Disease and the Cardiovascular Imaging, Clinical Cardiology, and Interventional Cardiology Associations of the Spanish Society of Cardiology. Rev Esp Cardiol (Engl Ed) 2022; 75:911-922. [PMID: 35926720 DOI: 10.1016/j.rec.2022.05.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/27/2022] [Indexed: 10/16/2022]
Abstract
The diagnosis and management of mitral and tricuspid valve disease have undergone major changes in the last few years. The expansion of transcatheter interventions and widespread use of new imaging techniques have altered the recommendations for the diagnosis and treatment of these diseases. Because of the exponential growth in the number of publications and clinical trials in this field, there is a strong need for continuous updating of local protocols. The recently published 2021 European Society of Cardiology guidelines for the management of valvular heart disease did not include some of the new data on these new therapies and, moreover, the number of mitral and tricuspid interventions varies widely across Europe. Therefore, all this information must be summarized to facilitate its use in each specific country. Consequently, we present the consensus document of the Section on Valvular Disease, Cardiovascular Imaging, Clinical Cardiology, and Interventional Cardiology Associations of the Spanish Society of Cardiology for the diagnosis and management of mitral and tricuspid valve disease.
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Affiliation(s)
- Ignacio Cruz-González
- Servicio de Cardiología, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
| | - Rodrigo Estévez-Loureiro
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, Pontevedra, Spain
| | - Manuel Barreiro-Pérez
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, Pontevedra, Spain
| | - Almudena Aguilera-Saborido
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Grupo de Investigación Fisiopatología Cardiovascular del Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain
| | - Carmen Olmos-Blanco
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Luis Miguel Rincón
- Servicio de Cardiología, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Juan Carlos Gómez-Polo
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Dabit Arzamendi
- Servicio de Cardiología Intervencionista en Cardiopatía Estructural, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Luis Borreguero
- Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
| | - Isidre Vilacosta
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - José María Gámez
- Servicio de Cardiología, Hospital Universitario Son Llàtzer, Departamento de Medicina, Universidad de las Islas Baleares, Palma de Mallorca, Balearic Islands, Spain
| | - Amparo Martínez-Monzonis
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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25
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Caneiro-Queija B, Estévez-Loureiro R, Raposeiras-Roubín S, Abu-Assi E, González-Ferreiro R, Cruz-González I, Diego-Nieto A, Miguel-Castro AAD, Bastos-Fernández G, Baz-Alonso JA, O’Hara G, Rodés-Cabau y J, Íñiguez-Romo A. Cierre de orejuela izquierda frente a ACOD en pacientes mayores: an�lisis con emparejamiento por puntuaci�n de propensi�n. RECIC 2022. [DOI: 10.24875/recic.m22000316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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26
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de la Torre Hernández JM, Lozano González M, García Camarero T, Serrano Lozano D, Cid B, Ojeda S, Jiménez Quevedo P, Serrador A, García Del Blanco B, Díaz JF, Moreno R, Cruz-González I, Pérez de Prado A, Fernández Lozano I, Cano Pérez Ó, Cantarero Prieto D. Interregional variability in the use of cardiovascular technologies (2011-2019). Correlation with economic indicators, admissions, and in-hospital mortality. Rev Esp Cardiol (Engl Ed) 2022; 75:805-815. [PMID: 35688688 DOI: 10.1016/j.rec.2022.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/11/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION AND OBJECTIVES Equal opportunities to access technical advances with recognized clinical value should be a priority of the publicly-funded health system. We analyzed variability among all the Spanish autonomous communities in the use of cardiovascular techniques with an established indication and its relationship with economic indicators, burden of disease, and hospital mortality. METHODS The activity registries of various Associations of the Spanish Society of Cardiology from 2011 to 2019 were analyzed for coronary angiography, overall percutaneous coronary intervention (PCI), primary PCI, implantable cardioverter-defibrillators (ICD), cardiac resynchronization therapy, and transcatheter aortic valve replacement (TAVR). Economic indices (gross domestic product and per capita health care expenditure) were obtained from public sources and data on attendance rates and mortality from the Resources and Quality in Cardiology (RECALCAR) reports of the Spanish Society of Cardiology. We analyzed the coefficient of variation for activity and the correlation of activity with regional economic indices, attendance rates, and risk-adjusted rates of in-hospital mortality. RESULTS We identified wide variability in the use of technologies, especially for primary PCI (18%), ICD (22%), cardiac resynchronization therapy (36%), and TAVR (42%). A certain correlation with attendance rates was seen only for overall PCI and ICD. In general, no significant correlation was found between the use of the techniques and the economic indices of wealth and expenditure. The correlation with in-hospital mortality showed no significant results, although this was the analysis with the greatest limitations because the impact of these techniques on survival is exerted more in the mid- and long-term. CONCLUSIONS The results of this study, despite its inherent limitations, show marked variability between autonomous communities in the use of cardiovascular technologies, which is not explained by economic differences or by hospital attendance rates due to the corresponding diseases.
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Affiliation(s)
- José M de la Torre Hernández
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, Spain.
| | - Manuel Lozano González
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, Spain
| | - Tamara García Camarero
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, Spain
| | - David Serrano Lozano
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, Spain
| | - Belén Cid
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Soledad Ojeda
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain
| | - Pilar Jiménez Quevedo
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain
| | - Ana Serrador
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Hemodinámica y Cardiología Intervencionista, Hospital Clínico Universitario de Valladolid, Instituto Ciencias del Corazón (ICICOR), Valladolid, Spain
| | - Bruno García Del Blanco
- Unidad de Hemodinámica, Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - José F Díaz
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Raúl Moreno
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, idiPAZ, Madrid, Spain
| | - Ignacio Cruz-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain
| | - Armando Pérez de Prado
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de León, León, Spain
| | - Ignacio Fernández Lozano
- Unidad de Arritmias, Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Óscar Cano Pérez
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain; Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - David Cantarero Prieto
- Departamento de Economía, Grupo de Economía de la Salud y Gestión de Servicios Sanitarios, Universidad de Cantabria-IDIVAL, Santander, Cantabria, Spain
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Antúnez-Muiños P, Vicente-Palacios V, Pérez-Sánchez P, Sampedro-Gómez J, Sánchez-Puente A, Dorado-Díaz PI, Nombela-Franco L, Salinas P, Gutiérrez-García H, Amat-Santos I, Peral V, Morcuende A, Asmarats L, Freixa X, Regueiro A, Caneiro-Queija B, Estevez-Loureiro R, Rodés-Cabau J, Sánchez PL, Cruz-González I. Predictive Power for Thrombus Detection after Atrial Appendage Closure: Machine Learning vs. Classical Methods. J Pers Med 2022; 12:jpm12091413. [PMID: 36143197 PMCID: PMC9503612 DOI: 10.3390/jpm12091413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/12/2022] [Accepted: 08/21/2022] [Indexed: 11/16/2022] Open
Abstract
Device-related thrombus (DRT) after left atrial appendage (LAA) closure is infrequent but correlates with an increased risk of thromboembolism. Therefore, the search for DRT predictors is a topic of interest. In the literature, multivariable methods have been used achieving non-consistent results, and to the best of our knowledge, machine learning techniques have not been used yet for thrombus detection after LAA occlusion. Our aim is to compare both methodologies with respect to predictive power and the search for predictors of DRT. To this end, a multicenter study including 1150 patients who underwent LAA closure was analyzed. Two lines of experiments were performed: with and without resampling. Multivariate and machine learning methodologies were applied to both lines. Predictive power and the extracted predictors for all experiments were gathered. ROC curves of 0.5446 and 0.7974 were obtained for multivariate analysis and machine learning without resampling, respectively. However, the resampling experiment showed no significant difference between them (0.52 vs. 0.53 ROC AUC). A difference between the predictors selected was observed, with the multivariable methodology being more stable. These results question the validity of predictors reported in previous studies and demonstrate their disparity. Furthermore, none of the techniques analyzed is superior to the other for these data.
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Affiliation(s)
- Pablo Antúnez-Muiños
- CIBERCV, University Hospital of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-923291100
| | | | - Pablo Pérez-Sánchez
- CIBERCV, University Hospital of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), 37007 Salamanca, Spain
| | | | | | - Pedro Ignacio Dorado-Díaz
- CIBERCV, University Hospital of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Luis Nombela-Franco
- Instituto Cardiovascular, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
| | - Pablo Salinas
- Instituto Cardiovascular, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
| | - Hipólito Gutiérrez-García
- CIBERCV, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Ignacio Amat-Santos
- CIBERCV, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Vicente Peral
- Department of Cardiology, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, 07120 Palma, Spain
| | - Antonio Morcuende
- Department of Cardiology, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, 07120 Palma, Spain
| | - Lluis Asmarats
- Quebec Heart and Kung Institute, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Xavier Freixa
- Institut Clínic Cardiovascular, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Ander Regueiro
- Institut Clínic Cardiovascular, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | | | | | - Josep Rodés-Cabau
- Quebec Heart and Kung Institute, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Pedro Luis Sánchez
- CIBERCV, University Hospital of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Ignacio Cruz-González
- CIBERCV, University Hospital of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), 37007 Salamanca, Spain
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28
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González-Del-Hoyo M, Rodríguez-Leor O, Cid-Álvarez AB, de Prado AP, Ojeda S, Serrador A, López-Palop R, Martín-Moreiras J, Rumoroso JR, Cequier Á, Ibáñez B, Cruz-González I, Romaguera R, Raposeiras-Roubin S, Moreno R, Rossello X. Short-term mortality differs between men and women according to the presence of previous cardiovascular disease: Insights from a nationwide STEMI cohort. Int J Cardiol 2022; 367:90-98. [PMID: 36030132 DOI: 10.1016/j.ijcard.2022.08.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/06/2022] [Accepted: 08/16/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Sex and prior cardiovascular disease (CVD) are known independent prognostic factors following an ST-elevation myocardial infarction (STEMI). We aimed to examine whether the association between sex and 30-day mortality differ according to the presence of previous CVD in STEMI patients. METHODS Prospective, observational, multicentre registry of consecutive patients managed in 17 STEMI networks in Spain (83 centres), between April and June 2019. Unadjusted and adjusted logistic regression models assessed the association of 30-day mortality with sex and prior CVD status, as well as their interaction. RESULTS Among 4366 patients (mean age 63.7 ± 13.0 years; 78% male), there were 337 (8.1%) deaths within the first 30 days. There was an association between crude 30-day mortality and sex (women 10.4% vs. men 7.4%, p = 0.003), and prior CVD (CVD 13.7% vs non-CVD 6.8%, p < 0.001). After adjustment for potential confounding, neither sex nor prior CVD were apparently associated with mortality. Nevertheless, we found a significant sex-CVD interaction (p-interaction = 0.006), since women were at lower risk than men in the subset of patients with prior CVD (OR = 0.30, 95%CI = 0.12-0.80) but not in those without CVD (OR = 1.17, 95%CI = 0.79-1.74). CONCLUSIONS Women as well as patients with prior CVD have an increased crude risk of 30-day mortality. However, sex-related differences in short term mortality are modulated by the interaction with CVD in STEMI patients. Compared to men, women had a similar prognosis in the subset of patients without CVD, whereas they were associated with a lower risk of mortality among those with prior CVD after adjusting for other prognostic factors.
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Affiliation(s)
- Maribel González-Del-Hoyo
- Servicio de Cardiología, Hospital Universitari Son Espases, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain
| | - Oriol Rodríguez-Leor
- Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain.
| | - Ana Belén Cid-Álvarez
- Servicio de Cardiología, Hospital Clínico de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | | | - Soledad Ojeda
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain
| | - Ana Serrador
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico de Valladolid, Valladolid, Spain
| | - Ramón López-Palop
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Javier Martín-Moreiras
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - José Ramón Rumoroso
- Servicio de Cardiología, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, Spain
| | - Ángel Cequier
- Servicio de Cardiología, Hospital de Bellvitge - IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Borja Ibáñez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, IIS-Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Ignacio Cruz-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Rafael Romaguera
- Servicio de Cardiología, Hospital de Bellvitge - IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sergio Raposeiras-Roubin
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Instituto de Investigación Sanitaria Galicia Sur, Vigo, Pontevedra, Spain
| | - Raúl Moreno
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital de La Paz, Madrid, Spain
| | - Xavier Rossello
- Servicio de Cardiología, Hospital Universitari Son Espases, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
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Amat-Santos IJ, Delgado-Arana JR, Cruz-González I, Gutiérrez H, García-Bolao I, Millán X, Tirado-Conte G, Ruiz-Nodar JM, Mohandes M, Palazuelos J, Torres Saura F, Del Valle R, Valero Picher E, Núñez García JC, Gómez I, Albarrán Rincón R, Arzamendi D, Nombela-Franco L, Korniiko L, Barrero A, Santos-Martínez S, Serrador A, San Román JA. Cardiac amyloidosis and left atrial appendage closure. The CAMYLAAC Study. Rev Esp Cardiol (Engl Ed) 2022:S1885-5857(22)00208-0. [PMID: 35934294 DOI: 10.1016/j.rec.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION AND OBJECTIVES Transthyretin cardiac amyloidosis (ATTR-CA) patients often have atrial fibrillation and increased bleeding/thrombogenic risks. We aimed to evaluate outcomes of left atrial appendage closure (LAAC) compared with patients without a known diagnosis of CA. METHODS Comparison at long-term of patients diagnosed with ATTR-CA who underwent LAAC between 2009 and 2020 and those without a known diagnosis of CA. RESULTS We studied a total of 1159 patients. Forty patients (3.5%) were diagnosed with ATTR-CA; these patients were older and had more comorbidities, higher HAS-BLED and CHA2DS2-VASc scores, and lower left ventricular function. Successful LAAC was achieved in 1137 patients (98.1%) with no differences between groups. Regarding in-hospital and follow-up complications, there were no differences between the groups in ischemic stroke (5% vs 2.5% in those without a known diagnosis of CA; P=.283), hemorrhagic stroke (2.5% and 0.8% in the control group; P=.284), major or minor bleeding. At the 2-year follow-up, there were no significant differences in mortality (ATTR-CA: 20% vs those without known CA: 13.6%, 0.248); however, the at 5-year follow-up, ATTR-CA patients had higher mortality (40% vs 19.2%; P <.001) but this difference was unrelated to hemorrhagic complications or ischemic stroke. CONCLUSIONS LAAC could reduce the risk of bleeding complications and ischemic cerebrovascular events without increasing the rate of early or mid-term complications. Although long-term survival was impaired in ATTR-CA patients, it was comparable to that of patients without a known diagnosis of CA at the 2-year follow-up, suggesting that LAAC for patients with ATTR-CA might not be futile.
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Affiliation(s)
- Ignacio J Amat-Santos
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
| | - José R Delgado-Arana
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Ignacio Cruz-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, Spain
| | - Hipólito Gutiérrez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Ignacio García-Bolao
- Servicio de Cardiología, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
| | - Xavier Millán
- Servicio de Cardiología, Hospital Universitario Sant Pau, Barcelona, Spain
| | | | - Juan Miguel Ruiz-Nodar
- Servicio de Cardiología, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Mohsen Mohandes
- Servicio de Cardiología, Hospital Universitario Joan XXIII, Tarragona, Spain
| | - Jorge Palazuelos
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain; Servicio de Cardiología, Hospital La luz, Madrid, Spain
| | | | - Raquel Del Valle
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Ernesto Valero Picher
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - Itziar Gómez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Dabit Arzamendi
- Servicio de Cardiología, Hospital Universitario Sant Pau, Barcelona, Spain
| | | | - Liza Korniiko
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Alejandro Barrero
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Sandra Santos-Martínez
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Ana Serrador
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - J Alberto San Román
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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Rodríguez-Leor O, Cid-Álvarez AB, Pérez de Prado A, Rosselló X, Ojeda S, Serrador A, López-Palop R, Martín-Moreiras J, Rumoroso JR, Cequier Á, Ibáñez B, Cruz-González I, Romaguera R, Raposeiras S, Moreno R. Analysis of the management of ST-segment elevation myocardial infarction in Spain. Results from the ACI-SEC Infarction Code Registry. Rev Esp Cardiol (Engl Ed) 2022; 75:669-680. [PMID: 35067471 DOI: 10.1016/j.rec.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/25/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION AND OBJECTIVES ST-segment elevation myocardial infarction (STEMI) networks should guarantee STEMI care with good clinical results and within the recommended time parameters. There is no contemporary information on the performance of these networks in Spain. The objective of this study was to analyze the clinical characteristics of patients, times to reperfusion, characteristics of the intervention performed, and 30-day mortality. METHODS Prospective, observational, multicenter registry of consecutive patients treated in 17 STEMI networks in Spain (83 centers with the Infarction Code), between April 1 and June 30, 2019. RESULTS A total of 5401 patients were attended (mean age, 64±13 years; 76.9% male), of which 4366 (80.8%) had confirmed STEMI. Of these, 87.5% were treated with primary angioplasty, 4.4% with fibrinolysis, and 8.1% did not receive reperfusion. In patients treated with primary angioplasty, the time between symptom onset and reperfusion was 193 [135-315] minutes and the time between first medical contact and reperfusion was 107 [80-146] minutes. Overall 30-day mortality due to STEMI was 7.9%, while mortality in patients treated with primary angioplasty was 6.8%. CONCLUSIONS Most patients with STEMI were treated with primary angioplasty. In more than half of the patients, the time from first medical contact to reperfusion was <120 minutes. Mortality at 30 days was relatively low.
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Affiliation(s)
- Oriol Rodríguez-Leor
- Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain.
| | - Ana Belén Cid-Álvarez
- Servicio de Cardiología, Hospital Clínico de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | | | - Xavier Rosselló
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Servicio de Cardiología, Institut d'Investigació Sanitària Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma de Mallorca, Balearic Islands, Spain
| | - Soledad Ojeda
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain
| | - Ana Serrador
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico de Valladolid, Valladolid, Spain
| | - Ramón López-Palop
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Javier Martín-Moreiras
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - José Ramón Rumoroso
- Servicio de Cardiología, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, Spain
| | - Ángel Cequier
- Servicio de Cardiología, Hospital de Bellvitge-IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Borja Ibáñez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Servicio de Cardiología, IIS-Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Ignacio Cruz-González
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Rafael Romaguera
- Servicio de Cardiología, Hospital de Bellvitge-IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sergio Raposeiras
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Instituto de Investigación Sanitaria Galicia Sur, Vigo, Pontevedra, Spain
| | - Raúl Moreno
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital de La Paz, Madrid, Spain
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Cruz-González I, Trejo-Velasco B, Freixa X, Regueiro A, Cubero-Gómez JM, Villa Gil-Ortega M, So CY, Keng W, LuJun C, Lam YY. Double LAmbre technique for percutaneous occlusion of very large left atrial appendages: a case series. EUROINTERVENTION 2022; 18:58-62. [PMID: 34338641 PMCID: PMC9903150 DOI: 10.4244/eij-d-21-00512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ignacio Cruz-González
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca, Salamanca, Spain,Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Blanca Trejo-Velasco
- Cardiology Department, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, San Vicente 182, 37007 Salamanca, Spain
| | - Xavier Freixa
- Cardiology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ander Regueiro
- Cardiology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | | | - Chak-yu So
- Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wu Keng
- Affiliated Hospital of Guangdong Medical University, Guangdong, China
| | - Chen LuJun
- Affiliated Hospital of Guangdong Medical University, Guangdong, China
| | - Yat-yin Lam
- Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, China,Centre Medical Hong Kong, Hong Kong SAR, China
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32
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Mesnier J, Cruz-González I, Arzamendi D, Freixa X, Nombela-Franco L, Peral V, Caneiro-Queija B, Mangieri A, Trejo-Velasco B, Asmarats L, Regueiro A, McInerney A, Mas-Lladó C, Estevez-Loureiro R, Laricchia A, O'Hara G, Rodés-Cabau J. Early Discontinuation of Antithrombotic Treatment Following Left Atrial Appendage Closure. Am J Cardiol 2022; 171:91-98. [PMID: 35317927 DOI: 10.1016/j.amjcard.2022.01.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 01/04/2023]
Abstract
Although antithrombotic treatment is recommended after left atrial appendage closure (LAAC), some patients require discontinuation of antithrombotic treatment after LAAC without evidence on the safety of such a strategy. We sought to evaluate outcomes of patients who had early antithrombotic treatment discontinuation after LAAC. This is a multicenter study including 1,082 patients who underwent successful LAAC. Early discontinuation of antithrombotic treatment was defined as discontinuation of all antiplatelet/anticoagulant treatment within 6 months following the procedure. A propensity-matched analysis was used to compare outcomes of patients with and without early antithrombotic treatment discontinuation. A total of 148 patients (13.7%) had early antithrombotic treatment discontinuation. In the entire population, antithrombotic treatment discontinuation patients exhibited a lower CHA2DS2-VASc score (p <0.001) and a higher rate of previous gastrointestinal bleeding episodes (p = 0.01) compared with patients without discontinuation. After a median follow-up of 2.1 (1,1-3.1) years after antithrombotic treatment discontinuation, the rates of death, ischemic stroke, and major bleeding were 12.1, 0.6, and 3.3 per 100 patient-years. In 119 matched pairs with similar baseline characteristics, antithrombotic treatment discontinuation patients had a similar risk of death (hazard ratio [HR] 1.06, 95% confidence interval [CI] 0.65 to 1.71, p = 0.82), ischemic stroke (HR 0.39, 95% CI 0.04 to 3.79, p = 0.42) and major bleeding (HR 1.48, 95% CI 0.56 to 3.88, p = 0.43) compared with those without discontinuation. In conclusion, antithrombotic treatment was discontinued in 1 of 7 selected patients within 6 months after LAAC, and this was not associated with an increased risk of death or thromboembolic events after a median follow-up of 2 years. These data support the safety of shorter periods of antithrombotic therapy after LAAC in high bleeding risk patients based on clinician judgment. Further trials are warranted.
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García-Guimarães M, Fuertes-Ferre G, Jiménez-Valero S, Lozano Í, Cruz-González I, Cortés C, Portero-Portaz JJ, Valero E, Bastante T, Alfonso F. Characteristics, Acute Results, and Prognostic Impact of Percutaneous Coronary Interventions in Spontaneous Coronary Artery Dissection (from the Prospective Spanish Registry on SCAD [SR-SCAD]). Am J Cardiol 2022; 171:177-178. [PMID: 35321804 DOI: 10.1016/j.amjcard.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/13/2022] [Accepted: 02/16/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Marcos García-Guimarães
- Department of Cardiology, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | | | | | - Íñigo Lozano
- Department of Cardiology, Hospital Universitario de Cabueñes, Gijon, Spain
| | - Ignacio Cruz-González
- Department of Cardiology, Hospital Clínico Universitario de Salamanca, Instituto de Investigación Biosanitaria de Salamanca (IBSAL), CIBERCV, Salamanca, Spain
| | - Carlos Cortés
- Department of Cardiology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Ernesto Valero
- Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Teresa Bastante
- Department of Cardiology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), CIBER-CV, Madrid, Spain
| | - Fernando Alfonso
- Department of Cardiology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), CIBER-CV, Madrid, Spain
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Estévez-Loureiro R, Sánchez-Recalde A, Amat-Santos IJ, Cruz-González I, Baz JA, Pascual I, Mascherbauer J, Abdul-Jawad Altisent O, Nombela-Franco L, Pan M, Trillo R, Moreno R, Delle Karth G, Salido-Tahoces L, Santos-Martinez S, Núñez JC, Moris C, Goliasch G, Jimenez-Quevedo P, Ojeda S, Cid-Álvarez B, Santiago-Vacas E, Jimenez-Valero S, Serrador A, Martín-Moreiras J, Strouhal A, Hengstenberg C, Zamorano JL, Puri R, Íñiguez-Romo A. Six-Month Outcomes of the TricValve® System in Patients with Tricuspid Regurgitation: TRICUS EURO Study. JACC Cardiovasc Interv 2022; 15:1366-1377. [PMID: 35583363 DOI: 10.1016/j.jcin.2022.05.022] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Severe tricuspid regurgitation (TR) is frequently associated with significant morbidity and mortality; such patients often deemed to be at high surgical risk. Heterotopic bi-caval stenting is an emerging, attractive transcatheter solution for these patients. OBJECTIVES To evaluate the 30-day safety and 6-month efficacy outcomes of specifically designed bioprosthetic valves for the superior and inferior vena cava. METHODS TRICUS EURO is a non-blinded, non-randomized, single-arm, multicenter, prospective trial that enrolled patients from 12 European centers between December 2019 to February 2021. High risk individuals with severe symptomatic TR despite optimal medical therapy were included. Primary end point was quality of life (QOL) improvement measured by Kansas City Cardiomyopathy Questionnaire (KCCQ12) and New York Heart Association functional class (NYHA) improvement at 6-month follow-up. RESULTS 35 patients (mean age 76±6.8 years; 83% women) were treated with TricValve® system. All patients at baseline were at NYHA ≥ 3 status. At 30-days, procedural success was 94% with no procedural deaths or conversions to surgery. A significant increase in QOL at 6-months follow-up was observed (baseline and 6-month KCCQ: 42.01±22.3 vs. 59.7±23.6 respectively; p=0.004), correlating with a significant improvement in NYHA functional class with 79.4% of patients noted to be in class I or II at 6 months (p=0.0006). The 6-month all-cause mortality and heart failure hospitalization rates were 8.5% and 20%, respectively. CONCLUSIONS The dedicated bi-caval system for treating severe, symptomatic TR was associated with high procedural success rate and significant increase in both, QOL and functional improvements at 6-months follow-up.
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Affiliation(s)
| | | | | | | | - Jose A Baz
- Complejo Hospitalario Universitario Alvaro Cunqueiro, Vigo, Spain
| | - Isaac Pascual
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Julia Mascherbauer
- Division of Cardiology, Department for Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | | | - Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Manuel Pan
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - Ramiro Trillo
- Hospital Clinico Universitario de Santiago de Compostela, CIBERCV, Santiago, Spain
| | - Raul Moreno
- Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | - Jean C Núñez
- Hospital Clinico Universitario de Salamanca, CIBERCV. IBSAL. Salamanca, Spain
| | - Cesar Moris
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Georg Goliasch
- Division of Cardiology, Department for Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | | | | | - Belén Cid-Álvarez
- Hospital Clinico Universitario de Santiago de Compostela, CIBERCV, Santiago, Spain
| | | | | | - Ana Serrador
- CIBERCV. Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | | | - Christian Hengstenberg
- Division of Cardiology, Department for Internal Medicine II, Medical University of Vienna, Vienna, Austria
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Veas N, Winter J, Soriano F, Valdebenito M, Piccaluga E, Nava S, Muñoz R, Cruz-González I, Puentes A, Lindefjeld D. [Use of anticoagulants in patients with atrial fibrillation undergoing transcatheter aortic valve implantation]. Rev Med Chil 2022; 150:618-624. [PMID: 37906762 DOI: 10.4067/s0034-98872022000500618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/04/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Transcatheter Aortic Valve Implantation (TAVI) is beneficial in patients with symptomatic severe Aortic Stenosis (AS). There is no consensus about the best anticoagulation strategy for patients with a recent TAVI and with atrial fibrillation (AF). Direct oral anticoagulants (DOACs) are effective to prevent embolic events with a significant lower incidence of bleeding. There is scarce evidence about the use of these drugs in patients undergoing TAVI. AIM To assess the management of anticoagulation at the moment of discharge of patients with AF and TAVI. MATERIAL AND METHODS A four question survey was sent to cardiologists involved in TAVI programs in different international centers. RESULTS The survey was answered by 72 interventional cardiologists. Even with the lack of randomized evidence, in most of the scenarios DOACs are prescribed at discharge in patients with indication for anticoagulation. Also, in patients with high bleeding risk, most cardiologists would perform a left atrial appendage closure. In patients with concomitant coronary artery disease, if a stent was recently implanted, prescription of the combination of a DOAC and one antiplatelet drug was the most common answer. In patients with a former coronary angioplasty, DOAC or Warfarin was the therapy of choice. CONCLUSIONS In the absence of randomized data, interventional cardiologists prescribe DOACs at discharge to patients with AF and TAVI, without following current guidelines in most cases.
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Affiliation(s)
| | | | | | | | | | - Stefano Nava
- Gran Ospedale Metropolitano Niguarda, Milán, Italia
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Barrero A, Carrasco-Chinchilla F, Benito-González T, Pascual I, Arzamendi D, Estévez-Loureiro R, Nombela-Franco L, Pan M, Freixa X, Trillo-Nouche R, Sánchez-Recalde Á, Andraka L, Cruz-González I, López-Mínguez JR, Diez Gil JL, Urbano-Carrillo C, Sanmiguel Cervera D, Sanchis J, Bosa F, Ruiz V, del Trigo M, Molina E, Serrador AM, Alonso-Briales JH, Garrote C, Avanzas P, Li CH, Baz JA, Jiménez-Quevedo P, Mesa D, Regueiro A, Cid B, Carrasco-Moraleja M, Rodríguez-Gabella T, Hernández-García JM, Fernández-Vázquez F, Amat-Santos IJ. Cambios en la selección e impacto potencial de los inhibidores de neprilisina y del receptor de la angiotensina en los pacientes sometidos a reparación mitral percutánea borde a borde. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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López-Tejero S, Antúnez-Muiños P, Martín-Moreiras J, Díaz-Peláez E, Herrero-Garibi J, Diego-Nieto A, Núñez-García JC, Rodríguez-Collado J, Sánchez-Fernández PL, Cruz-González I. Mitral Valve in Valve over “invisible” prothesis with thrombus guided by CT-Fluoro fusion. Can J Cardiol 2022; 38:1323-1324. [DOI: 10.1016/j.cjca.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 11/17/2022] Open
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Cepas-Guillen PL, López-Mínguez JR, García JCN, Nombela-Franco L, Benito-González T, Cruz-González I, Freixa X. Left atrial appendage occlusion in hereditary haemorrhagic telangiectasia patients (Rendu Osler Syndrome) with non-valvular atrial fibrillation: Prevention of cardioembolic events while avoiding the long-term risks of oral anticoagulation. Cardiovascular Revascularization Medicine 2022; 43:140-142. [DOI: 10.1016/j.carrev.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/26/2022] [Accepted: 04/12/2022] [Indexed: 11/03/2022]
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López-Tejero S, Núñez-García JC, Antúnez-Muiños P, González-Calle D, Martín-Moreiras J, Diego-Nieto A, Rodríguez-Collado J, Herrero-Garibi J, Sánchez-Fernández PL, Cruz-González I. TAVR to Solve Perceval Sutureless Valve Migration. JACC Cardiovasc Interv 2022; 15:e65-e67. [PMID: 35219616 DOI: 10.1016/j.jcin.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/15/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Affiliation(s)
- Sergio López-Tejero
- Department of Cardiology, Complejo Asistencial Universitario Salamanca, CIBER-CV, IBSAL, Salamanca, Spain.
| | - Jean C Núñez-García
- Department of Cardiology, Complejo Asistencial Universitario Salamanca, CIBER-CV, IBSAL, Salamanca, Spain. https://twitter.com/JeanNunezG
| | - Pablo Antúnez-Muiños
- Department of Cardiology, Complejo Asistencial Universitario Salamanca, CIBER-CV, IBSAL, Salamanca, Spain. https://twitter.com/pjantunez
| | - David González-Calle
- Department of Cardiology, Complejo Asistencial Universitario Salamanca, CIBER-CV, IBSAL, Salamanca, Spain. https://twitter.com/icruzgonzalez
| | - Javier Martín-Moreiras
- Department of Cardiology, Complejo Asistencial Universitario Salamanca, CIBER-CV, IBSAL, Salamanca, Spain. https://twitter.com/jmmoreiras
| | - Alejandro Diego-Nieto
- Department of Cardiology, Complejo Asistencial Universitario Salamanca, CIBER-CV, IBSAL, Salamanca, Spain
| | - Javier Rodríguez-Collado
- Department of Cardiology, Complejo Asistencial Universitario Salamanca, CIBER-CV, IBSAL, Salamanca, Spain
| | - Jesús Herrero-Garibi
- Department of Cardiology, Complejo Asistencial Universitario Salamanca, CIBER-CV, IBSAL, Salamanca, Spain
| | | | - Ignacio Cruz-González
- Department of Cardiology, Complejo Asistencial Universitario Salamanca, CIBER-CV, IBSAL, Salamanca, Spain
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Núņez JC, Diego-Nieto A, Barreiro-Pérez M, Cruz-González I, Martín-Moreiras J. CT-Angiography Fusion During Coronary Chronic Total Occlusion PCI. J Invasive Cardiol 2022; 34:E255-E256. [PMID: 35235534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A 56-year-old male presented with angina pectoris despite optimal medical treatment. A coronary computed tomography angiography revealed a chronic total occlusion of the proximal right coronary artery with a moderately calcified long path, and a chronic total occlusion of the distal circumflex. In selected cases with long occlusions and the need for a hybrid approach, the use of computed tomography angiography fusion could help to identify the right wire position, prevent perforations, reduce the use of contrast and fluoroscopy time, improve patient safety, and increase success rate.
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Affiliation(s)
- Jean C Núņez
- Paseo San Vicente 182, 37007, Cardiology Department, Hospital Universitario de Salamanca, Salamanca, Spain.
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Echarte-Morales J, Minguito-Carazo C, Cepas-Guillén PL, Vallejo García V, Poveda Pinedo ID, Martínez Gómez E, Sánchez Muñoz E, López Benito M, Salazar Rodríguez A, Cruz-González I, Arbas Redondo E, Benito-González T, Guzmán-Bofarull J, Tebar Márquez D, Viana Tejedor A, Sánchez Fernández PL, Sabaté y M, Fernández-Vázquez F. Incidencia, morbimortalidad y manejo del s�ndrome coronario agudo durante el confinamiento por COVID-19. RECIC 2022. [DOI: 10.24875/recic.m22000267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Benito-González T, Quirós A, Torres-Saura F, Cruz-González I, Ruiz-Nodar JM, Pérez de Prado A. Diseño y resultados intermedios del registro de cierre de orejuela izquierda con el dispositivo Watchman en pacientes en hemodiálisis, EPIC06-WATCH-HD. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Benito-González T, Quirós A, Torres-Saura F, Cruz-González I, Ruiz-Nodar JM, Pérez de Prado A. Design and interim results of a registry of left atrial appendage occlusion with the Watchman device in patients on hemodialysis: EPIC06-WATCH-HD. Rev Esp Cardiol (Engl Ed) 2022; 75:179-180. [PMID: 34475001 DOI: 10.1016/j.rec.2021.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Affiliation(s)
| | - Alicia Quirós
- Departamento de Matemáticas, Universidad de León, León, Spain
| | - Francisco Torres-Saura
- Servicio de Cardiología, Hospital Universitario de Elche-Vinalopó, Elche, Alicante, Spain
| | - Ignacio Cruz-González
- Servicio de Cardiología, Hospital Universitario de Salamanca, IBSAL, Instituto de Biomedicina Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Juan M Ruiz-Nodar
- Servicio de Cardiología, Hospital General de Alicante, Alicante, Spain
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Cruz-González I, Torres Saura F, Trejo-Velasco B, Antonio Fernández Díaz J, Fajardo Molina R, del Valle-Fernández R, Moreno Terribas G, Martí Sánchez D, López-Mínguez JR, Gomez-Blazquez I, Sanmartin Pena JC, Botas J, Martin Lorenzo P, Palazuelos J, Albarrán Rincon R, Mohandes M, Rodriguez Entem FJ, Martí G, Valero E, Gutiérrez H, Amat-Santos IJ, Nombela-Franco L, Salinas P, Teruel L, Gomez-Hospital JA, Arzamendi D, Torres Sanabria M, Calle Pérez G, Cañadas Pruaño D, Pérez de Prado A, Benito González T, Arroyo-Úcar E, Estévez-Loureiro R, Caneiro-Queija B, Ibañez Criado JL, Ruiz-Nodar JM. Impact of operatoŕs experience on peri-procedural outcomes with Watchman FLX: Insights from the FLX-SPA registry. Int J Cardiol Heart Vasc 2022; 38:100941. [PMID: 35024431 PMCID: PMC8728396 DOI: 10.1016/j.ijcha.2021.100941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/09/2021] [Accepted: 12/23/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Watchman FLX is a device upgrade of the Watchman 2.5 that incorporates several design enhancements intended to simplify left atrial appendage occlusion (LAAO) and improve procedural outcomes. This study compares peri-procedural results of LAAO with Watchman FLX (Boston Scientific, Marlborough, Massachusetts) in centers with varying degrees of experience with the Watchman 2.5 and Watchman FLX. METHODS Prospective, multicenter, "real-world" registry including consecutive patients undergoing LAAO with the Watchman FLX at 26 Spanish sites (FLX-SPA registry). Implanting centers were classified according to the center's prior experience with the Watchman 2.5. A further division of centers according to whether or not they had performed ≤ 10 or > 10Watchman FLX implants was prespecified at the beginning of the study. Procedural outcomes of institutions stratified according to their experience with the Watchman 2.5 and FLX devices were compared. RESULTS 359 patients [mean age 75.5 (SD8.1), CHA2DS2-VASc 4.4 (SD1.4), HAS-BLED 3.8(SD0.9)] were included. Global success rate was 98.6%, successful LAAO with the first selected device size was achieved in 95.5% patients and the device was implanted at first attempt in 78.6% cases. There were only 9(2.5%) major peri-procedural complications. No differences in efficacy or safety results according to the centeŕs previous experience with Watchman 2.5 and procedural volume with Watchman FLX existed. CONCLUSIONS The Watchman FLX attains high procedural success rates with complete LAA sealing in unselected, real-world patients, along with a low incidence of peri-procedural complications, regardless of operatoŕs experience with its previous device iteration or the number of Watchman FLX devices implanted.
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Affiliation(s)
- Ignacio Cruz-González
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca, Spain
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | | | - Blanca Trejo-Velasco
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca, Spain
| | | | | | | | - Gerardo Moreno Terribas
- Interventional Cardiology Unit, Cardiology Department, University Hospital Clinico San Cecilio Granada, Spain
- Medical School, University of Granada, Spain
| | - David Martí Sánchez
- Cardiology Department, Hospital Central de la Defensa, Madrid, Spain
- Medical School, University of Alcalá, Madrid, Spain
| | - José-Ramón López-Mínguez
- Cardiology Department, Infanta Cristina University Hospital of Badajoz, Spain
- Medical School, University of Extremadura, Badajoz, Spain
| | | | | | - Javier Botas
- Cardiology Department, University Hospital Fundación Alcorcón, Madrid, Spain
- Rey Juan Carlos University School of Medicine, Madrid, Spain
| | - Pedro Martin Lorenzo
- Interventional Cardiology Unit, Cardiology Department, University Hospital of Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain
| | | | - Ramón Albarrán Rincon
- Cardiology and Cardiac Surgery Department, University Clinic of Navarra, Pamplona, Spain
| | - Mohsen Mohandes
- Interventional Cardiology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | | | - Gerard Martí
- Cardiology Department, University Hospital Vall d́Hebron, Barcelona, Spain
| | - Ernesto Valero
- Cardiology Department, Clinic University Hospital of Valencia, Valencia, Spain
| | - Hipólito Gutiérrez
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cardiology Department, Clinic University Hospital of Valladolid, Spain
| | - Ignacio J. Amat-Santos
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cardiology Department, Clinic University Hospital of Valladolid, Spain
| | | | - Pablo Salinas
- Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain
| | - Luis Teruel
- Cardiology Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan-Antoni Gomez-Hospital
- Cardiology Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Dabit Arzamendi
- Cardiology Department, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Mario Torres Sanabria
- Cardiology Department, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | | | - Eduardo Arroyo-Úcar
- Interventional Cardiology Unit, University Hospital del Vinalopó, Elche, Spain
| | | | | | - Jose L. Ibañez Criado
- Cardiology Department, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Spain
| | - Juan M. Ruiz-Nodar
- Cardiology Department, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, Spain
- Facultad de Medicina, Universidad Miguel Hernández, Sant Joan, Alicante, Spain
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Trejo-Velasco B, Cruz-González I, Barreiro-Pérez M, Díaz-Peláez E, García-González P, Martín-García A, Eiros R, Merchán-Gómez S, Pérez del Villar C, Fabregat-Andrés O, Ridocci-Soriano F, Sánchez PL. Mean Velocity of the Pulmonary Artery as a Clinically Relevant Prognostic Indicator in Patients with Heart Failure with Preserved Ejection Fraction. J Clin Med 2022; 11:jcm11030491. [PMID: 35159943 PMCID: PMC8836987 DOI: 10.3390/jcm11030491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Right ventricular (RV) to pulmonary circulation (PC) coupling can stratify prognosis in heart failure (HF). In this study, we assessed the prognostic role of the mean velocity of the pulmonary artery (mvPA) determined by cardiac magnetic resonance (CMR) in HF with preserved ejection fraction (HFpEF). Methods: Inclusion of 58 HFpEF outpatients that underwent CMR with measurement of RV–PC coupling parameters including mvPA between 2016 and 2019. The primary combined endpoint was a composite of HF readmissions and all-cause mortality. Results: Optimal cut-off value of mvPA calculated by receiver operating curve for the prediction of the primary endpoint was 9 cm/s. Over a median follow-up of 23 months (interquartile range: 24), 21 patients met the primary endpoint. The primary endpoint was more frequent in patients with mvPA ≤ 9 cm/s, as indicated by Kaplan–Meier survival curves; Log-Rank: 9.193, p = 0.02, regardless of RV dysfunction. On Cox multivariate analysis, mvPA ≤ 9 cm/s emerged as an independent prognostic predictor of the primary endpoint (HR: 4.11, 95% CI: 1.28–13.19, p = 0.017), together with left atrial area by CMR (HR: 1.08, 95% CI: 1.01–1.24, p = 0.034). Conclusions: In our HFpEF cohort, mvPA was associated with a higher rate of the primary endpoint, regardless of RV function, thus enabling identification of patients at higher risk of cardiovascular events before structural damage onset.
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Affiliation(s)
- Blanca Trejo-Velasco
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (I.C.-G.); (M.B.-P.); (E.D.-P.); (A.M.-G.); (R.E.); (S.M.-G.); (C.P.d.V.); (P.L.S.)
- Correspondence: or
| | - Ignacio Cruz-González
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (I.C.-G.); (M.B.-P.); (E.D.-P.); (A.M.-G.); (R.E.); (S.M.-G.); (C.P.d.V.); (P.L.S.)
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
| | - Manuel Barreiro-Pérez
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (I.C.-G.); (M.B.-P.); (E.D.-P.); (A.M.-G.); (R.E.); (S.M.-G.); (C.P.d.V.); (P.L.S.)
- Cardiology Department, University Hospital Alvaro Cunqueiro, 36213 Vigo, Spain
| | - Elena Díaz-Peláez
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (I.C.-G.); (M.B.-P.); (E.D.-P.); (A.M.-G.); (R.E.); (S.M.-G.); (C.P.d.V.); (P.L.S.)
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
| | | | - Ana Martín-García
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (I.C.-G.); (M.B.-P.); (E.D.-P.); (A.M.-G.); (R.E.); (S.M.-G.); (C.P.d.V.); (P.L.S.)
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
| | - Rocío Eiros
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (I.C.-G.); (M.B.-P.); (E.D.-P.); (A.M.-G.); (R.E.); (S.M.-G.); (C.P.d.V.); (P.L.S.)
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
| | - Soraya Merchán-Gómez
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (I.C.-G.); (M.B.-P.); (E.D.-P.); (A.M.-G.); (R.E.); (S.M.-G.); (C.P.d.V.); (P.L.S.)
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
| | - Candelas Pérez del Villar
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (I.C.-G.); (M.B.-P.); (E.D.-P.); (A.M.-G.); (R.E.); (S.M.-G.); (C.P.d.V.); (P.L.S.)
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
| | | | - Francisco Ridocci-Soriano
- Cardiology Department, General University Hospital of Valencia, 46014 Valencia, Spain;
- Department of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Pedro L. Sánchez
- Cardiology Department, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (I.C.-G.); (M.B.-P.); (E.D.-P.); (A.M.-G.); (R.E.); (S.M.-G.); (C.P.d.V.); (P.L.S.)
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), 28029 Madrid, Spain
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Trejo-Velasco B, Diego-Nieto A, C. Núñez J, Herrero-Garibi J, Cruz-González I, Martín-Moreiras YJ. Eficacia y seguridad del acceso transradial en el intervencionismo coronario percut�neo de oclusiones totales cr�nicas. RECIC 2022. [DOI: 10.24875/recic.m20000167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Benito-González T, Carrasco-Chinchilla F, Estévez-Loureiro R, Pascual I, Arzamendi D, Garrote-Coloma C, Nombela-Franco L, Pan M, Serrador A, Freixa X, Cid Alvarez AB, Hernández Antolín RA, Andraka L, Cruz-González I, López-Minguez JR, Díez Gil JL, Urbano-Carrillo C, Sanmiguel Cervera D, Sanchís J, Bosa F, Ruíz V, Molina E, Becerra-Muñoz VM, Gualis J, Avanzas P, Li CH, Baz JA, Jimenez-Quevedo P, Mesa D, Amat-Santos IJ, Regueiro A, Trillo R, Domínguez Franco AJ, Alonso-Briales JH, Fernández-Vázquez F. Clinical and echocardiographic outcomes of transcatheter mitral valve repair in atrial functional mitral regurgitation. Int J Cardiol 2021; 345:29-35. [PMID: 34610357 DOI: 10.1016/j.ijcard.2021.09.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/11/2021] [Accepted: 09/27/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Isolated atrial fibrillation can cause mitral regurgitation (MR) in patients with normal left ventricular systolic function and no organic disease of the mitral valve. Little information is available regarding outcomes of Mitraclip in patients with atrial functional mitral regurgitation (AFMR). We aimed to evaluate 12-month clinical and echocardiographic outcomes of transcatheter mitral valve repair (TMVR) with MitraClip in patients with AFMR compared to those with ventricular functional or degenerative/mixed MR. METHODS Registry-based analysis of all consecutive patients who underwent TMVR and were included in the Spanish Registry of Mitraclip. Changes in MR and NYHA functional class, and a combined endpoint including all-cause mortality and hospitalizations due to heart failure were the main outcomes. RESULTS Overall, 1074 (69.1% male, 73.3 ± 10.2 years-old) patients were analyzed in this report. 48 patients (4.5%) presented AFMR. AFMR was significantly reduced after TMVR, with a procedural success rate of 91.7%, and this reduction persisted at 12-month (p < 0.001). Patients with AFMR showed a significant functional improvement at 6- and 12-month follow-up in our series (baseline: NYHA III 70.8% IV 18.8% vs. 1-year: NYHA III 21.7% IV 0%; p < 0.001). The probability of survival free of readmission for heart failure and all-cause mortality within the first year after TMVR was 74.9%. Procedural and clinical outcomes, as well as recurrent rates of MR were similar acutely and at 1-year compared to other etiologies. CONCLUSION TMVR in patients with AFMR showed no significant differences compared to ventricular functional or degenerative/mixed MR regarding MR reduction or clinical outcomes.
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Affiliation(s)
| | - Fernando Carrasco-Chinchilla
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, CIBERCV, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
| | | | - Isaac Pascual
- Heart Area, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Dabit Arzamendi
- Division of Interventional Cardiology, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain
| | | | - Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Manuel Pan
- Department of Cardiology, Hospital Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Ana Serrador
- Department of Cardiology, University Clinic Hospital, CIBERCV, Valladolid, Spain
| | - Xavier Freixa
- Department of Cardiology, Cardiovascular Institute, Hospital Clínic, Barcelona, Spain
| | - Ana Belén Cid Alvarez
- Department of Cardiology, University Clinic Hospital, CIBERCV, Santiago de Compostela, Spain
| | | | - Leire Andraka
- Department of Cardiology, Hospital Universitario de Basurto, Bilbao, Spain
| | - Ignacio Cruz-González
- Department of Cardiology, Hospital Universitario de Salamanca, CIBERCV, IBSAL, Salamanca, Spain
| | | | - José Luis Díez Gil
- Department of Cardiology, Hospital Universitario y Politécnico La FE, Valencia, Spain
| | | | - Darío Sanmiguel Cervera
- Unidad de Hemodinámica y Cardiologia Intervencionista, Hospital General de Valencia, Valencia, Spain
| | - Juan Sanchís
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, CIBERCV, Valencia, Spain
| | - Francisco Bosa
- Department of Cardiology, Hospital Universitario de Canarias, Islas Canarias, Spain
| | - Valeriano Ruíz
- Department of Cardiology, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Eduardo Molina
- Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Víctor Manuel Becerra-Muñoz
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, CIBERCV, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
| | - Javier Gualis
- Department of Cardiology, University Hospital of León, León, Spain
| | - Pablo Avanzas
- Heart Area, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Chi Hion Li
- Division of Interventional Cardiology, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - José Antonio Baz
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain
| | | | - Dolores Mesa
- Department of Cardiology, Hospital Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | | | - Ander Regueiro
- Department of Cardiology, Cardiovascular Institute, Hospital Clínic, Barcelona, Spain
| | - Ramiro Trillo
- Department of Cardiology, University Clinic Hospital, CIBERCV, Santiago de Compostela, Spain
| | - Antonio Jesús Domínguez Franco
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, CIBERCV, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
| | - Juan Horacio Alonso-Briales
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, CIBERCV, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
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Rodríguez-Leor O, Cid-Álvarez AB, Pérez de Prado A, Rosselló X, Ojeda S, Serrador A, López-Palop R, Martín-Moreiras J, Rumoroso JR, Cequier Á, Ibáñez B, Cruz-González I, Romaguera R, Raposeiras S, Moreno R. Análisis de la atención al infarto con elevación del segmento ST en España. Resultados del Registro de Código Infarto de la ACI-SEC. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2021.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Romaguera R, Ojeda S, Cruz-González I, Moreno R, Guisado Rasco A, Gutiérrez-Barrios A, Gómez-Menchero A, Morales Ponce FJ, Sánchez Burguillos FJ, Oneto J, Caballero Borrego J, Sánchez Gila J, Bullones Ramírez JA, Fernández JC, Alonso Briales JH, Íñigo García LA, Vizcaíno Arellano M, Fajardo Molina R, Ojeda S, Ramírez-Moreno A, Suárez de Lezo J, García-Borbolla Fernández R, Camacho Freire SJ, Ballesteros Pradas SM, Lozano I, Avanzas P, Bango MJ, Bosa Ojeda F, Jiménez Cabrera FM, Martin Lorenzo P, Pimienta González R, Rihawi ZK, Zueco J, Sánchez Pérez I, Jiménez-Mazuecos J, Novo García E, Moreu Burgos J, Pérez de Prado A, Cruz-González I, Amat-Santos IJ, Robles Alonso J, Vaquerizo B, García del Blanco B, Bosch Peligero E, Roura G, Mohandes M, Bassaganyas J, Casanova-Sandoval JM, Sabaté M, Carrillo Suárez X, García Picart J, Muñoz Camacho JF, Carballo Garrido J, Sanchis J, Berenguer Jofresa A, Planas del Viejo AM, Frutos García A, Pomar Domingo F, Torres Saura F, Díez Gil JL, Ruiz Nodar JM, Jerez Valero M, Aguar P, Tejedor P, López Palop R, Mainar V, Merchán Herrera A, Fernández Portales J, Rama Merchán JC, Baz JA, Trillo Nouche R, Calviño Santos R, Ocaranza R, Peña G, Gómez Jaume A, Bethencourt A, Vera Pernasetti L, Portero Pérez MP, Sánchez-Recalde Á, Rivero Crespo F, Sarnago Cebada F, Elízaga J, Franco Peláez JA, Oteo Domínguez JF, García JR, Hernando Marrupé L, Pérez Vizcayno MJ, Moreno R, Sánchez-Aquino González R, Álvarez Antón S, Rubio Alonso B, Macaya C, Alegría Barrero E, García E, Hernández Hernández F, Palazuelos Molinero J, Unzué L, Vázquez Álvarez ME, Pinar Bermúdez E, Lacunza Ruiz FJ, Ruiz Quevedo V, Artaiz Urdaci M, Torres Bosco AM, Subinas Elorriaga A, Garcia San Román K, Saez Moreno R, Andraka L, Larman Tellechea M, Diarte de Miguel JA, Ruiz Arroyo JR. Spanish Cardiac Catheterization and Coronary Intervention Registry. 30th Official Report of the Interventional Cardiology Association of the Spanish Society of Cardiology (1990-2020) in the year of the COVID-19 pandemic. Revista Española de Cardiología (English Edition) 2021; 74:1095-1105. [PMID: 34782287 PMCID: PMC8552543 DOI: 10.1016/j.rec.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/04/2021] [Indexed: 11/13/2022]
Abstract
Introduction and objectives The Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) presents its annual activity report for 2020, the year of the coronavirus disease (COVID-19) pandemic. Methods All Spanish centers with catheterization laboratories were invited to participate. Data were collected online and were analyzed by an external company, together with the members of the ACI-SEC. Results A total of 123 centers participated (4 more than 2019), of which 83 were public and 40 were private. Diagnostic coronary angiograms decreased by 9.4%, percutaneous coronary interventions by 10.1%, primary percutaneous coronary interventions by 4.1%, transcatheter aortic valve replacements by 0.9%, and left atrial appendage closure by 8.3%. The only procedures that increased with respect to previous years were edge-to-edge mitral valve repair (13.8%) and patent foramen ovale closure (19.4%). The use of pressure wire (5.5%), intravascular imaging devices and plaque preparation devices decreased (with the exception of lithotripsy, which increased by 62%). Conclusions In the year of the COVID-19 pandemic, the registry showed a marked drop in activity in all procedures except for percutaneous mitral valve repair and patent foramen ovale closure. This decrease was less marked than previously described, suggesting a rebound in interventional activity after the first wave.
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Salinas P, Vilchez-Tschischke JP, Noriega F, Macaya F, Rosillo S, García-Camarero T, de la Torre-Hernández JM, de Tapia B, Jiménez-Kockar M, Regueiro A, Flores-Umanzor E, García-Blas S, González-D'Gregorio J, Gómez-Menchero AE, Díaz-Fernandez JF, Rondán J, Amat-Santos I, Ojeda S, Diez-Gil JL, de Miguel Castro A, Lozano Ruiz-Poveda F, Fernández-Diaz JA, Manzano MC, Cruz-González I, Pascual Tejerina V, García Pérez-Velasco J, Serra A, Poveda-Andrés JL, Macaya C, Escaned J. Design and rationale for a real-world prospective, multicenter registry of myocardial revascularization failure and secondary revascularization: The REVASEC study. Cardiovasc Revasc Med 2021; 40:50-56. [PMID: 34857473 DOI: 10.1016/j.carrev.2021.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 11/03/2022]
Abstract
AIM To investigate key aspects of the problem of myocardial revascularization failure (MRF) and repeat or secondary myocardial revascularization (SR) in contemporary practice. METHODS The registry of secondary revascularization (REVASEC) is an investigator-initiated, multicenter, prospective registry enhanced with data monitoring and independent event adjudication (ClinicalTrials.govNCT03349385). It includes patients with prior revascularization referred to coronary angiography for suspected MRF with broad inclusion criteria. The main objectives are to describe the characteristics of patients with prior revascularization referred for repeat angiography, to describe and the rate and mechanisms of MRF (stent or graft failure, coronary artery disease progression or residual coronary artery disease); to evaluate the management including medical treatment and SR of these patients; and to assess the prognosis according to the outlined causative mechanisms. The registry has one year follow up for the primary endpoint (Patient-oriented composite endpoint including all-cause death, any myocardial infarction or any new unplanned revascularization according to subsets of MRF), but extended follow-up will be carried out up to 5 years. CONCLUSION The REVASEC Registry will provide updated data on the characteristics, patterns of treatment, and 1-year outcomes of patients with MRF and SR in contemporary clinical practice.
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Affiliation(s)
- Pablo Salinas
- Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Jean Paul Vilchez-Tschischke
- Hospital Universitario y Politécnico La Fe, Valencia, Spain; Complejo Hospitalario Ruber Juan Bravo, Madrid, Spain
| | - Francisco Noriega
- Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Fernando Macaya
- Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | - Juan Rondán
- Hospital Universitario de Cabueñes, Gijón, Spain
| | | | - Soledad Ojeda
- Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimonides de Investigación Biomédica (IMIBIC), Universidad de Cordoba, Spain
| | | | | | | | | | | | | | | | | | - Antonio Serra
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Carlos Macaya
- Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Javier Escaned
- Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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