Browsing by Author "Besa, Santiago"

Now showing 1 - 8 of 8
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    Cardiogenic shock due to arrhythmia-induced cardiomyopathy and its recovery after radiofrequency ablation under extracorporeal membrane oxygenation support
    (Elsevier B.V., 2022) Sanhueza, Sebastián; Vergara, Ismael; Bittner, Alex; Paredes, Alejandro; Garrido, Luis; Besa, Santiago; Castillo, Josefina; Acevedo, Mónica
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    Case report: Multi-site perfusion strategy for type A acute aortic dissection complicated with cerebral malperfusion
    (2023) Besa, Santiago; Castelli, Fiorenza; Garrido-Olivares, Luis; Gonzalez, Rodrigo; Marine, Leopoldo; Becker, Pedro
    Acute type A dissection presenting with cerebral malperfusion has high morbidity and mortality. Given the complexity of underlying vascular involvement, it is a challenging clinical scenario. Many of these patients are not deemed surgical candidates. If surgery is considered, it often requires complex aortic arch and neck vessel reconstruction. We present a 48-year-old male with an acute type A aortic dissection that presented with paraplegia and decreased level of consciousness. A Computed Tomography showed occlusion of both common carotid arteries. He was successfully treated with a multi-site perfusion strategy and a Hybrid Frozen Elephant Trunk graft to achieve fast restoration of the cerebral circulation and minimize brain ischemia and permanent neurological damage. From this case, we learn that aggressive arch and neck vessel reconstruction supported by multi-site perfusion could help improve mortality and neurological outcomes in selected patients.
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    Extracorporeal membrane oxygenation for tuberculosis pneumonia with empyema
    (2021) Besa, Santiago; Morales, Alvaro J.; Salas, Patricio; Bravo M, Sebastian; Garrido-Olivares, Luis
    Acute respiratory distress syndrome (ARDS) caused by Mycobacterium Tuberculosis (TB) is a rare entity. Extracorporeal membrane oxygenation (ECMO) therapy had been used as an effective therapy for this cases, but the evidence is scarce. We present a case that took place in the middle of SARS-CoV2 pandemic. A 33-year-old female presented with ARDS due to pulmonary TB infection (pneumonia with empyema and pneumothorax), which required invasive mechanical ventilation with poor response. Long term veno-arterio-venous (VAV) ECMO, overlapped with veno-venous ECMO, was used as a salvage therapy with a good response for a total of 26 days. This is an example of the effectiveness of this therapy in this scenario, never described before. The fact that this therapy was used in the middle of SARS-CoV2 pandemic, with limited resources available, was remarkable, but it was encouraged by previous successful experiences.
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    Extracorporeal membrane oxygenation for tuberculosis-related acute respiratory distress syndrome: An international multicentre retrospective cohort study
    (2024) Ait Hssain, Ali; Petit, Matthieu; Wiest, Clemens; Simon, Laura; Al-Fares, Abdulrahman A.; Hany, Ahmed; Garcia-Gomez, Dafna I.; Besa, Santiago; Nseir, Saad; Guervilly, Christophe; Alqassem, Wael; Lesouhaitier, Mathieu; Chelaru, Adrian; Sin, Simon W.; Roncon-Albuquerque, Roberto; Giani, Marco; Lepper, Philipp M.; Lavillegrand, Jean-Rémi; Park, Sunghoon; Schellongowski, Peter; Fawzy Hassan, Ibrahim; Combes, Alain; Sonneville, Romain; Schmidt, Matthieu; Salas Villarroel, Patricio; Bravo Morales, Sebastián
    Abstract Objective To report the outcomes of patients with severe tuberculosis (TB)-related acute respiratory distress syndrome (ARDS) on extracorporeal membrane oxygenation (ECMO), including predictors of 90-day mortality and associated complications. Methods An international multicenter retrospective study was conducted in 20 ECMO centers across 13 countries between 2002 and 2022. Results We collected demographic data, clinical details, ECMO-related complications, and 90-day survival status for 79 patients (median APACHE II score of 20 [25th to 75th percentile, 16 to 28], median age 39 [28 to 48] years, PaO2/FiO2 ratio of 69 [55 to 82] mmHg before ECMO) who met the inclusion criteria. Thoracic computed tomography showed that 61 patients (77%) had cavitary TB, while 18 patients (23%) had miliary TB. ECMO-related complications included major bleeding (23%), ventilator-associated pneumonia (41%), and bloodstream infections (32%). The overall 90-day survival rate was 51%, with a median ECMO duration of 20 days [10 to 34] and a median ICU stay of 42 days [24 to 65]. Among patients on VV ECMO, those with miliary TB had a higher 90-day survival rate than those with cavitary TB (90-day survival rates of 81% vs. 46%, respectively; log-rank P = 0.02). Multivariable analyses identified older age, drug-resistant TB, and pre-ECMO SOFA scores as independent predictors of 90-day mortality. Conclusion The use of ECMO for TB-related ARDS appears to be justifiable. Patients with miliary TB have a much better prognosis compared to those with cavitary TB on VV ECMO.
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    Gastrointestinal neuroendocrine tumor with unresectable liver metastases : an example of multimodal therapeutic approach
    (2015) Martínez Castillo, Jorge; Besa, Santiago; Arab Verdugo, Juan Pablo; Quintana, Juan Carlos; Regonesi, Carlos; Huete, Isidro; Jarufe Cassis, Nicolás; Guerra Castro, Juan Francisco; Benítez, Carlos; Arrese Jiménez, Marco; Martínez Castillo, Jorge; Besa, Santiago; Arab Verdugo, Juan Pablo; Quintana, Juan Carlos; Regonesi, Carlos; Huete, Isidro; Jarufe Cassis, Nicolás; Guerra Castro, Juan Francisco; Benítez, Carlos; Arrese Jiménez, Marco
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    Reparación valvular mitral en insuficiencia mitral degenerativa : Reparabilidad, resultados inmediatos y seguimiento hasta 20 años
    (2015) Gonzalo, Latorre; Almeida Z., Josefina; Besa, Santiago; Córdova Alvestegui, Samuel Edmundo; Zalaquett Sepúlveda, Ricardo
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    Resultados de un programa nacional de trasplante cardiaco pediátrico: fortalezas y debilidades. Results of a national program of pediatric heart transplantation: strengths and weakness.
    (2017) Becker Rencoret, Pedro Antonio; Besa, Santiago; Riveros, Sergio; González Foretic, Rodrigo Vicente; Navia, Alfonso; Dellepiane, Paulina; Springmüller P., Daniel; Urcelay Montecinos, Gonzalo
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    Venoarterial Extracorporeal Membrane Oxygenation as A Bridge to Surgery in Post-Myocardial Infarction Ventricular Septal Defect with Cardiogenic Shock: Case Report
    (2023) Besa, Santiago; Walbaum, Jonathan; Gonzalez, Rodrigo; Baraona, Fernando; Garrido-Olivares, Luis
    We describe a 60-year-old woman with post-myocardial infarction (MI) ventricular septal defect (VSD) and cardiogenic shock who was successfully stabilized with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge therapy for the surgical closure of her VSD. This case highlights the role of VA-ECMO in the management of post-MI VSD to improve the results of surgical repair and patient survival.