Browsing by Author "Fuensalida A."

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Left and right internal mammary artery angioplasties in a 3-year-old patient with Kawasaki disease and failed coronary artery bypass graft surgery
    (Arquivos Brasileiros de Cardiologia, 2020) Hameau R.; Springmuller D.; Garay F.; Fuensalida A.; Martinez G.
  • Thumbnail Image
    Item
    Procedural and clinical benefits of selective thrombus aspiration in primary PCI. Insights from the TAPER Registry
    (Permanyer Publications, 2019) Jurado-Roman A.; Abellan J.; Lopez-Lluva M.T.; Sanchez-Perez I.; Lozano F.; Montero-Cabezas J.M.; Schalij M.J.; Martinez G.; Fuensalida A.; de Nicolas J.M.M.; de Labriolle A.
    © 2019 Permanyer Publications. All rights reserved.Introduction and objectives: After the results of several randomized trials, routine thrombus aspiration (TA) has remained out of the spotlight after not improving the prognosis of patients with ST-segment elevation myocardial infarction and even increasing their complications. The goal here was to assess the impact of selective TA during primary percutaneous coronary intervention (pPCI), its safety and clinical benefits at 1-year follow-up. Methods: The TAPER registry (efficacy and safety of selective Thrombus Aspiration in Real clinical Practice) retrospectively included patients with ST-segment elevation myocardial infarction treated with pPCI. The clinical and procedural characteristics and the composite endpoint of cardiovascular mortality, non-fatal myocardial infarction, stent thrombosis, target lesion revascularization or stroke were evaluated after at 1-year follow-up. Results: 687 patients (76.9% males, 64 ± 12 years) were analyzed. The TA was performed in 40.3% of cases (in 89.9% as the initial strategy and in 10.1% as the bailout strategy) and it was successful in 93.8% of them. The most important predictor of TA use was a higher initial Thrombolysis in Myocardial Infarction (TIMI) thrombus grade (OR, 3.2; 95%CI, 2.5-3.9; P < .0001). TA achieved a significant improvement of TIMI-flow (2.4 points) and a significant reduction of the TIMI thrombus grade (2.6 points). At 1-year follow-up, no stroke was observed in the TA-group and the rate of the composite endpoint (cardiovascular mortality, non-fatal myocardial infarction, stent thrombosis, target lesion revascularization or stroke) was similar in both groups (TA-group 8% vs non-TA-group 5.7%; P = .24). Conclusions: Selective TA is frequently used in the current clinical practice with a high success rate and a low rate of associated complications. It significantly reduces thrombotic burden and improves coronary flow. At 1-year follow-up, a similar rate of adverse events was observed regardless of the use of TA.
  • No Thumbnail Available
    Item
    Transcatheter aortic-valve implantation. A ten years clinical experienceResultados del implante percutáneo de válvula aórtica (TAVI). Experiencia después de la primera década desde la introducción de la técnica
    (Springer, 2022) Martinez G.; Fuensalida A.; Sepulveda P.; Bulnes J.F.; Quitral J.; Pacheco F.; Valenzuela E.; Lazen R.; Flores A.; Zalaquett R.; Martinez A.; CEDEUS (Chile)
    © 2022 Sociedad Medica de Santiago. All rights reserved.Background: Transcatheter aortic-valve implantation (TAVI) was introduced in 2002 and the first implants in our country were performed in 2010. Aim: To review the TAVI experience in our hospital, considering the technology improvements and gained experience throughout this period. Material and Methods: All patients undergoing TAVI in our center were included. Results and complications were adjudicated according to the Valve Academic Research Consortium-2 (VARC-2) criteria. Patients were divided in 3 groups, according to procedural year: Period 1: 2010-2015 (n = 35); Period 2: 2016-2018 (n = 35); Period 3: 2019-2021 (n = 41). Mortality up to one year after the procedure was recorded. Results: Between 2010 and 2021, 111 TAVI procedures were performed. The mean age of patients was 82 years and 47% were women. Risk scores for in-hospital mortality were STS 6.7%, EUROSCORE II 8.0% and ACC/STS TAVR Score 4.9%. The trans-femoral route was used in 88% and a balloon-expandable valve was chosen in 82% of patients. A successful implant was achieved in 96%, with an in-hospital mortality of 1.8%. Mortality at 30 days and 1-year were 2.7 and 9.0%, respectively. During period 3, 100% of implants were successful, with no in-hospital mortality, less vascular complications (p < 0.01), less stroke (p = 0.04), less severe paravalvular leak (p = 0.01) and significantly lower rate of acute complications (p < 0.01). Conclusions: TAVI achieves excellent results. With greater experience and better available technologies, these results are even more favorable.