Browsing by Author "Valdés E., Francisco"

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    Interrupción de la vena cava inferior mediante filtros de inserción percutánea: Indicaciones y resultados en 287 pacientes
    (SOC MEDICA SANTIAGO, 2007) Arriagada J., Ivette; Mertens M., Renato; Valdés E., Francisco; Kramer S., Albrecht; Marine M., Leopoldo; Bergoeing R., Michel; Soto G., Sebastian; Vergara G., Jeannette; Valdebenito G., Magaly
    Background: Anticoagulation is the treatment of choice for deep vein thrombosis (DVI) and pulmonary embolism, (PE). Occasionally this treatment is contraindicated or fails to prevent PE In these patients, inferior vena caval (IVC) interruption is indicated and insertion of a filter is the most commonly performed procedure. Aim: To report the experience with IVC filters. Material and methods: Retrospective review of all medical records and operative protocols of patients subjected to IVC filter implantations. Follow up was performed by telephone contact with the patients relatives or primary physicians, ambulatory consultation or by death certificates. Results: During the period 1993-2005 we implanted IVC filters on 287 patients, 55.4% male average age, 62.1 yrs (17-99). Indications for the procedure were DVT or PE and contraindication of anticoagulation in 141 patient, (49.1%), DVT or PF and complication of anticoagulation in 65 patients (22.6%). prophylaxis in 39 patients (13.6%), PF or poor respiratory function in 31 patients (10.8%), paradoxal emboli in 4 patients (1.4%) and other causes in seven patients. All percutaneous devices were successfully inserted, There was no morbidity or mortality related to the procedure. ne most frequent access site was the internal jugular vein (66.6%). In 24 patients (8.4%) the filter was intentionally deployed above the renal veins. Six patients (2.1%) were lost to follow up after discharge. A mean follow up of 41.5 months was achieved. Ninety one patients died, with a 5 years survival of 64.7%. Symptomatic recurrent PE occurred in 6 patients (2.1%) and was The cause of death on 3 of them (1%), DVT has been detected in 22 patients (7.7%) during the follow up period. Conclusions. IVC filter implantation is a safe and effective short and long term measure to Prevent PE and its consequences.
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    Results of the surgical management of abdominal aortic eurysms in 80 patients over 80 years of age
    (2003) Valdés E., Francisco; Bergoeing Reid, Michel Paul; Kramer, Albrecht; Mertens Martin, Renato; Canessa, Roberto; Lema F., Guillermo; Garayar Pulgar, Bernardita; Urzua Urzua, Jorge
    Background: Abdominal aortic aneurysms (AAA) may be lethal unless appropriately and timely treated. Since age is a surgical risk, octogenarians are usually not considered as candidates for surgical intervention. Aim: To asses surgical complications and mortality in octogenarians treated for AAA. Subjects and Methods: Patients aged 80 years older, treated consecutively between 1984-2001 were retrospectively analyzed. Results: Sixty one patients were male, and their age ranged from 80 to 95 years. All were treated with open surgery. The operation was elective in 58 and as an emergency in 22 patients (symptomatic or ruptured AAA). Aortic diameter was 6.8+/-1.4 cm in asymptomatic patients and 7.7+/-1.8 cm in emergency cases (p=0.024). Thirty days postoperative mortality was 5.1% in elective surgery compared to 40.6% in emergency operations (p < 0.01). Five years survival rate was 44.7% in asymptomatic patients compared to 10.4% in the emergency cases (p < 0.023). Conclusions: Elective surgery for asymptomatic AAA can be performed with low operative mortality in octogenarians. However, surgery in emergency cases has an 8 fold increase in risk. Accordingly, octogenarian patients should be considered for elective AAA repair in a selective basis.
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    Three Cases of Intracardiac Leiomyomatosis with Very Long-term Follow-up
    (Korean Society for Vascular Surgery, 2024) González Urquijo, Mauricio; Valdés E., Francisco; Mertens Martin, Renato; Mariné M., Leopoldo; Vargas Serrano, José Francisco; Bergoeing Reid, Michel Paul
    Uterine intravascular leiomyomatosis (IVL) with extension into the right heart is uncommon, with no more than 400 cases reported in the literature since 1907. The present study aims to report three patients with intracardiac IVL surgically treated in our institution, with long-term follow-up. Three female patients in their third to fifth decades of life, with a history of difficult hysterectomy due to extensive myomatosis, presented with symptoms of right-sided heart failure. Echocardiography and computed tomography were performed, where IVL extending from the pelvis into the right heart was observed. All three patients underwent a one-stage operation under extracorporeal circulation through a right auriculotomy and inferior vena cavotomy, accessed via a sterno-laparotomy. The tumors were extirpated without complications, with ligation of the vena cava or iliac vein. The patients at 10-, 13-, and 37-year follow-up were well and alive with mild lower extremities symptoms.