Pub Date : 2026-01-01DOI: 10.1016/j.circv.2025.11.001
Juan Antonio Margarit Calabuig
{"title":"Más allá del acto quirúrgico: bienestar físico y emocional en la recuperación intensificada de la cirugía cardiaca (RICC)","authors":"Juan Antonio Margarit Calabuig","doi":"10.1016/j.circv.2025.11.001","DOIUrl":"10.1016/j.circv.2025.11.001","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 1","pages":"Pages 1-2"},"PeriodicalIF":0.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.circv.2024.11.005
Miguel A. Medina-Andrade , Jaime Lopez-Taylor , David Ramírez-Cedillo , Ítalo D. Masini-Aguilera , Carlos A. Jimenez-Fernandez , Miguel Angel Matos Hernandez , Rocio A. Peña-Juárez
{"title":"Origen anómalo de la rama pulmonar derecha de la aorta ascendente: una cardiopatía poco común","authors":"Miguel A. Medina-Andrade , Jaime Lopez-Taylor , David Ramírez-Cedillo , Ítalo D. Masini-Aguilera , Carlos A. Jimenez-Fernandez , Miguel Angel Matos Hernandez , Rocio A. Peña-Juárez","doi":"10.1016/j.circv.2024.11.005","DOIUrl":"10.1016/j.circv.2024.11.005","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 6","pages":"Pages 319-321"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.circv.2024.11.007
Eduardo Segovia-Vergara, Javiera Villota-Neumann, Erick Rivera-Soto, Paolo Bozzo-Camponovo
Introduction
Carotid body tumor (CBT) is a type of paraganglioma, with an incidence of 3-4 per 100,000 inhabitants per year. These tumors are often diagnosed incidentally, though they may present with dysphagia, dysphonia, adrenergic symptoms, and vessels compromise. Diagnosis is confirmed through computed tomography, and the only curative option is surgery, which carries various risks and complications and requires advanced surgical technique.
Case presentation
Two patients with carotid body tumor were referred to the vascular surgery service. Both underwent successful tumor resection. One patient had a favorable outcome, while the other developed dysphagia and dysphonia due to the sectioning of a loop of the hypoglossal nerve to free the tumor.
Discussion and conclusion
CBTs are typically benign and have the lowest malignancy rate among all paragangliomas, reported to be less than 5%. The standard surgical technique involves periadventitial resection and presents significant therapeutic challenges depending on the tumor's location and involvement of adjacent structures. The most common complications include damage to the vagus and hypoglossal nerves, with average blood loss ranging from 78 to 404 ml. Given the complexity of these complications, highly specialized surgeons are required, and modifications to conventional surgical techniques, including preoperative tumor embolization, have been proposed.
{"title":"Tumor del glomus carotídeo: evaluación y abordaje quirúrgico a partir de 2 casos","authors":"Eduardo Segovia-Vergara, Javiera Villota-Neumann, Erick Rivera-Soto, Paolo Bozzo-Camponovo","doi":"10.1016/j.circv.2024.11.007","DOIUrl":"10.1016/j.circv.2024.11.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Carotid body tumor (CBT) is a type of paraganglioma, with an incidence of 3-4 per 100,000 inhabitants per year. These tumors are often diagnosed incidentally, though they may present with dysphagia, dysphonia, adrenergic symptoms, and vessels compromise. Diagnosis is confirmed through computed tomography, and the only curative option is surgery, which carries various risks and complications and requires advanced surgical technique.</div></div><div><h3>Case presentation</h3><div>Two patients with carotid body tumor were referred to the vascular surgery service. Both underwent successful tumor resection. One patient had a favorable outcome, while the other developed dysphagia and dysphonia due to the sectioning of a loop of the hypoglossal nerve to free the tumor.</div></div><div><h3>Discussion and conclusion</h3><div>CBTs are typically benign and have the lowest malignancy rate among all paragangliomas, reported to be less than 5%. The standard surgical technique involves periadventitial resection and presents significant therapeutic challenges depending on the tumor's location and involvement of adjacent structures. The most common complications include damage to the vagus and hypoglossal nerves, with average blood loss ranging from 78 to 404<!--> <!-->ml. Given the complexity of these complications, highly specialized surgeons are required, and modifications to conventional surgical techniques, including preoperative tumor embolization, have been proposed.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 6","pages":"Pages 325-329"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.circv.2024.10.006
Ubaldo Ernesto Rivas-Aguilar , Andrés Ramírez Vélez , Yamile Muñoz Perez , Sharoon de Jesús Suarez-Ramírez , Eric Edward Vinck-Geerman , Bruno Ramírez Castillero
In acute pulmonary embolism (PTE) there are some conditions that may change the indication for medical management to a surgical one, such as the presence of intracavitary thrombi associated with a Pulmonary Embolism Severity Index (PESI) with high risk or greater than 106; we present the case of a 57 year old male who presented dyspnea of one day of evolution, in transthoracic echocardiography report (ECHO TT) presented good bi-ventricular function and presence of a thrombus from right to left atrium through patent foramen ovale and in computed axial tomography (CAT) with acute thrombi in both pulmonary branches; In surgery, a thrombus was removed from the atrium and both pulmonary branches. There are few cases reported in the literature with a similar picture and it is interesting to report our management.
{"title":"Reporte de caso: tromboembolia pulmonar aguda y trombo interauricular en foramen oval permeable","authors":"Ubaldo Ernesto Rivas-Aguilar , Andrés Ramírez Vélez , Yamile Muñoz Perez , Sharoon de Jesús Suarez-Ramírez , Eric Edward Vinck-Geerman , Bruno Ramírez Castillero","doi":"10.1016/j.circv.2024.10.006","DOIUrl":"10.1016/j.circv.2024.10.006","url":null,"abstract":"<div><div>In acute pulmonary embolism (PTE) there are some conditions that may change the indication for medical management to a surgical one, such as the presence of intracavitary thrombi associated with a Pulmonary Embolism Severity Index (PESI) with high risk or greater than 106; we present the case of a 57 year old male who presented dyspnea of one day of evolution, in transthoracic echocardiography report (ECHO TT) presented good bi-ventricular function and presence of a thrombus from right to left atrium through patent foramen ovale and in computed axial tomography (CAT) with acute thrombi in both pulmonary branches; In surgery, a thrombus was removed from the atrium and both pulmonary branches. There are few cases reported in the literature with a similar picture and it is interesting to report our management.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 6","pages":"Pages 330-332"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Currently, neonatal electrical cardiac stimulation is done using generators designed for adults. This increases the difficulty of the initial implantation, making it a high-risk procedure due to the risk of infection and erosion.
In 2022, a small pediatric pacemaker was designed (Pediatric IPG). This device is the result of a modification of the Micra leadless model for adults. This modification allows the pacemaker to be implanted in the epicardium.
We present a 3-month-old patient with a large interventricular communication (VSD) and congenital lobar emphysema (CLE). A VSD closure was performed with the patient weighing 2.8 kg, resulting in a post-surgical complete atrioventricular block. Due to severe malnutrition and with prior authorization, a Pediatric IPG pacemaker was implanted. This pacemaker was maintained for 4 weeks with basic stimulation, which allowed for growth despite an unstable threshold. These unstable thresholds persisted even after changing the generator. With the suspicion of a mechanical interaction between the CLE and the correct function of the leads, a medial right lobectomy was performed at the age of 4 months, after which the threshold values normalized and the patient remained asymptomatic.
This is the first case in the literature to describe an interaction between CLE and the correct function of the leads of a pacemaker.
We also describe the safety and usefulness of the Pediatric IPG pacemaker. Designs like these are important in stimulating pediatric patients in the first months of life, for whom we currently do not have adequate devices.
{"title":"Is it important to have a reduced size pacemaker for pediatric patients? An initial Spanish experience of an adapted Micra leadless pacemaker in a patient less than 3 kg with an interventricular communication and a congenital lobar emphysema","authors":"Raúl Sanchez-Perez , Cristina Sayago-Fernández , Sonía Arias Castro , Bunty Ramchandani , Blanca Torres-Maestro , Juvenal Rey-Lois , Paula P. Burgos-Morales , Iñigo Velasco-Leon , Jorge Utanda Hervás , Alvaro González-Rocafort , Luz Polo-Lopez , Angel Aroca-Peinado","doi":"10.1016/j.circv.2024.11.006","DOIUrl":"10.1016/j.circv.2024.11.006","url":null,"abstract":"<div><div>Currently, neonatal electrical cardiac stimulation is done using generators designed for adults. This increases the difficulty of the initial implantation, making it a high-risk procedure due to the risk of infection and erosion.</div><div>In 2022, a small pediatric pacemaker was designed (Pediatric IPG). This device is the result of a modification of the Micra leadless model for adults. This modification allows the pacemaker to be implanted in the epicardium.</div><div>We present a 3-month-old patient with a large interventricular communication (VSD) and congenital lobar emphysema (CLE). A VSD closure was performed with the patient weighing 2.8<!--> <!-->kg, resulting in a post-surgical complete atrioventricular block. Due to severe malnutrition and with prior authorization, a Pediatric IPG pacemaker was implanted. This pacemaker was maintained for 4 weeks with basic stimulation, which allowed for growth despite an unstable threshold. These unstable thresholds persisted even after changing the generator. With the suspicion of a mechanical interaction between the CLE and the correct function of the leads, a medial right lobectomy was performed at the age of 4 months, after which the threshold values normalized and the patient remained asymptomatic.</div><div>This is the first case in the literature to describe an interaction between CLE and the correct function of the leads of a pacemaker.</div><div>We also describe the safety and usefulness of the Pediatric IPG pacemaker. Designs like these are important in stimulating pediatric patients in the first months of life, for whom we currently do not have adequate devices.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 6","pages":"Pages 322-324"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.circv.2025.04.003
Carlos-A. Mestres , Pēteris Stradiņš , Gvido J. Varpins , Cristina Ibáñez , Eduard Quintana
The gold standard in the treatment of hypertrophic obstructive cardiomyopathy is transaortic surgical myectomy, a technique with a proven 60-year track record, which eliminates obstruction and improves symptoms and, therefore, functional capacity and with established cost-effectiveness. Newer pharmacological agents such as myosin inhibitors are now being tested in clinical practice. A surgical alternative has recently been introduced, transapical beating-heart septal myectomy. This approach has the same goals as transaortic myectomy and offers additional advantages such as its minimally invasive nature, as no cardiopulmonary bypass and cardiac arrest are needed, together with a real-time assessment of resection with intraoperative transesophageal echocardiography. Time is needed, however, surgical treatment of patients with an appropriate indication for septal myectomy will benefit from this newly introduced procedure.
{"title":"Transapical beating-heart septal myectomy, a game changer in the treatment of obstructive hypertrophic cardiomyopathy: The Wei operation","authors":"Carlos-A. Mestres , Pēteris Stradiņš , Gvido J. Varpins , Cristina Ibáñez , Eduard Quintana","doi":"10.1016/j.circv.2025.04.003","DOIUrl":"10.1016/j.circv.2025.04.003","url":null,"abstract":"<div><div>The gold standard in the treatment of hypertrophic obstructive cardiomyopathy is transaortic surgical myectomy, a technique with a proven 60-year track record, which eliminates obstruction and improves symptoms and, therefore, functional capacity and with established cost-effectiveness. Newer pharmacological agents such as myosin inhibitors are now being tested in clinical practice. A surgical alternative has recently been introduced, transapical beating-heart septal myectomy. This approach has the same goals as transaortic myectomy and offers additional advantages such as its minimally invasive nature, as no cardiopulmonary bypass and cardiac arrest are needed, together with a real-time assessment of resection with intraoperative transesophageal echocardiography. Time is needed, however, surgical treatment of patients with an appropriate indication for septal myectomy will benefit from this newly introduced procedure.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 6","pages":"Pages 295-298"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.circv.2025.09.006
Rafael García Fuster
{"title":"Últimos avances en la cirugía de la miocardiopatía hipertrófica obstructiva: hacia un futuro prometedor","authors":"Rafael García Fuster","doi":"10.1016/j.circv.2025.09.006","DOIUrl":"10.1016/j.circv.2025.09.006","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 6","pages":"Pages 281-282"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.circv.2024.11.008
Valentina Mescola , Juan B. Grau-Álvaro , Virginia Álvarez-Asiáin , Luis Jiménez-Alfaro , Félix Gómez-Blasco , Javier de Diego-Candela , Facundo Machado-Fernandez , Rebeca Manrique-Antón , Gregorio Rábago-Aracil , Rafael Sádaba-Sagredo
Introduction
In the hypertrophic cardiomyopathy, the outflow tract obstruction is due, in addition to the hypertrophy, to the dynamic mitral regurgitation. This depends on the anterior systolic motion of the anterior leaflet and on subvalvular anomalies, often underdetected.
Objectives
Results of the surgical treatment of obstructive hypertrophic cardiomyopathy with a systematic subvalvular apparatus approach.
Methods
We recruited all adults who underwent elective surgery and whose multimodal preoperative study included: transthoracic and transesophageal echocardiogram (baseline/stress), cardiac tomography, magnetic resonance imaging, and genetic study. The surgery was performed transaorticly in three steps: extended septal myectomy, resection of the aberrant chordae and posterior reorientation and realignment of the papillary muscles. Demographic, echocardiographic, and clinical pre- and postoperative variables were analyzed. Stata 16 (StataCorp LLC) was used for statistical analysis.
Results
From October 2021 to May 2023, 8 patients were included, 63% women. All presented with dyspnea on exertion (2 patients in functional class II, 5 in class III, and 1 in class IV) and significant mitral regurgitation due to: anterior systolic motion, subvalvular anomalies, and dynamic obstruction, causing an average gradient at rest of 71 mmHg, peak of 103 mmHg. The average septal thickness was 19.8 mm. Postoperatively, no patient presented anterior systolic motion or significant mitral regurgitation. Echocardiographically, the post-intervention mean septal thickness was 13.5 mm, the average mean gradient was 19 mmHg, and the provoked gradient was 31 mmHg.
Conclusions
The surgical management of the mitral subvalvular apparatus, added to the extended myectomy, achieves the clinical and echocardiographic recovery of physiological hemodynamics.
{"title":"Manejo del aparato subvalvular mitral en pacientes con miocardiopatía hipertrófica obstructiva","authors":"Valentina Mescola , Juan B. Grau-Álvaro , Virginia Álvarez-Asiáin , Luis Jiménez-Alfaro , Félix Gómez-Blasco , Javier de Diego-Candela , Facundo Machado-Fernandez , Rebeca Manrique-Antón , Gregorio Rábago-Aracil , Rafael Sádaba-Sagredo","doi":"10.1016/j.circv.2024.11.008","DOIUrl":"10.1016/j.circv.2024.11.008","url":null,"abstract":"<div><h3>Introduction</h3><div>In the hypertrophic cardiomyopathy, the outflow tract obstruction is due, in addition to the hypertrophy, to the dynamic mitral regurgitation. This depends on the anterior systolic motion of the anterior leaflet and on subvalvular anomalies, often underdetected.</div></div><div><h3>Objectives</h3><div>Results of the surgical treatment of obstructive hypertrophic cardiomyopathy with a systematic subvalvular apparatus approach.</div></div><div><h3>Methods</h3><div>We recruited all adults who underwent elective surgery and whose multimodal preoperative study included: transthoracic and transesophageal echocardiogram (baseline/stress), cardiac tomography, magnetic resonance imaging, and genetic study. The surgery was performed transaorticly in three steps: extended septal myectomy, resection of the aberrant chordae and posterior reorientation and realignment of the papillary muscles. Demographic, echocardiographic, and clinical pre- and postoperative variables were analyzed. Stata 16 (StataCorp LLC) was used for statistical analysis.</div></div><div><h3>Results</h3><div>From October 2021 to May 2023, 8 patients were included, 63% women. All presented with dyspnea on exertion (2<!--> <!-->patients in functional class<!--> <!-->II, 5 in class<!--> <!-->III, and 1 in class<!--> <!-->IV) and significant mitral regurgitation due to: anterior systolic motion, subvalvular anomalies, and dynamic obstruction, causing an average gradient at rest of 71<!--> <!-->mmHg, peak of 103<!--> <!-->mmHg. The average septal thickness was 19.8<!--> <!-->mm. Postoperatively, no patient presented anterior systolic motion or significant mitral regurgitation. Echocardiographically, the post-intervention mean septal thickness was 13.5<!--> <!-->mm, the average mean gradient was 19<!--> <!-->mmHg, and the provoked gradient was 31<!--> <!-->mmHg.</div></div><div><h3>Conclusions</h3><div>The surgical management of the mitral subvalvular apparatus, added to the extended myectomy, achieves the clinical and echocardiographic recovery of physiological hemodynamics.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 6","pages":"Pages 289-294"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.circv.2024.10.005
Clara Isabel Pérez , Alberto Forteza , David Rodrigo , Pedro Pérez , Ainhoa Gandiaga , Rubén García , Inés Jáuregui , Cristina del Amo , Roberto Voces
Introduction and aim
Surgical treatment of hypertrophic cardiomyopathy faces challenges related to the extend and depth of septal resection. Three-dimensional printing presents itself as a useful tool in surgical planning, providing a visual and tangible representation of the surgical field. This study aims to compare surgical outcomes in patients with hypertrophic obstructive cardiomyopathy, depending on whether or not a 3D model was used.
Methods
A retrospective observational study was performed in 55 patients with surgical indication for obstructive hypertrophic cardiomyopathy between May 2017 and May 2022 at Cruces University Hospital (Spain). A homogeneity analysis was performed between groups, followed by a comparative analysis to assess surgical success according to improvement in functional class, presence of complications associated with septal myectomy, reduction in interventricular gradient and mortality.
Results
A 3D model was used as a complementary tool in 18 patients. Functional class improved in both groups, but was more pronounced in the 3D model group. No patient in the 3D group showed a significant interventricular gradient, whereas 20% of the no-model group did. Complications were more prevalent in the no 3D model group (40.54% vs. 11.11%). At 30 days, mortality was lower in the 3D model group (5.56% vs. 11.16%).
Conclusions
The use of 3D models improves surgical planning and reduces complications in septal myectomy.
前言与目的肥厚性心肌病的外科治疗面临着与室间隔切除的范围和深度有关的挑战。三维打印在外科手术计划中是一种有用的工具，它提供了外科手术领域的视觉和有形的表现。本研究旨在比较肥厚性梗阻性心肌病患者的手术结果，这取决于是否使用3D模型。方法对2017年5月至2022年5月在西班牙克鲁塞斯大学医院接受手术指征的55例阻塞性肥厚性心肌病患者进行回顾性观察研究。组间进行同质性分析，随后进行比较分析，根据功能等级的改善、室间隔肌切除术相关并发症的存在、室间隔梯度的降低和死亡率来评估手术成功。结果18例患者采用sa三维模型作为辅助工具。功能分级在两组均有改善，但在3D模型组更明显。3D组没有患者表现出明显的室间梯度，而无模型组有20%的患者表现出明显的室间梯度。无3D模型组并发症发生率更高（40.54%比11.11%）。30 d时，3D模型组死亡率较低（5.56% vs. 11.16%）。结论三维模型的应用改善了手术计划，减少了室间隔肌切除术的并发症。
{"title":"Estudio comparativo del tratamiento quirúrgico de la miocardiopatía hipertrófica obstructiva en función del empleo o no de un modelo 3D. Experiencia de nuestro centro","authors":"Clara Isabel Pérez , Alberto Forteza , David Rodrigo , Pedro Pérez , Ainhoa Gandiaga , Rubén García , Inés Jáuregui , Cristina del Amo , Roberto Voces","doi":"10.1016/j.circv.2024.10.005","DOIUrl":"10.1016/j.circv.2024.10.005","url":null,"abstract":"<div><h3>Introduction and aim</h3><div>Surgical treatment of hypertrophic cardiomyopathy faces challenges related to the extend and depth of septal resection. Three-dimensional printing presents itself as a useful tool in surgical planning, providing a visual and tangible representation of the surgical field. This study aims to compare surgical outcomes in patients with hypertrophic obstructive cardiomyopathy, depending on whether or not a 3D model was used.</div></div><div><h3>Methods</h3><div>A retrospective observational study was performed in 55 patients with surgical indication for obstructive hypertrophic cardiomyopathy between May 2017 and May 2022 at Cruces University Hospital (Spain). A homogeneity analysis was performed between groups, followed by a comparative analysis to assess surgical success according to improvement in functional class, presence of complications associated with septal myectomy, reduction in interventricular gradient and mortality.</div></div><div><h3>Results</h3><div>A 3D model was used as a complementary tool in 18 patients. Functional class improved in both groups, but was more pronounced in the 3D model group. No patient in the 3D group showed a significant interventricular gradient, whereas 20% of the no-model group did. Complications were more prevalent in the no 3D model group (40.54% vs. 11.11%). At 30 days, mortality was lower in the 3D model group (5.56% vs. 11.16%).</div></div><div><h3>Conclusions</h3><div>The use of 3D models improves surgical planning and reduces complications in septal myectomy.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 6","pages":"Pages 283-288"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.circv.2025.08.002
Lourdes Montero-Cruces , Rafael Rodríguez-Lecoq , José López-Menéndez , Fabrizio Sbraga , José C. Sureda-Barbosa , Juan J. Legarra-Calderón , Juan M. Gracia-Baena , Marta Matamala-Adell , José F. Valderrama-Marcos , Félix Gómez-Blasco , Nuria Arce-Ramos , Carlos E. Martín-López , Álvaro Pedraz-Prieto , Diego Macías-Rubio , Enrique Pérez-de la Sota , Alejandro Adsuar-Gómez , Mónica García-Bouza , Alejandro Crespo-de Hubsch , José A. Hernández-Campos , Jorge Rivas Oyarzabal , Manuel Carnero-Alcázar
The Spanish Cardiac Surgery Registry (RECC) is an essential tool for monitoring and analyzing cardiovascular surgical practice in Spain. Since its implementation in 2021 through the end of 2024, a total of 16631 procedures have been recorded, of which 14048 were major cardiac surgeries. The current analysis includes data from 23 centers that reported at least 40 procedures, representing a significant —though not exhaustive— sample of national activity. During 2024, the number of interventions included in the RECC increased by 81,7% compared to the previous year. The EuroSCORE II, with a mean of 5,4%, was used as a tool for preoperative risk stratification. Overall, it demonstrated good discriminative ability (AUC 0,787) in low-risk patients, although its performance was limited in specific subgroups such as coronary surgery, mitral valve replacement, tricuspid valve surgery, and aortic pathology. In terms of procedure distribution, valve surgery was the most common (53,0%), followed by isolated coronary surgery (25,4%) and aortic surgery (15,4%). The overall observed mortality was 5,1% (risk-adjusted mortality ratio, IMAR 0,94), rising slightly to 5,5% in 2024 (IMAR 1,08), although it remained below the mortality predicted by EuroSCORE II in most categories.
{"title":"Análisis de los datos del Registro Español de Cirugía Cardiaca (RECC) 2021-2024","authors":"Lourdes Montero-Cruces , Rafael Rodríguez-Lecoq , José López-Menéndez , Fabrizio Sbraga , José C. Sureda-Barbosa , Juan J. Legarra-Calderón , Juan M. Gracia-Baena , Marta Matamala-Adell , José F. Valderrama-Marcos , Félix Gómez-Blasco , Nuria Arce-Ramos , Carlos E. Martín-López , Álvaro Pedraz-Prieto , Diego Macías-Rubio , Enrique Pérez-de la Sota , Alejandro Adsuar-Gómez , Mónica García-Bouza , Alejandro Crespo-de Hubsch , José A. Hernández-Campos , Jorge Rivas Oyarzabal , Manuel Carnero-Alcázar","doi":"10.1016/j.circv.2025.08.002","DOIUrl":"10.1016/j.circv.2025.08.002","url":null,"abstract":"<div><div>The Spanish Cardiac Surgery Registry (RECC) is an essential tool for monitoring and analyzing cardiovascular surgical practice in Spain. Since its implementation in 2021 through the end of 2024, a total of 16631 procedures have been recorded, of which 14048 were major cardiac surgeries. The current analysis includes data from 23 centers that reported at least 40 procedures, representing a significant —though not exhaustive— sample of national activity. During 2024, the number of interventions included in the RECC increased by 81,7% compared to the previous year. The EuroSCORE II, with a mean of 5,4%, was used as a tool for preoperative risk stratification. Overall, it demonstrated good discriminative ability (AUC 0,787) in low-risk patients, although its performance was limited in specific subgroups such as coronary surgery, mitral valve replacement, tricuspid valve surgery, and aortic pathology. In terms of procedure distribution, valve surgery was the most common (53,0%), followed by isolated coronary surgery (25,4%) and aortic surgery (15,4%). The overall observed mortality was 5,1% (risk-adjusted mortality ratio, IMAR 0,94), rising slightly to 5,5% in 2024 (IMAR 1,08), although it remained below the mortality predicted by EuroSCORE II in most categories.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 6","pages":"Pages 299-318"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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