Pub Date : 2025-09-01DOI: 10.1016/j.circv.2024.07.008
Gustavo Rojas-Velasco , Regina Aguilar-López , Renata Toledo-Elías , Octavio Salazar-Delgado , Natalia Coello-Niembro , María Jiménez-Fernández , Eduardo A. Arias , Daniel Manzur-Sandoval
{"title":"ECMO as rescue therapy in TAVI-induced cardiogenic shock: A case of suicide left ventricle","authors":"Gustavo Rojas-Velasco , Regina Aguilar-López , Renata Toledo-Elías , Octavio Salazar-Delgado , Natalia Coello-Niembro , María Jiménez-Fernández , Eduardo A. Arias , Daniel Manzur-Sandoval","doi":"10.1016/j.circv.2024.07.008","DOIUrl":"10.1016/j.circv.2024.07.008","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 5","pages":"Pages 273-275"},"PeriodicalIF":0.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061033","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 : 2025-07-01DOI: 10.1016/j.circv.2025.05.003
Alberto Juffé Stein
{"title":"Un gigante, un maestro de la cirugía cardíaca pediátrica, una buena persona, pero sobre todo un gran amigo","authors":"Alberto Juffé Stein","doi":"10.1016/j.circv.2025.05.003","DOIUrl":"10.1016/j.circv.2025.05.003","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 4","pages":"Page 229"},"PeriodicalIF":0.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596613","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 : 2025-07-01DOI: 10.1016/j.circv.2024.05.006
Federico Altamirano-Medel, Miguel A. Gomez-Vidal, Tomás Daroca-Martinez
Introduction and objectives
Transcatheter aortic valve implantation as a treatment for aortic stenosis is positioned as the therapy of choice for a specific population of patients, which is steadily increasing and is no longer limited to patients with prohibitively high surgical risk. This stems from the advancement and refinement of devices, as well as the development of different access routes. Our goal is to share and standardize the transcarotid access technique, which we have implemented and developed since 2019 with very good results.
Method and results
Between 01/01/2019 and 31/12/2023, 79 transcatheter valves were implanted via the carotid route (21.43% of the total implants in our center), with no intraoperative mortality and less than 1% mortality during the first month of intervention. The incidence of established strokes in these patients is 0%.
Conclusions
We have adopted the transcarotid route as an equally valid alternative to the transaxillary access. Due to recent changes in patient selection criteria, we believe that the cardiovascular surgeon should have an active role in decision-making and implantation of this type of prosthesis, since many patients have low surgical risk and are consequently susceptible to intervention in case of procedure complications.
{"title":"TAVI transcarotídeo: la técnica paso a paso","authors":"Federico Altamirano-Medel, Miguel A. Gomez-Vidal, Tomás Daroca-Martinez","doi":"10.1016/j.circv.2024.05.006","DOIUrl":"10.1016/j.circv.2024.05.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Transcatheter aortic valve implantation as a treatment for aortic stenosis is positioned as the therapy of choice for a specific population of patients, which is steadily increasing and is no longer limited to patients with prohibitively high surgical risk. This stems from the advancement and refinement of devices, as well as the development of different access routes. Our goal is to share and standardize the transcarotid access technique, which we have implemented and developed since 2019 with very good results.</div></div><div><h3>Method and results</h3><div>Between 01/01/2019 and 31/12/2023, 79 transcatheter valves were implanted via the carotid route (21.43% of the total implants in our center), with no intraoperative mortality and less than 1% mortality during the first month of intervention. The incidence of established strokes in these patients is 0%.</div></div><div><h3>Conclusions</h3><div>We have adopted the transcarotid route as an equally valid alternative to the transaxillary access. Due to recent changes in patient selection criteria, we believe that the cardiovascular surgeon should have an active role in decision-making and implantation of this type of prosthesis, since many patients have low surgical risk and are consequently susceptible to intervention in case of procedure complications.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 4","pages":"Pages 201-207"},"PeriodicalIF":0.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596608","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 : 2025-07-01DOI: 10.1016/j.circv.2025.05.002
Rafael García Fuster
{"title":"Factor de impacto, indexación en PubMed y nuevos monográficos en Cirugía Cardiovascular","authors":"Rafael García Fuster","doi":"10.1016/j.circv.2025.05.002","DOIUrl":"10.1016/j.circv.2025.05.002","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 4","pages":"Page 189"},"PeriodicalIF":0.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596607","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 : 2025-07-01DOI: 10.1016/j.circv.2024.10.003
Federico Altamirano-Medel, Jose Manuel Vignau Cano, Diego Macias-Rubio, Juan Otero-Forero, Miguel A. Gomez-Vidal, Anibal Bermudez Garcia, Cristina Jaen-Garrido, Eloy Rueda-Gomariz, Adrian Fontaine, Jose Mamani-Moriano, Patric Callero-Hernandez, Tomás Daroca-Martinez
Introduction and objectives
Alternative “non-femoral” access routes are presented as an alternative option in current clinical guidelines for transcatheter valve implantation when the femoral route is not possible. Our main objective is describing the activity carried out in our center and to show the results of a series of transcatheter aortic prostheses implanted exclusively by a team of cardiovascular surgeons.
Methods
Descriptive study of a series of TAVIs implanted by cardiovascular surgeons with non-transfemoral approach. Data collection on preoperative variables and postoperative variables.
Results
304 non-transfemoral TAVI: 21 implants with transaortic access (6.91%), 62 transapical access (20.40%), 168 transaxillary (55.26%) and 53 transcarotid (17.43%). A total of 69.73% (212) implantations were with self-expandable prostheses and 30.27% (92) with balloon expandable prostheses. A total of 65 leaks (21.38%) were registered. First year mortality was 5.38%. Three ischaemic strokes (0.98%).
Forty-five patients (14.80%) required implantation of a permanent pacemaker. There were 4 vascular complications in the case of the transaxillary approach (2.43%) and 1 in the case of the transapical approach (1.62%).
Conclusions
Balloon expandable prostheses have lower blockage rates and fewer periprosthetic leaks but slightly higher mortality (non-significant). The transaxillary and transcarotid access are not inferior to the transfemoral access in terms of morbidity and mortality. Vascular non-transfemoral access should be considered an option when they are of better quality. The transcarotid access is positioning itself as a possibly better alternative to the transaxillary access.
{"title":"Resultados comparativos de las vías transvasculares no femorales en un mismo centro, 11 años de nuestro programa TAVI","authors":"Federico Altamirano-Medel, Jose Manuel Vignau Cano, Diego Macias-Rubio, Juan Otero-Forero, Miguel A. Gomez-Vidal, Anibal Bermudez Garcia, Cristina Jaen-Garrido, Eloy Rueda-Gomariz, Adrian Fontaine, Jose Mamani-Moriano, Patric Callero-Hernandez, Tomás Daroca-Martinez","doi":"10.1016/j.circv.2024.10.003","DOIUrl":"10.1016/j.circv.2024.10.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Alternative “non-femoral” access routes are presented as an alternative option in current clinical guidelines for transcatheter valve implantation when the femoral route is not possible. Our main objective is describing the activity carried out in our center and to show the results of a series of transcatheter aortic prostheses implanted exclusively by a team of cardiovascular surgeons.</div></div><div><h3>Methods</h3><div>Descriptive study of a series of TAVIs implanted by cardiovascular surgeons with non-transfemoral approach. Data collection on preoperative variables and postoperative variables.</div></div><div><h3>Results</h3><div>304 non-transfemoral TAVI: 21 implants with transaortic access (6.91%), 62 transapical access (20.40%), 168 transaxillary (55.26%) and 53 transcarotid (17.43%). A total of 69.73% (212) implantations were with self-expandable prostheses and 30.27% (92) with balloon expandable prostheses. A total of 65 leaks (21.38%) were registered. First year mortality was 5.38%. Three ischaemic strokes (0.98%).</div><div>Forty-five patients (14.80%) required implantation of a permanent pacemaker. There were 4 vascular complications in the case of the transaxillary approach (2.43%) and 1 in the case of the transapical approach (1.62%).</div></div><div><h3>Conclusions</h3><div>Balloon expandable prostheses have lower blockage rates and fewer periprosthetic leaks but slightly higher mortality (non-significant). The transaxillary and transcarotid access are not inferior to the transfemoral access in terms of morbidity and mortality. Vascular non-transfemoral access should be considered an option when they are of better quality. The transcarotid access is positioning itself as a possibly better alternative to the transaxillary access.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 4","pages":"Pages 216-222"},"PeriodicalIF":0.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596610","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 : 2025-07-01DOI: 10.1016/j.circv.2024.09.003
Pilar Garrido-Martín , José R. González-Rodríguez , Nora García-Borges , Javier Montoto-López , Rafael Martínez-Sanz
{"title":"Tratamiento de disfunción protésica aórtica transcatéter mediante explante e implante de nueva prótesis aórtica transcatéter in situ","authors":"Pilar Garrido-Martín , José R. González-Rodríguez , Nora García-Borges , Javier Montoto-López , Rafael Martínez-Sanz","doi":"10.1016/j.circv.2024.09.003","DOIUrl":"10.1016/j.circv.2024.09.003","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 4","pages":"Pages 226-228"},"PeriodicalIF":0.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596612","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 : 2025-07-01DOI: 10.1016/j.circv.2024.06.005
Víctor X. Mosquera , Adrian Muinelo-Paul , Laura Fernandez-Arias , Miguel Gonzalez-Barbeito , José Manuel Martínez-Comendador , Carmen Iglesias-Gil , Guillermo Ventosa Fernández , María García Vieites , Carlos Velasco García , José J. Cuenca-Castillo
Objectives
This study aimed to compare the outcomes of extrathoracic (ET) transcatheter aortic valve implantation (TAVI) to intrathoracic (IT) TAVI, specifically focusing on in-hospital or 30-day all-cause mortality (ACM), postoperative and 30-day complications, and 1-year ACM.
Methods
Between January 2009 and December 2023, 447 non-TF TAVI procedures were performed at our institution. Patients were categorized into IT (transapical) and ET (transcarotid and transaxillary) accesses. Propensity score matching was employed to compare outcomes between the two groups.
Results
Patients undergoing ET TAVI were older (mean age: 81.9 vs. 79.5 years) and had a higher prevalence of peripheral vascular and coronary artery diseases. ET TAVI was associated with a lower 30-day mortality rate (1.6% vs. 10.2%, P = .006) and fewer respiratory complications (0.8% vs. 19.9%, P < .001) compared to IT TAVI. The 1-year ACM was significantly lower in the ET group compared to the IT group. No significant differences were observed in procedural success rates, device success rates, or hemodynamic outcomes between the two groups. The ET group demonstrated consistently higher survival probabilities throughout the study period (P < .001).
Conclusions
ET TAVI appears to offer advantages in terms of lower short-term and 1-year mortality, as well as reduced postoperative complications compared to IT TAVI. Both approaches are comparable in terms of procedural and hemodynamic outcomes. These findings can assist clinicians in selecting the most appropriate TAVI approach tailored to individual patient profiles.
本研究旨在比较胸外（ET）经导管主动脉瓣植入术（TAVI）与胸内（IT） TAVI的结果，特别关注院内或30天全因死亡率（ACM）、术后和30天并发症以及1年ACM。方法2009年1月至2023年12月在我院行非tf TAVI手术447例。患者分为IT（经根尖）和ET（经颈动脉和经腋窝）通道。采用倾向评分匹配来比较两组的结果。结果接受ET TAVI的患者年龄较大（平均81.9岁vs. 79.5岁），外周血管和冠状动脉疾病的患病率较高。ET TAVI与较低的30天死亡率（1.6% vs. 10.2%, P = 0.006）和较少的呼吸并发症(0.8% vs. 19.9%, P <；.001)与IT TAVI相比。与IT组相比，ET组的1年ACM显著降低。两组之间的手术成功率、器械成功率或血流动力学结果均无显著差异。在整个研究期间，ET组始终表现出较高的生存率(P <；措施)。结论与IT TAVI相比，set TAVI在较低的短期和1年死亡率以及减少术后并发症方面具有优势。两种方法在手术和血流动力学结果方面具有可比性。这些发现可以帮助临床医生根据个别患者的情况选择最合适的TAVI方法。
{"title":"Abordajes intratorácicos versus extratorácicos en la implantación de válvula aórtica transcatéter no transfemoral: un análisis de puntuación de propensidad","authors":"Víctor X. Mosquera , Adrian Muinelo-Paul , Laura Fernandez-Arias , Miguel Gonzalez-Barbeito , José Manuel Martínez-Comendador , Carmen Iglesias-Gil , Guillermo Ventosa Fernández , María García Vieites , Carlos Velasco García , José J. Cuenca-Castillo","doi":"10.1016/j.circv.2024.06.005","DOIUrl":"10.1016/j.circv.2024.06.005","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to compare the outcomes of extrathoracic (ET) transcatheter aortic valve implantation (TAVI) to intrathoracic (IT) TAVI, specifically focusing on in-hospital or 30-day all-cause mortality (ACM), postoperative and 30-day complications, and 1-year ACM.</div></div><div><h3>Methods</h3><div>Between January 2009 and December 2023, 447 non-TF TAVI procedures were performed at our institution. Patients were categorized into IT (transapical) and ET (transcarotid and transaxillary) accesses. Propensity score matching was employed to compare outcomes between the two groups.</div></div><div><h3>Results</h3><div>Patients undergoing ET TAVI were older (mean age: 81.9 vs. 79.5 years) and had a higher prevalence of peripheral vascular and coronary artery diseases. ET TAVI was associated with a lower 30-day mortality rate (1.6% vs. 10.2%, <em>P</em> <!-->=<!--> <!-->.006) and fewer respiratory complications (0.8% vs. 19.9%, <em>P</em> <!--><<!--> <!-->.001) compared to IT TAVI. The 1-year ACM was significantly lower in the ET group compared to the IT group. No significant differences were observed in procedural success rates, device success rates, or hemodynamic outcomes between the two groups. The ET group demonstrated consistently higher survival probabilities throughout the study period (<em>P</em> <!--><<!--> <!-->.001).</div></div><div><h3>Conclusions</h3><div>ET TAVI appears to offer advantages in terms of lower short-term and 1-year mortality, as well as reduced postoperative complications compared to IT TAVI. Both approaches are comparable in terms of procedural and hemodynamic outcomes. These findings can assist clinicians in selecting the most appropriate TAVI approach tailored to individual patient profiles.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"32 4","pages":"Pages 208-215"},"PeriodicalIF":0.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596609","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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