A preliminary assessment of mercury, methylmercury and other potentially toxic elements in largemouth bass (Micropterus salmoides) from the Almadén mining district.

The food chain of the Valdezogues River system is at considerable risk due to the presence of mercury in the environment and to intense bioaccumulation and biomagnification processes in some fish species, particularly in piscivorous. Moreover, the presence of mercury in fish is a reliable indicator of the presence of its most toxic form, methylmercury. Of interest is that selenium, when present together with mercury in food, represents a significant decrease in the risks related to the ingestion of methylmercury.

Biogeochemical prospecting of metallic critical raw materials: soil to plant transfer in SW Ciudad Real Province, Spain.

The soil-plant transfer of trace elements is a complex system in which many factors are involved such as the availability and bioavailability of elements in the soil, climate, pedological parameters, and the essential or toxic character of the elements. The present study proposes the evaluation of the use of multielement contents in vascular plants for prospecting ore deposits of trace elements of strategic interest for Europe. To accomplish this general goal, a study of the soil-plant transfer of major and trace elements using Quercus ilex as a study plant has been developed in the context of two geological domains with very different characteristics in geological terms and in the presence of ore deposits: the Almadén syncline for Hg and the Guadalmez syncline for Sb.

Trace metals from different anthropic sources on the mid-west coast of Asturias: Concentrations, dispersion and environmental considerations.

The central coast of Asturias (Spain), which has suffered significant anthropogenic impacts during the last 150 years, has been studied using 71 sediment samples to establish a preliminary scenario of the geochemical and environmental state of sediments, relating them to their potential sources. In general, As (max 28.5 μg g), Cd (max 1.

Role of age and comorbidities in mortality of patients with infective endocarditis.

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality.

Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.

Biological or mechanical prostheses for isolated aortic valve replacement in patients aged 50-65 years: the ANDALVALVE study.

Objectives: The decision about whether to use a biological or a mechanical prosthesis for aortic valve replacement remains controversial in patients between 50 and 65 years of age and has yet to be addressed in a Mediterranean population. This research aimed to analyse long-term survival and major morbidity rates (30-day mortality, stroke, any prosthetic reoperation and major bleeding) within this population.

Methods: Our multicentre observational retrospective study included all subjects aged 50-65 years who had a primary isolated aortic valve replacement due to severe aortic stenosis at 7 public hospitals from Andalusia (Spain) between 2000 and 2015.

Transcatheter Valve-in-Valve Replacement Through Apicoaortic Conduit for Aortic Bypass Valve Failure.

We report a case of a 69-year-old woman who required an apicoaortic bypass conduit after stenosis of a biological aortic prosthesis valve previously implanted 4 years earlier. The patient was admitted to the emergency department 8 years later with a diagnosis of congestive heart failure. Echocardiography and nuclear magnetic resonance revealed severe regurgitation of the conduit valve.

Factors influencing mercury uptake by leaves of stone pine (Pinus pinea L.) in Almadén (Central Spain).

The use of trees for biomonitoring of mercury (Hg) and other atmospheric pollutants is of increasing importance today. Leaves from different species have been the most widely used plant organ for this purpose, but only pine bark, and not leaves, was used to monitor Hg pollution. In Almadén (South Central Spain), the largest cinnabar (HgS) deposits in the world have been mined for over 2000 years to obtain metallic Hg and this activity has caused the widespread dispersion of this toxic element in the local environment.

Atrial Fibrillation and Stroke Risk After Coronary Artery Bypass Grafting Surgery.

The present multicentre study was aimed at determining the effect of preoperative atrial fibrillation (preop-AF) as stroke risk factor in coronary artery bypass graft surgery (CABG) during the perioperative period. Patients undergoing isolated CABG surgery were enrolled from 21 Spanish centers. Baseline variables related with perioperative stroke risk were recorded and analysed.

Primary inferior vena cava leiomyosarcoma: reconstruction is not mandatory.

Computed tomography in an 81-year-old woman revealed obstruction of the inferior vena cava by a large primary vascular leiomyosarcoma, and involvement of the right renal vein. She underwent successful en-bloc resection of the tumor, right kidney, hepatic segments IV and VI, and inferior vena cava, without caval reconstruction. A renal vein-to-remaining infrahepatic inferior vena cava saphenous vein graft bypass was performed for left renal venous drainage.

Transapical aortic valve implantation in bicuspid aortic valves: must be an absolute contraindication?

Transcatheter Aortic Valve Implantation (TAVI) is a new therapeutic option for patients with severe aortic stenosis with unacceptable surgical risk for conventional aortic valve surgery. A Bicuspid Aortic Valve (BAV) is the most common congenital cardiac disorder (1% of the population) and currently is considered exclusion criteria for TAVI, because it predicts an increased risk of adverse aortic events as incomplete sealing, severe paravalvular regurgitation, or dislocation due to more frequent elliptic shape and asymmetric calcifications in BAV annulus. Only few cases have been published in recent literature, so in this case report we illustrate our experience and management of TAVI in a BAV, with excellent outcomes and no late complications at 1 year follow-up.

Mega-aorta syndrome development in giant cell arteritis. A same entity?

Giant cell arteritis (GCA) is the most common form of large vessel arteritis. GCA typically involves the branches of the external carotid artery, but is the leading cause of inflammatory aortitis. However, involvement of the aorta often goes undetected.

Management of aortic valve dysfunction after transapical approach using the technique "valve after valve".

We report a case of a 77-year-old patient with severe aortic stenosis who underwent transapical aortic valve implantation with a 23-mm Edwards Sapien valve (Edwards Lifesciences Inc, Irvine CA). This procedure was complicated with the occurrence of an acute regurgitation due to entrapment of one of the leaflets that was successfully managed by valve after valve technique.

Spontaneous closure of pseudoaneurysm after transapical aortic valve implantation.

Transcatheter aortic valve implantation by an apical approach has been developed as an alternative to conventional aortic valve replacement. Complications with these relatively new procedures are being reported. We report a case of transapical transcatheter aortic valve implantation, in which a pseudoaneurysm at the apex of the left ventricle as a complication of the procedure developed in the patient and was treated without surgery.

Coronary sinus aneurysm and left ventricular-coronary sinus fistula. Implantation of CRT device.

We describe a 72-year-old man referred for implantation of a cardiac resynchronization therapy device who had previously undergone repeated operations to replace the mitral valve. Retrograde venography of the coronary sinus (CS) to implant the left ventricular (LV) pacing lead revealed aneurysmal dilatation of the CS with LV-CS fistula that hindered-but did not prevent-complete implantation of the system.

Mitroaortic valve replacement after aortic transapical approach failure in a patient with essential thrombocytosis.

There is a lack of published information about intraoperative and postoperative course of cardiac surgery in patients with essential thrombocytosis using cardiopulmonary bypass. Both risks of intraoperative thrombosis of extracorporeal conduits or uncontrolled postoperative bleeding are present, but its incidence and treatment are not well known. Here, we present a rare case of a patient with essential thrombocytosis, moderate mitral regurgitation and severe aortic stenosis who had a transapical aortic valve implantation with short-term severe periprosthetic regurgitation, who needed a mitroaortic replacement on cardiopulmonary bypass with no complications.

Functional anatomy of aortic regurgitation. Role of transesophageal echocardiography in aortic valve-sparing surgery.

Introduction And Objectives: The aim was to evaluate the usefulness of transesophageal echocardiography (TEE) for the preoperative functional anatomical assessment of patients with aortic regurgitation (AR) to identify those eligible for valve-sparing surgery (VSS).

Methods: We determined the accuracy and diagnostic value of TEE for identifying underlying lesions and mechanisms in 66 patients who underwent surgery for severe AR by comparing TEE findings with those obtained on surgical inspection. The usefulness of TEE for predicting the feasibility of VSS was determined.

Video-assisted cardioscopy for removal of primary left ventricular fibroma.

We present a case of a cardiac fibroma affecting the base of the anterior papillary muscle resected under cardiopulmonary bypass with cardioscopy and video-assisted thoracic surgery (VATS) instruments through the mitral valve. The surgical approach and instrumentation of previous case reports are reviewed.

Replacement of A2 and A3 by pericardium due to endocarditis of the anterior leaflet of the mitral valve.

We present a case of acute endocarditis due to enterococcus faecalis involving partially A2 and completely A3 (Carpentier classification) with destruction of the free margin of the mitral valve. Repair was performed by using glutaraldehyde treated porcine pericardium to replace the defect and neochordae of polytetrafluoroethylene sutured to the free margin of the pericardium to achieve competence. Intraoperative and follow-up echocardiogaphies showed no regurgitation.

Masson tumor as humeral artery aneurysm.

Intravascular papillary endothelial hyperplasia (Masson's vegetant hemangioendothelioma) is a rare condition affecting the arteries. In the literature, we did not find any reference to this lesion involving the humeral artery. We present a case of asymptomatic humeral artery vascular tumor due to this abnormality.

Aortic valve endocarditis by Capnocytophaga haemolytica.

We report a case of a 51-year-old patient with suspected prosthetic valve endocarditis. Capnocytophaga haemolytica was isolated in blood cultures and the repeated echocardiograms showed growth of vegetations and disruption of the proximal prosthetic valve suture line with progressive aortic regurgitation. The patient underwent a root debridement and replacement with a stentless bioprosthesis.

Austrian syndrome: a clinical rarity.

We present a case of classical Austrian syndrome in a 55-year-old man with a history of alcoholism. The rapid destruction in aortic valve cusps caused perforations with severe aortic insufficiency, acute pulmonary edema, and determined an urgent aortic valve substitution with good postoperative evolution. The review of the literature suggests cardiac surgery in this syndrome to improve the poor survival with conservative treatment.