Publications by authors named "Jose L Pomar"

Objectives: Decellularized aortic homografts (DAH) were introduced as a new option for aortic valve replacement for young patients.

Methods: A prospective, EU-funded, single-arm, multicentre study in 8 centres evaluating non-cryopreserved DAH for aortic valve replacement.

Results: A total of 144 patients (99 male) were prospectively enrolled in the ARISE Trial between October 2015 and October 2018 with a median age of 30.

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Background: The transplantation of tissues is a developing practice. Improving cryopreservation techniques and emerging of new immunobiology concepts have let to establish the transplant of vascular allografts as a suitable alternative. This study aims to expose the Catalan experience in vascular allograft transplantation by disclosing basic data about clinical outcomes.

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Tricuspid regurgitation is associated with a poor outcome and its quantification remains a challenge. Tricuspid annulus dilatation is one of the parameters that influences clinical decision-making. The aim of this study was to compare the use of 2D transoesophageal echocardiography with surgical assessment for the measurement of the tricuspid annulus.

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Article Synopsis
  • A COVID-19 webinar on April 17, 2020, featured international experts discussing treatment for 42 patients with severe respiratory failure using VV-ECMO, predominantly involving male patients with an average age of 51.
  • Approximately 30% of ventilated COVID-19 patients required VV-ECMO support, with an average of 16.5 days on mechanical ventilation and 10.6 days on ECMO.
  • By the webinar's date, 25.6% of patients had died from multiorgan failure, but expert centers reported VV-ECMO as a valid advanced life-support option with promising outcomes.
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Functional mitral regurgitation.

Indian J Thorac Cardiovasc Surg

January 2020

Article Synopsis
  • Dr. O.P. Yadava and Dr. J.L. Pomar address the complexities of secondary mitral regurgitation (MR), emphasizing its classification as a ventricular disease.
  • They note that while the mitral valve leaflets may not appear completely normal, the subvalvular apparatus alignment is more crucial than the dilatation of the annulus.
  • The discussion advocates for early repair as the preferred treatment approach for secondary MR.
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Article Synopsis
  • Decellularized aortic homografts (DAH) may be a promising alternative for aortic valve replacement in young patients, potentially addressing issues of early failure associated with traditional valve prostheses.
  • A multicenter study involving 144 patients assessed the safety and efficacy of non-cryopreserved DAH, finding a low mortality rate and favorable postoperative outcomes, including excellent hemodynamics.
  • Initial findings suggest that DAH can be safely utilized, with performance metrics comparable to the Ross procedure, even in patients with a history of multiple cardiac surgeries.
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Article Synopsis
  • The study outlines the establishment of a registry, ReVAC, for vascular and valvular allograft transplants in Catalonia, Spain, addressing the need for administrative and clinical oversight in the evolving transplant field.
  • It involved key focus groups that defined essential requirements and included data collection from 380 patients across ten hospitals between 1995 and 2015, ensuring comprehensive coverage of transplant data.
  • The project's outcome is an online platform for ReVAC that categorizes data into patient, surgery, and transplant-related information, facilitating better administrative control and enabling guideline development for future transplants.
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Background: Revascularization is the best alternative to reduce symptoms and to improve the limb salvage rate in patients with chronic limb-threatening ischemia (CLI). Alternative grafts as synthetic prostheses and allografts must be considered for patients without a suitable autologous graft. Our aim was to evaluate outcomes of cryopreserved allografts used as a vascular conduit for bypass surgery in the infrainguinal territory.

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Article Synopsis
  • Heart transplantation (HT) is the preferred treatment for advanced heart failure, and the study aimed to analyze the costs associated with both emergency and elective HT procedures in a hospital setting.
  • The average cost for HT was found to be €62,203, with elective procedures costing significantly less (about €47,540) compared to emergency procedures (about €102,733), largely due to longer hospital stays and increased medication expenses for emergency cases.
  • Despite the higher costs, elective HT had a much better survival rate (96%) compared to emergency HT (68%), suggesting a need for better management strategies for patients with heart failure to prevent the necessity for emergency transplants.
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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.

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Cryopreserved pulmonary homograft (CPH) implantation remains the gold standard for reconstruction of the right ventricular outflow tract (RVOT). Harvesting homografts < 24-h post mortem is the international norm, thereby largely excluding cadaveric donors. This study examines the structural integrity and stability of ovine pulmonary homografts harvested after a 48-h post mortem period, cryopreserved and then implanted for up to 180 days.

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Article Synopsis
  • A forum held at the 2015 EACTS meeting aimed to gather opinions on the controversial topic of publishing surgeon-specific data.
  • A questionnaire revealed that while a majority (69%) believed mortality rates should be reported at a broader hospital level rather than at the individual surgeon level, there was significant support (91%) for collecting individual data without public disclosure.
  • Participants expressed concerns that publicizing surgeon-specific outcomes could lead to risk-averse behavior (81%) and stifle innovation (65%), despite acknowledging challenges with existing quality measures like EuroSCORE II.
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The time interval for the doubling of medical knowledge continues to decline. Physicians, patients, administrators, government officials, and payors are struggling to keep up to date with the waves of new information and to integrate the knowledge into new patient treatment protocols, processes, and metrics. Guidelines, Consensus Guidelines, and Consensus Statements, moderated by seasoned content experts, offer one method to rapidly distribute new information in a timely manner and also guide minimal standards of treatment of clinical care pathways as they are developed as part of bundled care programs.

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BACKGROUND AIM OF THE STUDY: The real burden of valvular heart disease (VHD) is scarcely known, as several factors may potentially lead to its increased prevalence. The study aim was to assess the prevalence of VHD and its treatment in the authors' environment to plan the healthcare requisites for optimal management of the condition. METHODS: A retrospective analysis was conducted of data acquired from patients who had been assessed at different consultation levels for cardiovascular disorders during a six-month period between January and June 2014 in public health referral area of 500,00 inhabitants.

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Background: To analyze the indications, actions and results of the operations performed in the Cardiovascular Surgery Intensive Care Unit.

Methods: Retrospective analysis of consecutive non-selected adult patients operated in the ICU. All operations were included.

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Introduction: Pulmonary endarterectomy (PE) is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to analyze our experience in the medical and surgical management of CTEPH.

Methods: We included 80 patients diagnosed with CTEPH between January 2000 and July 2012.

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Article Synopsis
  • A 55-year-old male received a mitral valve homograft in the tricuspid position, which performed well for 21 years.
  • During the 13th year post-surgery, the homograft required repair.
  • The case highlights unexpected long-term success and discusses findings from the eventual reoperation and associated late clinical events.
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Objective: The aim of the study was to establish clinical event rates for the On-X bileaflet mechanical heart valve (On-X Life Technologies Inc, Austin, Tex) using an audit of data from the 3 centers within Europe with the longest history of implanting.

Methods: All patients receiving the On-X valve between March 1, 1998, and June 30, 2009, at 3 European centers were studied. Data were collected using questionnaire and telephone surveys augmented by outpatient visits and examination of clinical records.

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Objective: SYNTAX study compares outcomes of coronary artery bypass grafting with percutaneous coronary intervention in patients with 3-vessel and/or left main disease. Complexity of coronary artery disease was quantified by the SYNTAX score, which combines anatomic characteristics of each significant lesion. This study aims to clarify whether SYNTAX score affects the outcome of bypass grafting as defined by major adverse cerebrovascular and cardiac events (MACCE) and its components over a 2-year follow-up period.

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