Publications by authors named "Soledad Ojeda"
The improvement in survival rates in pediatric malignancies has led to an increase in the number of cancer survivors who are at risk of developing cardiotoxicity and heart failure. Cardiac dysfunction in these patients can occur asymptomatically, and the diagnosis in a symptomatic phase is associated with reduced treatment response and worse prognosis. For this reason, it is essential to establish protocols to follow up on these patients and identify those at risk of cardiotoxicity in order to start early and effective therapies.
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- - The study investigated the effectiveness of using a SyncVision/iFR (S-iFR)-guided strategy for percutaneous coronary intervention (PCI) in patients with complex coronary lesions, compared to a standard angiography-guided approach.
- - 100 patients were randomized into two groups: one using S-iFR guidance and the other using angiography; the main focus was on the implanted stent length and target vessel failure (TVF) after one year.
- - Results showed that the S-iFR group had a shorter total stent length but also a slight increase in TVF, although this increase was not statistically significant.
Introduction: There is current controversy surrounding the benefits of percutaneous coronary intervention (PCI) of chronic total coronary occlusions (CTO). We aimed to evaluate the impact of complete percutaneous revascularization on major adverse cardiovascular events (MACE) in patients with CTO.
Methods: A retrospective observational study was conducted of consecutive patients referred for invasive coronary angiography at a single center between January 2018 and December 2019 and at least a CTO.
Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study.
JACC Cardiovasc Interv
February 2024
Article Synopsis
- The COVID-19 pandemic led to significant treatment delays for patients needing transcatheter aortic valve replacement (TAVR), with a marked decrease in procedure volumes during the first two waves of the pandemic.
- The study analyzed TAVR case data from 130 centers in 61 countries, finding a 15% drop in cases during the first wave and 7% in the second, particularly affecting regions like Africa, Central-South America, and Asia.
- Factors such as hospital type (private vs public), urban vs rural location, low procedure volumes, a country's socioeconomic status, and stringent public health measures contributed to these reductions, highlighting the need for improved public health policies for future health crises.
Introduction And Objectives: Stent implantation is the preferred treatment in older children and adults with aortic coarctation (CoA). We aimed to determine the incidence of very late events after CoA stenting.
Methods: We analyzed a cohort of CoA patients who underwent stent implantation at our center between 1993 and 2018.
There are limited data regarding right ventricle (RV) impairment in long-term survivors of childhood acute lymphoblastic leukemia (CLS). The aim of this study was to assess RV function in these patients using echocardiographic conventional measurements and automated RV strain. Echocardiographic recordings of 90 CLS and 58 healthy siblings from the CTOXALL cohort were analyzed.
View Article and Find Full Text PDFCTO and Bifurcation Lesions: An Expert Consensus From the European Bifurcation Club and EuroCTO Club.
JACC Cardiovasc Interv
September 2023
Knowledge in the field of bifurcation lesions and chronic total occlusions (CTOs) has progressively improved over the past 20 years. Therefore, the European Bifurcation Club and the EuroCTO Club have decided to write a joint consensus statement to share general knowledge and practical approaches in this complex field. When percutaneously treating CTOs, bifurcation lesions with relevant side branches (SBs) are found in approximately one-third of cases (35% at the proximal cap, 38% at the distal cap, and 27% within the CTO body).
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- The study looked at a special scoring system (CHIP-PCI) to see how well it predicts heart problems in older people (75 years and older) who have heart surgery.
- They gathered data from three different studies, including over 2,700 older patients, and found that some medical conditions could help predict the risk of serious heart issues.
- The researchers improved the original CHIP-PCI score by adding some new risk factors, making it better at predicting problems during the hospital stay and shortly after surgery, but not as good for predicting issues one year later.
Article Synopsis
- There has been a significant increase in the use of transcatheter aortic valve implantation (TAVI) to treat symptomatic severe aortic stenosis, prompting the need for streamlined procedures in specialized Heart Valve Centres.
- The 2022 European TAVI Pathway Survey collected input from 147 TAVI centres in 26 countries, revealing details about their procedural practices and patient management.
- Findings indicate that while minimalist TAVI methods are widely adopted, many patients still experience longer hospital stays, suggesting room for improvement in discharge processes.
Myocardial revascularization failure among patients requiring cardiac catheterization and secondary revascularization in contemporary clinical practice: Results of the REVASEC multicenter registry.
Catheter Cardiovasc Interv
October 2023
Background: Myocardial revascularization failure (MRF) and Secondary revascularization (SR) are contemporary interventional cardiology challenges.
Aim: To investigate the characteristics, management, and prognosis of patients with myocardial revascularization failure (MRF) and need for secondary revascularization (SR) in contemporary practice.
Methods: The REVASEC study is a prospective registry (NCT03349385), which recruited patients with prior revascularization referred for coronary angiography at 19 centers.
Unlabelled: The identification of vertebral fracture is a key point in an FLS. We have analyzed the characteristics of 570 patients according to the route of identification (referral by other doctors, emergency registry or through VFA), concluding that promoting referral by other doctors with a training campaign is effective.
Purpose: Vertebral fractures (VF) are associated with increased risk of further VFs.
Background: A small aortic annulus (SAA) is a risk factor for prosthesis-patient mismatch (PPM) in patients undergoing surgical or transcatheter aortic valve implantation (TAVI). Data regarding TAVI in patients with extra-SAA are scarce.
Aims: The aim of this study was to analyse the safety and efficacy of TAVI in patients with extra-SAA.
Background: Coronary obstruction (CO) following transcatheter aortic valve replacement (TAVR) is a life-threatening complication, scarcely studied.
Objectives: The authors analyzed the incidence of CO after TAVR, presentation, management, and in-hospital and 1-year clinical outcomes in a large series of patients undergoing TAVR.
Methods: Patients from the Spanish TAVI (Transcatheter Aortic Valve Implantation) registry who presented with CO in the procedure, during hospitalization or at follow-up were included.
Introduction And Objectives: Survivors of childhood cancer might be at increased risk of diastolic dysfunction at follow-up due to exposure to cardiotoxic treatment. Although assessment of diastolic function is challenging in this relatively young population, left atrial strain might provide a novel insight in this evaluation. Our aim was to examine diastolic function in a cohort of long-term survivors of childhood acute lymphoblastic leukemia by using left atrial strain and conventional echocardiographic parameters.
View Article and Find Full Text PDFProvisional stenting has become the default technique for the treatment of most coronary bifurcation lesions. However, the side branch (SB) can become compromised after main vessel (MV) stenting and restoring SB patency can be difficult in challenging anatomies. Angiographic and intracoronary imaging criteria can predict the risk of side branch closure and may encourage use of side branch protection strategies.
View Article and Find Full Text PDFChanges in the Treatment Strategy Following Intracoronary Pressure Wire in a Contemporaneous Real-Life Cohort of Patients With Intermediate Coronary Stenosis. Results From a Nationwide Registry.
Cardiovasc Revasc Med
June 2023
Article Synopsis
- The study focused on the use of intracoronary pressure wires in guiding treatment for patients with coronary artery disease, aiming to assess changes in diagnosis, treatment strategies, and clinical outcomes.
- Involving 1,414 patients and observing 1,781 lesions, the study found significant changes in the extent of coronary disease and treatment plans, with over half of the patients experiencing adjustments after using the pressure wire.
- The findings indicated that using the pressure wire was generally safe and led to a lower incidence of major adverse cardiovascular events (MACE), particularly when percutaneous coronary intervention (PCI) was the initial treatment strategy.
Background: Coronary artery perforation is one of the most feared and common complications of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: To assess the usefulness of the recently developed PROGRESS-CTO (NCT02061436) perforation risk score in independent cohorts. Individual patient-level data pooled analysis of three registries was performed.
Background: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is associated with a considerable risk of complications, and risk stratification is of utmost importance.
Aims: To assess the clinical usefulness of the recently developed PROGRESS-CTO (NCT02061436) complication risk scores in an independent cohort.
Methods: Individual patient data pooled analysis of 3 registries was performed.
Coronary artery perforation is one of the most common and feared complications of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We evaluated the utility of the recently presented OPEN-CLEAN (Coronary artery bypass graft, Length of occlusion, Ejection fraction, Age, calcificatioN) perforation score in an independent multicenter CTO PCI dataset. Of the 2,270 patients who underwent CTO PCI at 7 centers, 150 (6.
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- Patients with spontaneous coronary artery dissection (SCAD) who presented as ST-segment-elevation myocardial infarction (STEMI) exhibited more severe coronary lesions and worse blood flow compared to those presenting as non-ST-segment elevation myocardial infarction (NSTEMI).
- During treatment, STEMI patients were more frequently treated with percutaneous coronary intervention (PCI) and had higher rates of left ventricular systolic dysfunction, but both groups had similar rates of major adverse events during hospital admission.
- In the long term, despite the initial differences in severity and treatment, both STEMI and NSTEMI SCAD patients had comparable outcomes concerning major adverse cardiac and cerebrovascular events.
Introduction And Objectives: The use of a pressure wire as a jailed wire to evaluate side branch results during provisional stenting seems feasible. However, safety concerns exist due to the mechanical damage of the wire and the lack of prospective data evaluating the prognosis of patients treated using this technique. This study sought to evaluate the structural damage of the pressure wire in patients treated using the jailed pressure wire technique and to assess mid-term clinical outcomes.
View Article and Find Full Text PDFInstantaneous Wave-Free Ratio for the Assessment of Intermediate Left Main Coronary Artery Stenosis: Correlations With Fractional Flow Reserve/Intravascular Ultrasound and Prognostic Implications: The iLITRO-EPIC07 Study.
Circ Cardiovasc Interv
November 2022
Article Synopsis
- This study investigates the agreement between fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) in patients with intermediate stenosis in the left main coronary artery (LMCA), finding an 80% concordance between the two methods.
- The research involved 300 patients and emphasized the role of intravascular ultrasound (IVUS) for assessing cases where FFR and iFR results disagreed, identifying minimal lumen areas as a factor in decision-making.
- Over a 20-month follow-up, deferral of revascularization based on iFR and IVUS showed a lower incidence of major adverse cardiac events compared to those who underwent revascularization, suggesting that deferring treatment
Article Synopsis
- The study investigates how sex and previous cardiovascular disease (CVD) influence 30-day mortality in patients who experienced ST-elevation myocardial infarction (STEMI).
- It analyzed 4,366 patients across 83 centers in Spain, finding that women and those with prior CVD generally had higher unadjusted mortality rates.
- Surprisingly, after adjusting for other factors, the difference in mortality risk between men and women varied; women with prior CVD showed lower mortality risk compared to men, while no difference was evident in patients without CVD.
The use of transcatheter edge-to-edge repair for the treatment of mitral regurgitation has markedly increased in the last few years. The rate of adverse events related to the procedure is low; however, some of the complications that may occur are potentially dangerous. Due to the growing popularity of the technique, which is no longer limited to high-volume centers, knowledge of the complications related to the procedure is fundamental.
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