48 results match your criteria: "Clinica Las Vegas[Affiliation]"

[Spontaneous splenic rupture following endoscopic studies: a case report].

Rev Gastroenterol Peru

January 2025

Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Servicio de Cirugía General, Clínica Las Vegas, Medellín, Colombia.

Endoscopic procedures, currently, are characterized by being minimally invasive diagnostic and therapeutic methods, which allow the management of a wide number of pathologies and in the hands of a good operator, present few complications. Both traumatic and spontaneous splenic rupture is a rare entity, mainly associated with abdominal trauma or splenomegaly due to hematological diseases, respectively. Splenic rupture secondary to endoscopic studies is a complication with a mortality close to 5%, of which only 100 cases have been reported to date, none of them in Colombia.

View Article and Find Full Text PDF

Background: Anemia represents a commonly reported comorbidity in patients diagnosed with heart failure (HF), related with a higher risk of unfavorable outcomes such as recurrent hospitalizations and mortality. There is a lack of evidence in Latin America regarding this topic. Our aim was to evaluate the prognostic value of the diagnosis of anemia in patients from the Colombian Heart Failure Registry (RECOLFACA).

View Article and Find Full Text PDF

Background: Patient's clinical characteristics, technical resources, center and operator volume, and operator experience and training are known variables impacting outcomes. Although international standards have been agreed to maximize the benefits of this therapy, regional and global differences still exist. Latin American information has not been updated in the last 10 years.

View Article and Find Full Text PDF

Background: Left bundle branch area pacing (LBBAP) and endocardial resynchronization (Endo-CRT) are alternatives to biventricular pacing for cardiac resynchronization therapy (CRT).

Objective: To compare the outcomes of LBBAP versus Endo-CRT using conventional pacing leads.

Methods: Patients with heart failure (HF) undergoing CRT with LBBAP or Endo-CRT were included.

View Article and Find Full Text PDF

Introduction: Heart failure (HF) is one of the leading causes of morbidity and mortality worldwide. This study aimed to assess the impact of sex on sociodemographic, clinical, and laboratory parameters in patients with HF who were included in the Colombian Heart Failure Registry (RECOLFACA).

Methods: This was a cross-sectional analytical research.

View Article and Find Full Text PDF

Aims: The concept of "atrial cardiomyopathy" (AtCM) had been percolating through the literature since its first mention in 1972. Since then, publications using the term were sporadic until the decision was made to convene an expert working group with representation from four multinational arrhythmia organizations to prepare a consensus document on atrial cardiomyopathy in 2016 (EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication). Subsequently, publications on AtCM have increased progressively.

View Article and Find Full Text PDF

Measures to Prevent Infection in Cardiac Implantable Electronic Device Replacements or Upgrades.

Rev Cardiovasc Med

January 2024

Cardiac Arrhythmia Service, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Cardiac implantable electronic device (CIED) infections represent one of the most threatening complications associated with device implantation, due to an increase in morbidity and mortality rates, as well as healthcare costs. Besides, it is important to highlight that when compared to the initial implantation of a device, the risks associated with procedures like generator changes, lead and pocket revisions, or device upgrades double. Consequently, to address this issue, various scoring systems, like the PADIT (Prior Procedures, Age, Depressed Renal Function, Immunocompromised Status, Type of Procedure), the RI-AIAC (Ricerca Sulle Infezioni Associate a ImpiAnto o Sostituzione di CIED), and the Shariff score, along with predictive models, have been developed to identify patients at a greater risk of infection.

View Article and Find Full Text PDF

Background: The value of Sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitor) therapy in individuals with heart failure with preserved EF (HFpEF) was unknown until the EMPEROR-Preserved trial. We aimed to assess the proportion of patients with HFpEF that are eligible for empagliflozin therapy within the Colombian Heart Failure Registry (RECOLFACA).

Methods: RECOLFACA enrolled adult patients with a HF diagnosis during 2017-2019 from 60 medical centers in Colombia.

View Article and Find Full Text PDF

Sex Differences in Left Bundle Branch Area Pacing Versus Biventricular Pacing for Cardiac Resynchronization Therapy.

JACC Clin Electrophysiol

July 2024

Cardiac Arrhythmia Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Article Synopsis
  • * The research included patients with significantly reduced heart function and compared outcomes like heart failure hospitalizations and all-cause mortality between LBBAP and BIVP for both sexes.
  • * Results showed men had better outcomes with LBBAP compared to BIVP, while women showed no significant difference in outcomes between the two pacing methods.
View Article and Find Full Text PDF

Background: Left bundle branch area pacing (LBBAP) has emerged as a physiological alternative pacing strategy to biventricular pacing (BIVP) in cardiac resynchronization therapy (CRT). We aimed to assess the impact of LBBAP vs. BIVP on all-cause mortality and heart failure (HF)-related hospitalization in patients undergoing CRT.

View Article and Find Full Text PDF

Intracardiac Echocardiography-guided Left Atrial Appendage Occlusion.

Arrhythm Electrophysiol Rev

March 2024

Cardiac Arrhythmia Service, Brigham and Women's Hospital, Harvard Medical School Boston, MA, US.

Left atrial appendage occlusion (LAAO) is a suitable alternative to oral anticoagulant therapy to prevent stroke in patients with AF. Most procedures are performed under transoesophageal echocardiography (TOE) guidance, which facilitates transseptal puncture, reduces the risk of procedurerelated complications and provides an additional method for device selection and real-time monitoring during device deployment. However, TOE has significant shortcomings, including the need for general anaesthesia/deep sedation as well as a significant risk of procedure-related adverse events.

View Article and Find Full Text PDF

Cardiac resynchronisation therapy (CRT) reduces the risk of heart failure-related hospitalisations and all-cause mortality, as well as improving quality of life and functional status in patients with persistent heart failure symptoms despite optimal medical treatment and left bundle branch block. CRT has traditionally been delivered by implanting a lead through the coronary sinus to capture the left ventricular epicardium; however, this approach is associated with significant drawbacks, including a high rate of procedural failure, phrenic nerve stimulation, high pacing thresholds and lead dislodgement. Moreover, a significant proportion of patients fail to derive any significant benefit.

View Article and Find Full Text PDF
Article Synopsis
  • This study compared three pacing strategies for cardiac resynchronization therapy: left bundle branch pacing (LBBP), left ventricular septal pacing (LVSP), and biventricular pacing (BIVP).
  • The primary outcome measured was freedom from heart failure-related hospitalizations and all-cause mortality, finding that LBBP significantly outperformed LVSP and showed better outcomes than BIVP.
  • Results indicated that LBBP patients had a higher rate of freedom from heart failure hospitalizations (83%) compared to LVSP patients (51.6%) and similar outcomes between LVSP and BIVP.
View Article and Find Full Text PDF

Introduction: as the population pyramid gets inverted, more active and longer lives are lived, geriatric patients with high energy trauma (HET) become more frequent; requiring more resources, getting worse results with more perioperative complications, coupled with a fragile state of health and osteopenia, make these fractures difficult to manage. With the hypothesis that the incidence of pelvic and acetabular fractures in the elderly due to HET is higher than that reported in the world literature, the research question was generated: What is the incidence of pelvic and acetabular fractures in the elderly due to HET, in a 5-year period?

Material And Methods: with the authorization of the Ethics Committee, an observational study of a retrospective cohort was carried out, using medical records, identifying the incidence of these fractures, surgically treated in our institution Clínica Las Vegas, Medellin, Colombia, a level III hospital, from July 1, 2016 to June 30, 2021.

Results: a cumulative incidence of 1.

View Article and Find Full Text PDF
Article Synopsis
  • Intracardiac echocardiography (ICE) is being evaluated against transesophageal echocardiography (TEE) for guiding left atrial appendage occlusion (LAAO) procedures, focusing on procedural characteristics and outcomes.
  • A review of twelve studies involving 5,637 patients shows that ICE and TEE have comparable success rates and adverse event occurrences, but ICE significantly reduces in-room time by about 28.6 minutes.
  • Although both methods result in similar rates of periprocedural leaks, ICE guidance is linked to a higher occurrence of residual interatrial septal defects compared to TEE.
View Article and Find Full Text PDF

Surgery first with clear aligners for a Class II patient: Case report and literature review.

J Stomatol Oral Maxillofac Surg

April 2024

Department of Facial Surgery, Clinica LLanogrande, Rionegro, Colombia; Department of Oral and Maxillofacial surgery, Clinica Las Vegas, Medellin, Colombia.

Orthognathic surgery has undergone multiple modifications in timing approaches, among them, surgery first represents an approach that potentially reduces length of time and shows earlier results in facial changes, nevertheless, it has been used mostly to treat Class III skeletal anomalies. Also, fixed appliances orthodontics is the most common choice, however, recent literature shows clear aligners can achieve the same results. This paper presents a case of a 20-year-old female with a skeletal Class II treated with surgery first and clear aligners protocol, with a literature review of surgery first in Class II patients; evidencing that this approach can be suitable to achieve satisfactory and stable results, although larger patient samples are needed.

View Article and Find Full Text PDF

Introduction: alkaptonuria is a very rare metabolic disease with autosomal recessive inheritance due to HGA oxidase deficiency. Classically described and diagnosed in the third to fourth decade of life, affecting both men and women; Its diagnostic impression is clinical based on the blue/black coloration of the conjunctivae, however it is confirmed by the specific analysis of the enzyme in the urine, to date there is no cure and its treatment is palliative and symptomatic.

Material And Methods: descriptive, observational, case series study, the primary objective of which is to describe the progression of the disease and its involvement in the musculoskeletal system.

View Article and Find Full Text PDF

Background: Infection is the most dreaded complication of cardiac implantable electronic devices (CIEDs), particularly in patients undergoing high-risk procedures (eg, generator change, device upgrade, lead/pocket revision).

Objective: The purpose of this study was to describe the impact of chlorhexidine gluconate (CHG) pocket lavage in high-risk procedures.

Methods: Patients from a prospective multicenter registry undergoing high-risk procedures were included.

View Article and Find Full Text PDF

Sustained Apnea for Epicardial Access With Right Ventriculography: The SAFER Epicardial Approach.

JACC Clin Electrophysiol

August 2023

Cardiac Arrhythmia Service, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Article Synopsis
  • Epicardial access (EA) is gaining importance for treating ventricular arrhythmias, but it's underused due to high complication risks and challenging procedures.
  • * A study assessed the SAFER technique for EA, finding it to be 100% successful with no severe complications like right ventricular perforation or major hemorrhagic issues.
  • * The SAFER technique is simple, efficient, and offers lower complication rates compared to older methods, making it a promising option for interventional cardiology.
View Article and Find Full Text PDF

High-Frequency Low-Tidal Volume Ventilation Improves Long-Term Outcomes in AF Ablation: A Multicenter Prospective Study.

JACC Clin Electrophysiol

August 2023

Cardiac Arrhythmia Service, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Background: High-frequency, low-tidal-volume (HFLTV) ventilation is a safe and simple strategy to improve catheter stability and first-pass isolation during pulmonary vein (PV) isolation. However, the impact of this technique on long-term clinical outcomes has not been determined.

Objectives: This study sought to assess acute and long-term outcomes of HFLTV ventilation compared with standard ventilation (SV) during radiofrequency (RF) ablation of paroxysmal atrial fibrillation (PAF).

View Article and Find Full Text PDF

Introduction: Chronic kidney disease (CKD) represents one of the most frequent comorbidities observed in heart failure (HF) patients and has been observed to increase this population's risk of adverse outcomes. Nevertheless, evidence analyzing kidney dysfunction in HF is scarce in Latin American populations. We aimed to analyze the prevalence of kidney dysfunction and assess its association with mortality in patients diagnosed with HF enrolled in the Colombian Heart Failure Registry (RECOLFACA).

View Article and Find Full Text PDF

Left Bundle Branch Area Pacing Versus Biventricular Pacing as Initial Strategy for Cardiac Resynchronization.

JACC Clin Electrophysiol

August 2023

Cardiac Arrhythmia Service, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Background: Left bundle branch area pacing (LBBAP) for cardiac resynchronization therapy (CRT) is an alternative to biventricular pacing (BiVp).

Objectives: The purpose of this study was to compare the outcomes between LBBAP and BiVp as an initial implant strategy for CRT.

Methods: In this prospective multicenter, observational, nonrandomized study, first-time CRT implant recipients with LBBAP or BiVp were included.

View Article and Find Full Text PDF

Performance of the REAL-AF Same-Day Discharge Protocol in Patients Undergoing Catheter Ablation of Atrial Fibrillation.

JACC Clin Electrophysiol

August 2023

Cardiac Arrhythmia Service, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Background: Same-day discharge (SDD) after catheter ablation of atrial fibrillation (AF) has been widely adopted. Nevertheless, planned SDD has been performed by using subjective criteria rather than standardized protocols.

Objectives: The goal of this study was to determine the efficacy and safety of the previously described SDD protocol in a prospective multicenter study.

View Article and Find Full Text PDF