Anaesthetic-surgical guide in the treatment of ascending aorta and surgery of the ascending aorta and aortic arch. Consensus document of the Spanish Society of Cardiovascular and Endovascular Surgery and the Sociedad of Anaesthesiology, Resuscitation and Pain Therapy.

Aortic pathology is always a challenge for the clinician, and must be diagnosed and treated by a multidisciplinary team due to the technical and technological complexity of the resources used. Ongoing efforts to implement a systematic, protocolized approach involving "Aortic teams" made up of cardiologists, cardiac surgeons, vascular surgeons, anaesthesiologists and radiologists, among others are now leading to improved outcomes. The aim of this consensus document drawn up by the Aortic working groups of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR) and the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) is to disseminate a set of working protocols.

Left atrial enlargement in competitive athletes and atrial electrophysiology.

Introduction And Objectives: There are scarce data on left atrial (LA) enlargement and electrophysiological features in athletes.

Methods: Multicenter observational study in competitive athletes and controls. LA enlargement was defined as LA volume indexed to body surface area ≥ 34mL/m.

Anaesthetic-surgical guide in the treatment of ascending aorta and surgery of the ascending aorta and aortic arch. Consensus document of the Spanish Society of Cardiovascular and Endovascular Surgery and the Sociedad of Anaesthesiology, Resuscitation and Pain Therapy.

Aortic pathology is always a challenge for the clinician, and must be diagnosed and treated by a multidisciplinary team due to the technical and technological complexity of the resources used. Ongoing efforts to implement a systematic, protocolized approach involving "Aortic teams" made up of cardiologists, cardiac surgeons, vascular surgeons, anaesthesiologists and radiologists, among others are now leading to improved outcomes. The aim of this consensus document drawn up by the Aortic working groups of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR) and the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) is to disseminate a set of working protocols.

RETRACTED: Anesthesic and surgical guideline for the treatment of the thoraco-abdominal aorta. Consensus Document of the Spanish Societies of Anesthesia and Cardiovascular Surgery.

Este artículo ha sido retirado por indicación del Editor Jefe de la revista, después de constatar que parte de su contenido había sido plagiado, sin mencionar la fuente original: European Heart Journal (2014) 35, 2873 926.: https://academic.oup.

Apparent Ventricular Dysfunction in Elite Young Athletes: Another Form of Cardiac Adaptation of the Athlete's Heart.

Background: The authors previously observed that some high-performance athletes, irrespective of type of sport, can show echocardiographically determined low left ventricular ejection fractions (LVEF; <52%) together with normal heart rates and nondilated left ventricular (LV) cavities under resting conditions. The aim of this study was to determine if this phenomenon is associated with dyssynchronous motion of the interventricular septum relative to the lateral LV wall.

Methods: Results of M-mode and two-dimensional echocardiography and pulsed-wave, pulsed-wave tissue, and color tissue Doppler were compared in 70 athletes (mean age, 20 ± 7 years; 77% men) with low LVEFs (<52%) participating in a wide variety of sports and a control group of 564 athletes (mean age, 22 ± 7 years; 61% men) with normal LVEFs (≥52%).

Bifurcated endograft in aortoiliac type C and D lesions: long-term results.

Purpose: To report long-term outcome when using a bifurcated aortic endograft for treatment of aortoiliac occlusive disease (AIOD) in Trans Atlantic Inter Society Consensus (TASC) classification C and D patients.

Materials And Methods: Between May 2001 and May 2009, 14 patients (11 men, 3 women) with aortoiliac TASC C and D type lesions and a mean age of 59 years ± 10 (range 41-73 years) were treated using a bifurcated aortic endograft. Although these patients were young, all were considered at high surgical risk.

Endovascular treatment for pseudoaneurysms after surgical correction of aortic coarctation.

Late complications after surgical repair of aortic coarctation are not uncommon. Among these complications pseudoaneurysms are the most frequent complications, occurring between 3 and 38%. Reoperation in these patients is associated with high morbidity and mortality.

Stent-assisted coil embolization of a mycotic renal artery aneurysm by use of a self-expanding neurointerventional stent.

Mycotic aneurysms are uncommon, especially those located in visceral arteries. We present a case of a patient with two visceral mycotic aneurysms due to bacterial endocarditis, one located in right upper pole renal artery and the second in the splenic artery. Both aneurysms were treated as endovascular embolization using microcoils.

Primary stenting immediatly after surgery in occluded anastomoses of aortoaortic tube graft: a case report.

The conventional elective open procedures for abdominal aortic aneurysm repair are reliable and yield durable results. The aortoaortic tube graft has the lowest morbidity incidence when compared with different techniques. Albeit infrequent, thrombosis can be present in the first 30 days.

Successful occlusion of a ruptured aortic aneurysm using the Amplatzer Vascular Plug: a technical note.

Ruptured abdominal aortic aneurysm is related with a 100% mortality rate if left untreated. Even with surgical intervention or endovascular repair, mortality is still extremely high. However, there are conditions in which neither open surgical aneurysm repair nor endovascular aneurysm repair can be considered a viable therapeutic option because of comorbidities or anatomic reasons.

[Transcranial Doppler ultrasonography usefulness in cardiac arrest resuscitation].

An effective tissue perfusion has decisive influence on the final prognosis both during cardiopulmonary resuscitation (CPR) and after recovery of spontaneous circulation (ROSC). The transcranial Doppler ultranosography (TCD) examines the velocity and pulsatility of cerebral blood flow, making it possible to perform "beat to beat" hemodynamic analysis. During CPR, TCD peak systolic velocity reflects cerebral perfusion of the chest compressions.

[Contribution of the patent foramen ovale to the etiopathogeny of the irritable bowel syndrome].

A higher prevalence of cardiac right-to-left shunt through a patent foramen ovale (PFO) has been recently reported in the irritable bowel syndrome (IBS). At the same time, signs of ischemia in medullary cerebral microcirculation and the presence of excess sympathetic activity in peripheral circulation have been identified, both related with change in pain perception and autonomic dysfunction characteristic of IBS. Considering these findings together, the possible etiopathogenic role of PFO in the development of IBS can be proposed, because the paradoxical embolism characteristic of PFO could damage the cerebral and intestinal microcirculation, and that injury would be also amplified by the percentage of venous blood that shunts the pulmonary filter, producing an alteration in the metabolism of serotonin, pro-inflammatory bradykinins or neurotensin, substances with a proven etiopathogenic relationship with IBS.

[Some uncommon applications of transcranial Doppler in the intensive care unit].

We present the case of a 64-year old woman with shock related to ischemic colitis associated with paradoxical embolism through a foramen ovale. Some utilities of transcranial Doppler ultra-sonography applied in this case that could have an usual interest in intensive and intermediate care are discussed. These include analysis of the regional distribution of cerebral blood flow, intracranial arterial continuous monitoring for detection of spontaneous microembolisms and injection of microbubbles to detect right to left shunts.

[Irritable bowel syndrome and cardiac right-to-left shunt through a patent foramen ovale].

Background And Objective: Both irritable bowel syndrome (IBS) and patent foramen ovale (PFO) have a similar prevalence in the general population, affect more commonly women and are related to comorbidities such as migraine. In IBS there are alterations in the metabolism of certain substances like serotonin. In the presence of PFO with a right- to left-shunt (RLS), a percentage of venous blood bypasses the lung filter and may increase these substances in blood.

[Avoidable mortality after out-of-hospital cardiac arrest].

More than 50,000 people suffer annually in Spain an episode of out-of-hospital cardiac arrest, but less than 10% of those individuals are successfully resuscitated and return home to live productive lives. The application of the scientific evidence available in resuscitation could substantially improve such dismal outcome. However, most of the procedures that have been able to reduce mortality are not sufficiently being used in Spain.

[Occlusion of a pulmonary arteriovenous fistula with an amplatzer vascular plug].

Pulmonary arteriovenous malformations are rare anomalies that carry a considerable risk of serious complications such as cerebral thromboembolism or abscess and pulmonary hemorrhage. The first-line treatment of such malformations is detachable coil or balloon embolotherapy. However, coils and balloons may migrate and cause paradoxical embolism especially in malformations with large arteriovenous shunts.

[Clinical relevance of patent foramen ovale and right-to-left shunt].

A frequent finding in healthy individuals, patent foramen ovale (PFO) with right-to-left shunt (RLSh), is an embrionary residue that has been linked with cryptogenic stroke and peripheral ischemia. Pulmonary hypertension and entities like decompression illness, migraine with aura or plathypnea-orthodeoxia have been found to have a higher prevalence of PFO with RLSh. Some dementias and unexplained syncopes could also have some relationship.