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1. Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Author

Laura Herrera-Hidalgo, Patricia Muñoz, Ana Álvarez-Uría, David Alonso-Menchén, Rafael Luque-Marquez, Encarnación Gutiérrez-Carretero, María Del Carmen Fariñas, Jose Maria Miró, Miguel Angel Goenaga, Luis Eduardo López-Cortés, Basilio Angulo-Lara, Lucia Boix-Palop, Arístides de Alarcón, Fernando Fernández Sánchez, José Mª García de Lomas, Gabriel Rosas, Javier de la Torre Lima, Elena Bereciartua, María José Blanco Vidal, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Laura Guio Carrión, Mikel Del Álamo Martínez de Lagos, Gorane Euba Ugarte, Ane Josune Goikoetxea, Marta Ibarrola Hierro, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodrigo, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, Mª Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ignacio Álvarez Rodríguez, Harkaitz Azkune Galparsoro, Elisa Berritu Boronat, Mª Jesús Bustinduy Odriozola, Cristina del Bosque Martín, Tomás Echeverría, Alberto Eizaguirre Yarza, Ana Fuentes, Miguel Ángel Goenaga, Muskilda Goyeneche del Río, Ángela Granda Bauza, José Antonio Iribarren, Xabier Kortajarena Urkola, José Ignacio Pérez-Moreiras López, Ainhoa Rengel Jiménez, Karlos Reviejo, Alberto Sáez Berbejillo, Elou Sánchez Haza, Rosa Sebastián Alda, Itziar Solla Ruiz, Irati Unamuno Ugartemendia, Diego Vicente Anza, Iñaki Villanueva Benito, Mar Zabalo Arrieta, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Alberto Bouzas, Brais Castelo, José Cuenca, Laura Gutiérrez, Lucía Ramos, María Rodríguez Mayo, Joaquín Manuel Serrano, Dolores Sousa Regueiro, Francisco Javier Martínez, Mª del Mar Alonso, Beatriz Castro, Teresa Delgado Melian, Javier Fernández Sarabia, Dácil García Rosado, Julia González González, Juan Lacalzada, Lissete Lorenzo de la Peña, Alina Pérez Ramírez, Pablo Prada Arrondo, Fermín Rodríguez Moreno, Antonio Plata Ciezar, José Mª Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Guillermo Cuervo, Carlos Falces, Mariana J Fernández-Pittol, Guillermina Fita, David Fuster, Cristina García de la Mària, Delia García-Pares, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, José M. Miró, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Mercè Roque, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, David Alonso, Juan Carlos Alonso, Javier Bermejo, Emilio Bouza, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Agustín Estévez, Ramón Fortuny Ribas, Esther Gargallo, Mª Eugenia García Leoni, Ana González Mansilla, Francisco Javier González Moraga, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Marina Machado, Mercedes Marín, Manuel Martínez-Sellés, Rosa Melero, Diego Monzón, María Olmedo, Álvaro Pedraz, Blanca Pinilla, Ángel Pinto, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Eduardo Sánchez-Pérez, Antonio Segado, Neera Toledo, Maricela Valerio, Pilar Vázquez, Eduardo Verde Moreno, Sofía de la Villa, Isabel Antorrena, Belén Loeches, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Sandra Rosillo, Jesús Agüero Balbín, Cristina Amado Fernández, Carlos Armiñanzas Castillo, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Marta Fernández Sampedro, Iván García, Claudia González Rico, Laura Gutiérrez-Fernández, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Jorge Calderón Parra, Marta Cobo, Fernando Domínguez, Pablo García Pavía, Ana Fernández Cruz, Antonio Ramos-Martínez, Isabel Sánchez Romero, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Jorge Rodríguez-Roda Stuart, Soledad Ruiz, Carmen Hidalgo Tenorio, Sergio Sequera, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, José Antonio Lepe, José López-Haldón, Rafael Luque-Márquez, Guillermo Marín, Antonio Ortiz-Carrellán, Eladio Sánchez-Domínguez, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Estíbaliz Corral Armas, Lara García-Álvarez, José Antonio Oteo, Antonio Barros Membrilla, Antonino Ginel Iglesias, Sara Grillo, Rubén Leta Petracca, Joaquín López-Contreras, María Alba Rivera Martínez, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Amaia Aguirre Quiñonero, Ángela Alonso Miñambres, Juan Carlos Gainzarain Arana, Sara González de Alaiza Ortega, Miguel Ángel Morán Rodríguez, Anai Moreno Rodríguez, Zuriñe Ortiz de Zárate, José Joaquín Portu Zapirain, Ester Sáez de Adana Arroniz, Daisy Carolina Sorto Sánchez, Sánchez-Porto Antonio, Úbeda Iglesias Alejandro, José Mª Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Mª Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Ivan Keituqwa Yañez, Julián Navarro Martínez, Ana Peláez Ballesta, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Mª Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Mª Pilar Palacián Ruiz, Juan Carlos Porres, Begoña Alcaraz Vidal, María Jesús Del Amor Espín, Francisco Buendía, Roberto Jiménez Sánchez, Rosario Mármol, Francisco Martínez, Antonio Meseguer, Beatriz Pérez, Leticia Risco, Zoser Saura, Vanina Silva, Mª Belén Villmarín, Mª Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Miquel Vives Borràs, Mª Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, Juan Carlos Segura Luque, Cristina Badía, Lucía Boix Palop, Mariona Xercavins, Sónia Ibars, Xerach Bosch, Eloy Gómez Nebreda, Ibalia Horcajada Herrera, Irene Menduiña Gallego, Imanol Pulido, Héctor Marrero Santiago, Isabel de Miguel Martínez, Elena Pisos Álamo, Daniel San Román Sánchez, Jorge Boan Pérez, Eva Mª Aguilar Blanco, Mercedes Catalán González, María Angélica Corres Peiretti, Andrea Eixerés Esteve, Laura Domínguez Pérez, Santiago de Cossío Tejido, Francisco Galván Román, José Antonio García Robles, Francisco López Medrano, Mª Jesús López Gude, Mª Ángeles Orellana Miguel, Patrick Pilkington, Yolanda Revilla Ostalaza, Juan Ruiz Morales, Sebastián Ruiz Solís, Ana Sabín Collado, Marcos Sánchez Fernández, Javier Solera Rallo, Jorge Solís Martín, Francesc Escrihuela-Vidal, Jordi Carratalà, Inmaculada Grau, Carmen Ardanuy, Dámaris Berbel, José Carlos Sánchez Salado, Oriol Alegre, Alejandro Ruiz Majoral, Fabrizio Sbraga, Arnau Blasco, Laura Gracia Sánchez, Iván Sánchez-Rodríguez, Gonzalo Aldamiz, Beatriz Álvarez, Marina Bernal Palacios, Alfonso Cabello Úbeda, Ricardo Fernández Roblas, Rafael Hernández, Victoria Andrea Hortigüela Martín, Andrea Kallmeyer, Cristina Landaeta Kancev, Marta Martín, Miguel Morante Ruiz, Miguel Ángel Navas Lobato, Ana María Pello, Laura Prieto, Marta Tomás Mallebrera, Laura Varela, Mireia de la Peña Triguero, Ruth Esther Figueroa Cerón, Lara Ruiz Gómez, Mireia Ble, Juan Pablo Horcajada Gallego, Antonio José Ginel, Inmaculada López, Alexandra Mas, Antoni Mestres, Lluís Molina, Ramón Serrat, Núria Ribas, Francisca Sánchez, Ana Silverio, Marina Suárez, Luisa Sorlí, Lluís Recasens, Manuel Taurón, María Fernández Regueras, María Ángeles Mantecón Vallejo, José Ángel Pérez Rivera, Nuria Sánchez Mata, Antonia Calvo Cano, Miguel Fajardo Olivares, María Victoria Millán Núñez, and Agustín Muñoz Sanz

Subjects
Infective endocarditis, Methicillin-susceptible Staphylococcus aureus, Cefazolin, Antistaphylococcal penicillin, Infectious and parasitic diseases, RC109-216
Abstract

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P

Published
2023
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2. Ecocardiografía transesofágica intraoperatoria en cirugía cardiovascular. Documento de consenso de la Sociedad Española de Anestesiología y Reanimación (SEDAR) y Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE)

Author

Paula Carmona García, Rafael García Fuster, Eva Mateo, Sara Badía Gamarra, Marta López Cantero, Encarna Gutiérrez Carretero, M. Luz Maestre, Vivian Legname, Guillermina Fita, Marc Vives, Tobias Koller Bernhard, Eduardo Sánchez Pérez, Jordi Miralles Bagán, Stefano Italiano, Behenaro Darias-Delbey, José María Barrio, Javier Hortal, José Ignacio Sáez de Ibarra, and Alberto Hernández

Subjects
Cardiovascular surgery, Transesophageal echocardiography, Intraoperative, Hemodynamic monitoring, Medicine, Surgery, RD1-811
Abstract

Resumen: La ecocardiografía transesfofágica es una técnica semiinvasiva que permite una evaluación de la morfología y función cardiaca a tiempo real y que constituye, a día de hoy, un estándar de calidad en las intervenciones de cirugía cardiovascular. Se ha convertido en una herramienta fundamental tanto de monitorización como de diagnóstico en el perioperatorio que permite la correcta planificación quirúrgica y manejo farmacológico dirigido.El objetivo de este documento es dar respuesta de forma consensuada y avalada por la evidencia científica de cuándo y cómo debe hacerse la ecocardiografía transesfofágica intraoperatoria en cirugía cardiovascular, qué aplicaciones tiene en el intraoperatorio, quién debe realizarla y cómo debe transmitirse la información obtenida durante el estudio. Los autores han hecho una revisión sistemática de las guías internacionales, artículos de revisión y ensayos clínicos para dar respuesta a estas preguntas. Abstract: Transesophageal echocardiography is a semi-invasive technique that allows an evaluation of cardiac morphology and function in real time and it is a quality standard in cardiovascular surgery. It has become a fundamental tool for both monitoring and diagnosis in the intraoperative period that allows decide the correct surgical planning and pharmacological management.The goal of this document is to answer the questions of when and how the perioperative TEE should be performed in cardiovascular surgery, what are their applications in the intraoperative, who should perform it and how the information should be transmitted. The authors made a systematic review of international guidelines, review articles and clinical trials to answer by consensus to these questions.

Published
2020
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4. Student Survey After Ten Years of Continuous Blended Teaching of Echocardiocraphy

Author

Víctor M. Parra, Guillermina Fita, Manel Azqueta, Mauricio González, Fernando Aranda, MaLuz Maestre, Jorge Silva, Javier Hortal, Daniel Morales, Emiliano Bórquez, Fabián Adasme, María Isabel Real, Jordi Mercadal, Pamela Zelada, Gonzalo Riobó, Katia Galdames, and Raúl J. Domenech

Abstract

Aims: The aim of this study is to analyze the impact of 10 years of blended learning in echocardiography. Methods and results: A total of 140 of 210 medical doctors who graduated from our teaching program from 2011 to 2020 responded to the survey. Among them, 53,57% were anesthesiologists and 26,42% intensivists. More than 85% of respondents indicated that the online period met their expectations, and 70,2% that the hands on practice met the objectives. Posterior to the Diploma there was a significant increase in the frequency of use of echo compared to before the Diploma, both in transthoracic and transesophageal echocardiography, from 24,29% to 40,71% and from 13,57% to 27,86%, respectively. The echo was applied mainly in the perioperative period (56,7%) and in intensive care (32,3%), and only in 11% of cases it was used in emergency units. Additionally, 92,4% of respondents revealed that it was very useful in their subsequent professional practice and 92,47% that it helped them in the interpretation of echo reports. Among the strengths they highlighted ‘the theoretical content, clinical cases, hands on activity and the teaching staff’. Among the weaknesses, 50% requested a practice period lasting more than one week. Conclusion: The blended learning of echocardiography over a decade has been satisfactorily evaluated by the graduated specialists and has been related to a significant increase in its use in the perioperative period and in intensive care. The main challenges are to establish a longer period of practice and achieve greater scope in Emergency Medicine.

Published
2022

5. Assessment of tricuspid annulus: anatomic and echocardiographic correlation

Author

Marta Sitges, Víctor M. Parra, Guillermina Fita, José L. Pomar, Alain Berrebi, and Irene Rovira

Subjects
medicine.medical_specialty, Regurgitation (circulation), 030204 cardiovascular system & hematology, Transoesophageal echocardiography, 03 medical and health sciences, 0302 clinical medicine, Tricuspid Valve Insufficiency, Predictive Value of Tests, Tricuspid annulus, Humans, Medicine, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, 030212 general & internal medicine, Cardiac imaging, Tricuspid valve, business.industry, Limits of agreement, Infant, Newborn, Ethics committee, medicine.anatomical_structure, Echocardiography, cardiovascular system, Tricuspid Valve, Radiology, Cardiology and Cardiovascular Medicine, business, Echocardiography, Transesophageal
Abstract

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. Sixty-one cardiac patients (median age 64 years) were included in the study. Echocardiographic tricuspid annulus measurements were obtained from four chamber and transgastric short axis views and compared with the surgical measurements of this valve. The study was approved by the Ethics Committee of our institution. The tricuspid annulus measurements were obtained from the four chamber and the short axis views in 57 and 49 patients, respectively, while surgical measurement was performed in all 61 patients. Bland–Altman analysis of 49 tricuspid annulus-matched dimensions of the short axis view and surgical values showed a mean bias of 0.223 mm/m2, with limits of agreement of −5.86 to 6.31 mm/m2. Echocardiographic measurements of the tricuspid annulus dimension were accurate (90% sensitivity and 90% specificity for a four chamber view cut-off value ≥ 24.5 mm/m2, and 89% sensitivity and 97% specificity for a short axis view cut-off value ≥ 37.6 mm/m2, P

Published
2021

6. Infective Endocarditis in Patients on Chronic Hemodialysis

Author

Juan M. Pericàs, Jaume Llopis, Maria Jesús Jiménez-Exposito, Wissam M. Kourany, Benito Almirante, Giampiero Carosi, Emanuele Durante-Mangoni, Claudio Querido Fortes, Efthymia Giannitsioti, Stamatios Lerakis, Rodrigo Montagna-Mella, Juan Ambrosioni, Ru-San Tan, Carlos A. Mestres, Dannah Wray, Orathai Pachirat, Asuncion Moreno, Vivian H. Chu, Elisa de Lazzari, Vance G. Fowler, Jose M. Miró, Liliana Clara, Marisa Sanchez, José Casabé, Claudia Cortes, Francisco Nacinovich, Pablo Fernandez Oses, Ricardo Ronderos, Adriana Sucari, Jorge Thierer, Javier Altclas, Silvia Kogan, Denis Spelman, Eugene Athan, Owen Harris, Karina Kennedy, Ren Tan, David Gordon, Lito Papanicolas, Tony Korman, Despina Kotsanas, Robyn Dever, Phillip Jones, Pam Konecny, Richard Lawrence, David Rees, Suzanne Ryan, Michael P. Feneley, John Harkness, Jeffrey Post, Porl Reinbott, Rainer Gattringer, Franz Wiesbauer, Adriana Ribas Andrade, Ana Cláudia Passos de Brito, Armenio Costa Guimarães, Max Grinberg, Alfredo José Mansur, Rinaldo Focaccia Siciliano, Tania Mara Varejao Strabelli, Marcelo Luiz Campos Vieira, Regina Aparecida de Medeiros Tranchesi, Marcelo Goulart Paiva, Auristela de Oliveira Ramos, Clara Weksler, Giovanna Ferraiuoli, Wilma Golebiovski, Cristiane Lamas, James A. Karlowsky, Yoav Keynan, Andrew M. Morris, Ethan Rubinstein, Sandra Braun Jones, Patricia Garcia, M. Cereceda, Alberto Fica, Rodrigo Montagna Mella, Ricardo Fernandez, Liliana Franco, Javier Gonzalez, Astrid Natalia Jaramillo, Bruno Barsic, Suzana Bukovski, Vladimir Krajinovic, Ana Pangercic, Igor Rudez, Josip Vincelj, Tomas Freiberger, Jiri Pol, Barbora Zaloudikova, Zainab Ashour, Amani El Kholy, Marwa Mishaal, Dina Osama, Hussien Rizk, Neijla Aissa, Corentine Alauzet, Francois Alla, CHU Catherine Campagnac, Thanh Doco-Lecompte, Christine Selton-Suty, Jean-Paul Casalta, Pierre-Edouard Fournier, Gilbert Habib, Didier Raoult, Franck Thuny, Francois Delahaye, Armelle Delahaye, Francois Vandenesch, Erwan Donal, Pierre Yves Donnio, Erwan Flecher, Christian Michelet, Matthieu Revest, Pierre Tattevin, Florent Chevalier, Antoine Jeu, Jean Paul Rémadi, Dan Rusinaru, Christophe Tribouilloy, Yvette Bernard, Catherine Chirouze, Bruno Hoen, Joel Leroy, Patrick Plesiat, Christoph Naber, Carl Neuerburg, Bahram Mazaheri, Carl Neuerburg Sophia Athanasia, Ioannis Deliolanis, Helen Giamarellou, Tsaganos Thomas, Elena Mylona, Olga Paniara, Konstantinos Papanicolaou, John Pyros, Athanasios Skoutelis, Konstantinos Papanikolaou, Gautam Sharma, Johnson Francis, Lathi Nair, Vinod Thomas, Krishnan Venugopal, Margaret M. Hannan, John P. Hurley, Maor Wanounou, Dan Gilon, Sarah Israel, Maya Korem, Jacob Strahilevitz, Domenico Iossa, Serena Orlando, Maria Paola Ursi, Pia Clara Pafundi, Fabiana D’Amico, Mariano Bernardo, Susanna Cuccurullo, Giovanni Dialetto, Franco Enrico Covino, Sabrina Manduca, Alessandro Della Corte, Marisa De Feo, Marie Françoise Tripodi, Enrico Cecchi, Francesco De Rosa, Davide Forno, Massimo Imazio, Rita Trinchero, Paolo Grossi, Mariangela Lattanzio, Antonio Toniolo, Antonio Goglio, Annibale Raglio, Veronica Ravasio, Marco Rizzi, Fredy Suter, Silvia Magri, Liana Signorini, Zeina Kanafani, Souha S. Kanj, Ahmad Sharif-Yakan, Imran Abidin, Syahidah Syed Tamin, Eduardo Rivera Martínez, Gabriel Israel Soto Nieto, Jan T.M. van der Meer, Stephen Chambers, David Holland, Arthur Morris, Nigel Raymond, Kerry Read, David R. Murdoch, Stefan Dragulescu, Adina Ionac, Cristian Mornos, O.M. Butkevich, Natalia Chipigina, Ozerecky Kirill, Kulichenko Vadim, Tatiana Vinogradova, Jameela Edathodu, Magid Halim, Yee-Yun Liew, Tatjana Lejko-Zupanc, Mateja Logar, Manica Mueller-Premru, Patrick Commerford, Anita Commerford, Eduan Deetlefs, Cass Hansa, Mpiko Ntsekhe, Manel Almela, Manuel Azqueta, Merce Brunet, Pedro Castro, Elisa De Lazzari, Carlos Falces, David Fuster, Guillermina Fita, Cristina Garcia- de- la- Maria, Javier Garcia-Gonzalez, Jose M. Gatell, Francesc Marco, José M. Miró, José Ortiz, Salvador Ninot, J. Carlos Paré, Juan M. Pericas, Eduard Quintana, Jose Ramirez, Irene Rovira, Elena Sandoval, Marta Sitges, Adrian Tellez, José M. Tolosana, Barbara Vidal, Jordi Vila, Ignasi Anguera, Bernat Font, Joan Raimon Guma, Javier Bermejo, Emilio Bouza, Miguel Angel Garcia Fernández, Victor Gonzalez-Ramallo, Mercedes Marín, Patricia Muñoz, Miguel Pedromingo, Jorge Roda, Marta Rodríguez-Créixems, Jorge Solis, Nuria Fernandez-Hidalgo, Pilar Tornos, Arístides de Alarcón, Ricardo Parra, Eric Alestig, Magnus Johansson, Lars Olaison, Ulrika Snygg-Martin, Pimchitra Pachirat, Burabha Pussadhamma, Vichai Senthong, Anna Casey, Tom Elliott, Peter Lambert, Richard Watkin, Christina Eyton, John L. Klein, Suzanne Bradley, Carol Kauffman, Roger Bedimo, G. Ralph Corey, Anna Lisa Crowley, Pamela Douglas, Laura Drew, Thomas Holland, Tahaniyat Lalani, Daniel Mudrick, Zaniab Samad, Daniel Sexton, Martin Stryjewski, Andrew Wang, Christopher W. Woods, Robert Cantey, Lisa Steed, Stuart A. Dickerman, Hector Bonilla, Joseph DiPersio, Sara-Jane Salstrom, John Baddley, Mukesh Patel, Gail Peterson, Amy Stancoven, Donald Levine, Jonathan Riddle, Michael Rybak, Christopher H. Cabell, Pericas, J. M., Llopis, J., Jimenez-Exposito, M. J., Kourany, W. M., Almirante, B., Carosi, G., Durante-Mangoni, E., Fortes, C. Q., Giannitsioti, E., Lerakis, S., Montagna-Mella, R., Ambrosioni, J., Tan, R. -S., Mestres, C. A., Wray, D., Pachirat, O., Moreno, A., Chu, V. H., de Lazzari, E., Fowler, V. G., Miro, J. M., Clara, L., Sanchez, M., Casabe, J., Cortes, C., Nacinovich, F., Oses, P. F., Ronderos, R., Sucari, A., Thierer, J., Altclas, J., Kogan, S., Spelman, D., Athan, E., Harris, O., Kennedy, K., Tan, R., Gordon, D., Papanicolas, L., Korman, T., Kotsanas, D., Dever, R., Jones, P., Konecny, P., Lawrence, R., Rees, D., Ryan, S., Feneley, M. P., Harkness, J., Post, J., Reinbott, P., Gattringer, R., Wiesbauer, F., Andrade, A. R., Passos de Brito, A. C., Guimaraes, A. C., Grinberg, M., Mansur, A. J., Siciliano, R. F., Varejao Strabelli, T. M., Campos Vieira, M. L., de Medeiros Tranchesi, R. A., Paiva, M. G., de Oliveira Ramos, A., Weksler, C., Ferraiuoli, G., Golebiovski, W., Lamas, C., Karlowsky, J. A., Keynan, Y., Morris, A. M., Rubinstein, E., Jones, S. B., Garcia, P., Cereceda, M., Fica, A., Mella, R. M., Fernandez, R., Franco, L., Gonzalez, J., Jaramillo, A. N., Barsic, B., Bukovski, S., Krajinovic, V., Pangercic, A., Rudez, I., Vincelj, J., Freiberger, T., Pol, J., Zaloudikova, B., Ashour, Z., El Kholy, A., Mishaal, M., Osama, D., Rizk, H., Aissa, N., Alauzet, C., Alla, F., Campagnac, C. C., Doco-Lecompte, T., Selton-Suty, C., Casalta, J. -P., Fournier, P. -E., Habib, G., Raoult, D., Thuny, F., Delahaye, F., Delahaye, A., Vandenesch, F., Donal, E., Donnio, P. Y., Flecher, E., Michelet, C., Revest, M., Tattevin, P., Chevalier, F., Jeu, A., Remadi, J. P., Rusinaru, D., Tribouilloy, C., Bernard, Y., Chirouze, C., Hoen, B., Leroy, J., Plesiat, P., Naber, C., Neuerburg, C., Mazaheri, B., Sophia Athanasia, C. N., Deliolanis, I., Giamarellou, H., Thomas, T., Mylona, E., Paniara, O., Papanicolaou, K., Pyros, J., Skoutelis, A., Papanikolaou, K., Sharma, G., Francis, J., Nair, L., Thomas, V., Venugopal, K., Hannan, M. M., Hurley, J. P., Wanounou, M., Gilon, D., Israel, S., Korem, M., Strahilevitz, J., Iossa, D., Orlando, S., Ursi, M. P., Pafundi, P. C., D'Amico, F., Bernardo, M., Cuccurullo, S., Dialetto, G., Covino, F. E., Manduca, S., Della Corte, A., De Feo, M., Tripodi, M. F., Cecchi, E., De Rosa, F., Forno, D., Imazio, M., Trinchero, R., Grossi, P., Lattanzio, M., Toniolo, A., Goglio, A., Raglio, A., Ravasio, V., Rizzi, M., Suter, F., Magri, S., Signorini, L., Kanafani, Z., Kanj, S. S., Sharif-Yakan, A., Abidin, I., Tamin, S. S., Martinez, E. R., Soto Nieto, G. I., van der Meer, J. T. M., Chambers, S., Holland, D., Morris, A., Raymond, N., Read, K., Murdoch, D. R., Dragulescu, S., Ionac, A., Mornos, C., Butkevich, O. M., Chipigina, N., Kirill, O., Vadim, K., Vinogradova, T., Edathodu, J., Halim, M., Liew, Y. -Y., Lejko-Zupanc, T., Logar, M., Mueller-Premru, M., Commerford, P., Commerford, A., Deetlefs, E., Hansa, C., Ntsekhe, M., Almela, M., Azqueta, M., Brunet, M., Castro, P., Falces, C., Fuster, D., Fita, G., Garcia- de- la- Maria, C., Garcia-Gonzalez, J., Gatell, J. M., Marco, F., Ortiz, J., Ninot, S., Pare, J. C., Quintana, E., Ramirez, J., Rovira, I., Sandoval, E., Sitges, M., Tellez, A., Tolosana, J. M., Vidal, B., Vila, J., Anguera, I., Font, B., Guma, J. R., Bermejo, J., Bouza, E., Garcia Fernandez, M. A., Gonzalez-Ramallo, V., Marin, M., Munoz, P., Pedromingo, M., Roda, J., Rodriguez-Creixems, M., Solis, J., Fernandez-Hidalgo, N., Tornos, P., de Alarcon, A., Parra, R., Alestig, E., Johansson, M., Olaison, L., Snygg-Martin, U., Pachirat, P., Pussadhamma, B., Senthong, V., Casey, A., Elliott, T., Lambert, P., Watkin, R., Eyton, C., Klein, J. L., Bradley, S., Kauffman, C., Bedimo, R., Corey, G. R., Crowley, A. L., Douglas, P., Drew, L., Holland, T., Lalani, T., Mudrick, D., Samad, Z., Sexton, D., Stryjewski, M., Wang, A., Woods, C. W., Cantey, R., Steed, L., Dickerman, S. A., Bonilla, H., Dipersio, J., Salstrom, S. -J., Baddley, J., Patel, M., Peterson, G., Stancoven, A., Levine, D., Riddle, J., Rybak, M., Cabell, C. H., Bristol-Myers Squibb Company, Vall d'Hebron University Hospital [Barcelona], Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Laboratoire Chrono-environnement (UMR 6249) (LCE)

Subjects
Male, relapses, medicine.medical_treatment, infective endocarditi, 030204 cardiovascular system & hematology, Kidney Failure, Cohort Studies, Catheters, Indwelling, 0302 clinical medicine, Surgical, Epidemiology, cardiac surgery, enterococci, hemodialysis, infective endocarditis, Staphylococcus aureus, Aged, Anti-Bacterial Agents, Arteriovenous Shunt, Surgical, Cardiac Surgical Procedures, Endocarditis, Female, Humans, Kidney Failure, Chronic, Methicillin-Resistant Staphylococcus aureus, Middle Aged, Renal Dialysis, Staphylococcal Infections, 030212 general & internal medicine, Chronic, Prospective cohort study, health care economics and organizations, relapse, Arteriovenous Shunt, 3. Good health, Cardiac surgery, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Indwelling, Infective endocarditis, Hemodialysis, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Catheters, education, 03 medical and health sciences, Internal medicine, medicine, business.industry, medicine.disease, hemodialysi, Etiology, Complication, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Background - Infective endocarditis (IE) is a common and serious complication in patients receiving chronic hemodialysis (HD). Objectives - This study sought to investigate whether there are significant differences in complications, cardiac surgery, relapses, and mortality between IE cases in HD and non-HD patients. Methods - Prospective cohort study (International Collaboration on Endocarditis databases, encompassing 7,715 IE episodes from 2000 to 2006 and from 2008 to 2012). Descriptive analysis of baseline characteristics, epidemiological and etiological features, complications and outcomes, and their comparison between HD and non-HD patients was performed. Risk factors for major embolic events, cardiac surgery, relapses, and in-hospital and 6-month mortality were investigated in HD-patients using multivariable logistic regression. Results - A total of 6,691 patients were included and 553 (8.3%) received HD. North America had a higher HD-IE proportion than the other regions. The predominant microorganism was Staphylococcus aureus (47.8%), followed by enterococci (15.4%). Both in-hospital and 6-month mortality were significantly higher in HD versus non-HD-IE patients (30.4% vs. 17% and 39.8% vs. 20.7%, respectively; p

Published
2021

7. A Contemporary Picture of Enterococcal Endocarditis

Author

Juan M. Pericàs, Jaume Llopis, Patricia Muñoz, Juan Gálvez-Acebal, Martha Kestler, Maricela Valerio, Marta Hernández-Meneses, Miguel Á. Goenaga, Manuel Cobo-Belaustegui, Miguel Montejo, Guillermo Ojeda-Burgos, M. Dolores Sousa-Regueiro, Arístides de Alarcón, Antonio Ramos-Martínez, José M. Miró, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre Lima, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Josune Goikoetxea, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Javier Nieto, David Rodrigo, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, Ma Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, Ma del Mar Alonso, Beatriz Castro, Dácil García Rosado, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, Antonio Plata Ciezar, José Ma Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Delia García-Pares, Jaume Llopis Pérez, Francesc Marco, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Daniel Celemín, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Ana García Mansilla, Ma Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Mercedes Marín, Manuel Martínez-Sellés, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Jorge Calderón Parra, Marta Cobo, Fernando Domínguez, Alberto Fortaleza, Pablo García Pavía, Jesús González, Ana Fernández Cruz, Elena Múñez, Antonio Ramos, Isabel Sánchez Romero, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Jorge Rodríguez-Roda Stuart, Soledad Ruiz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Antonio Cabrera Villegas, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, García-Domínguez Gloria, Sánchez-Porto Antonio, José Ma Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Ma Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Ivan Keituqwa Yañez, Julián Navarro Martínez, Ana Peláez Ballesta, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Ma Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Ma Pilar Palacián Ruiz, Juan Carlos Porres, Begoña Alcaraz Vidal, Nazaret Cobos Trigueros, María Jesús Del Amor Espín, José Antonio Giner Caro, Roberto Jiménez Sánchez, Amaya Jimeno Almazán, Alejandro Ortín Freire, Monserrat Viqueira González, Pere Pericás Ramis, Ma Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Ma Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, Juan Carlos Segura Luque, Cristina Badía, Lucía Boix Palop, Mariona Xercavins, Sónia Ibars, Eloy Gómez Nebreda, Ibalia Horcajada Herrera, Irene Menduiña Gallego, Héctor Marrero Santiago, Isabel de Miguel Martínez, Elena Pisos Álamo, Carmen Díaz Pedroche, Fernando Chaves, Santiago de Cossío, Francisco López Medrano, Ma Jesús López, Javier Solera, Jorge Solís, Carmen Ardanuy, Guillermo Cuervo Requena, Sara Grillo, and Alejandro Ruiz Majoral

Subjects
Aortic valve, Male, medicine.medical_specialty, relapses, Enterococci, Epidemiology, medicine.medical_treatment, heart failure, Heart failure, 030204 cardiovascular system & hematology, Logistic regression, Prosthesis, prosthetic valves, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, enterococci, Internal medicine, Post-hoc analysis, medicine, Enterococcus faecalis, Endocarditis, Humans, 030212 general & internal medicine, Gram-Positive Bacterial Infections, Aged, Bacteria, business.industry, infective endocarditis, ComputingMilieux_PERSONALCOMPUTING, Endocarditis, Bacterial, Middle Aged, Prosthetic valves, medicine.disease, medicine.anatomical_structure, Spain, Infective endocarditis, Cohort, epidemiology, Female, Cardiology and Cardiovascular Medicine, business, Relapses
Abstract

GAMES Investigators., [Background] Enterococcal endocarditis (EE) is a growing entity in Western countries. However, quality data from large studies is lacking., [Objectives] The purpose of this study was to describe the characteristics and analyze the prognostic factors of EE in the GAMES cohort., [Methods] This was a post hoc analysis of a prospectively collected cohort of patients from 35 Spanish centers from 2008 to 2016. Characteristics and outcomes of 516 cases of EE were compared with those of 3,308 cases of nonenterococcal endocarditis (NEE). Logistic regression and Cox proportional hazards regression analysis were performed to investigate risk factors for in-hospital and 1-year mortality, as well as relapses., [Results] Patients with EE were significantly older; more frequently presented chronic lung disease, chronic heart failure, prior endocarditis, and degenerative valve disease; and had higher median age-adjusted Charlson score. EE more frequently involved the aortic valve and prosthesis (64.3% vs. 46.7%; p < 0.001; and 35.9% vs. 28.9%; p = 0.002, respectively) but less frequently pacemakers/defibrillators (1.5% vs. 10.5%; p < 0.001), and showed higher rates of acute heart failure (45% vs. 38.3%; p = 0.005). Cardiac surgery was less frequently performed in EE (40.7% vs. 45.9%; p = 0.024). No differences in in-hospital and 1-year mortality were found, whereas relapses were significantly higher in EE (3.5% vs. 1.7%; p = 0.035). Increasing Charlson score, LogEuroSCORE, acute heart failure, septic shock, and paravalvular complications were risk factors for mortality, whereas prior endocarditis was protective and persistent bacteremia constituted the sole risk factor for relapse., [Conclusions] Besides other baseline and clinical differences, EE more frequently affects prosthetic valves and less frequently pacemakers/defibrillators. EE presents higher rates of relapse than NEE.

Published
2020

8. Gentamicin may have no effect on mortality of staphylococcal prosthetic valve endocarditis

Author

Antonio Ramos-Martínez, Alejandro Muñoz Serrano, Arístides de Alarcón González, Patricia Muñoz, Ana Fernández-Cruz, Maricela Valerio, María Carmen Fariñas, Manuel Gutiérrez-Cuadra, José Ma Miró, Josefa Ruiz-Morales, Dolores Sousa-Regueiro, José Miguel Montejo, Juan Gálvez-Acebal, Carmen HidalgoTenorio, Fernando Domínguez, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre Lima, José Aramendi, Elena Bereciartua, Roberto Blanco, María Victoria Boado, Itxasne Cabezón Estébanez, Marta Campaña Lázaro, Josune Goikoetxea, Juan José Goiti, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodríguez, Regino Rodríguez, Roberto Voces, Ma Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, Ma del Mar Alonso, Beatriz Castro, Dácil García Rosado, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, Antonio Plata Ciezar, José Ma Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, José M. Miró, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Gregorio Cuerpo Caballero, Ana Fernández Cruz, Ma Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Mercedes Marín, Manuel Martínez-Sellés, Ma Cruz Menárguez, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Pablo García Pavíaz, Jesús Gonzálezz, Beatriz Ordenz, Antonio Ramosz, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Soledad Ruiz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Arístides de Alarcón, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, Gloria García Domínguez, Antonio Sánchez-Porto, José Ma Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Ma Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Pilar Egea Serrano, José Joaquín Hernández Roca, Ivan Keituqwa Yañez, Ana Peláez Ballesta, Víctor Soriano, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Ma Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Ma Pilar Palacián Ruiz, and Juan Carlos Porres

Subjects
Male, 0301 basic medicine, Microbiology (medical), Staphylococcus aureus, medicine.medical_specialty, Prosthesis-Related Infections, 030106 microbiology, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Cloxacillin, Vancomycin, Internal medicine, medicine, Humans, Endocarditis, Pharmacology (medical), Prospective Studies, Renal Insufficiency, 030212 general & internal medicine, Aged, Heart Failure, business.industry, Endocarditis, Bacterial, Middle Aged, Staphylococcal Infections, medicine.disease, Anti-Bacterial Agents, Regimen, Infectious Diseases, Heart Valve Prosthesis, Multivariate Analysis, Female, Gentamicin, Gentamicins, Rifampin, business, Complication, Rifampicin, medicine.drug
Abstract

Purpose: To analyze the influence of adding gentamicin to a regimen consisting of β-lactam or vancomycin plus rifampicin on survival in patients suffering from Staphylococcal prosthetic valve endocarditis (SPVE). Methods: From January 2008 to September 2016, 334 patients with definite SPVE were attended in the participating hospitals. Ninety-four patients (28.1%) received treatment based on β-lactam or vancomycin plus rifampicin and were included in the study. Variables were analyzed which related to patient survival during admission, including having received treatment with gentamicin. Results: Seventy-seven (81.9%) were treated with cloxacillin (or vancomycin) plus rifampicin plus gentamicin, and 17 patients (18.1%) received the same regimen without gentamicin. The causative microorganism was Staphylococcus aureus in 40 cases (42.6%) and coagulase-negative staphylococci in 54 cases (57.4%). Overall, 40 patients (42.6%) died during hospital admission, 33 patients (42.9%) in the group receiving gentamicin and 7 patients in the group that did not (41.2%, P = 0.899). Worsening renal function was observed in 42 patients (54.5%) who received gentamicin and in 9 patients (52.9%) who did not (p = 0.904). Heart failure as a complication of endocarditis (OR: 4.58; CI 95%: 1.84–11.42) and not performing surgery when indicated (OR: 2.68; CI 95%: 1.03–6.94) increased mortality. Gentamicin administration remained unrelated to mortality (OR: 1.001; CI 95%: 0.29–3.38) in the multivariable analysis. Conclusions: The addition of gentamicin to a regimen containing vancomycin or cloxacillin plus rifampicin in SPVE was not associated to better outcome.

Published
2018

9. Prevalence of Colorectal Neoplasms Among Patients With Enterococcus faecalis Endocarditis in the GAMES Cohort (2008-2017)

Author

Juan M. Pericàs, Juan Ambrosioni, Patricia Muñoz, Arístides de Alarcón, Martha Kestler, Amaia Mari-Hualde, Asunción Moreno, Miguel Á. Goenaga, M. Carmen Fariñas, Regino Rodríguez-Álvarez, Guillermo Ojeda-Burgos, Juan Gálvez-Acebal, Carmen Hidalgo-Tenorio, Mariam Noureddine, José M. Miró, Fernando Fernández Sánchez, Gabriel Rosas, Javier de la Torre Lima, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Josune Goikoetxea, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodrigo, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, Ma Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, Ma del Mar Alonso, Beatriz Castro, Dácil García Rosado, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, Antonio Plata Ciezar, José Ma Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Delia García-Pares, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Daniel Celemín, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Ana García Mansilla, Ma Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Mercedes Marín, Manuel Martínez-Sellés, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Maricela Valerio, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Jorge Calderón Parra, Marta Cobo, Fernando Domínguez, Alberto Fortaleza, Pablo García Pavía, Jesús González, Ana Fernández Cruz, Elena Múñez, Antonio Ramos, Isabel Sánchez Romero, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Jorge Rodríguez-Roda Stuart, Soledad Ruiz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Antonio Cabrera Villegas, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, García-Domínguez Gloria, Sánchez-Porto Antonio, José Ma Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Ma Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Ivan Keituqwa Yañez, Julián Navarro Martínez, Ana Peláez Ballesta, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Ma Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Ma Pilar Palacián Ruiz, Juan Carlos Porres, Begoña Alcaraz Vidal, Nazaret Cobos Trigueros, María Jesús Del Amor Espín, José Antonio Giner Caro, Roberto Jiménez Sánchez, Amaya Jimeno Almazán, Alejandro Ortín Freire, Monserrat Viqueira González, Pere Pericás Ramis, Ma Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Ma Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, Juan Carlos Segura Luque, Cristina Badía, Lucía Boix Palop, Mariona Xercavins, Sónia Ibars. Eloy Gómez Nebreda, Ibalia Horcajada Herrera, Irene Menduiña Gallego Héctor Marrero Santiago, Isabel de Miguel Martínez, and Elena Pisos Álamo

Subjects
Male, medicine.medical_specialty, Colorectal cancer, Population, Colonoscopy, Enterococcus faecalis, Risk Factors, Internal medicine, medicine, Prevalence, Endocarditis, Humans, education, Gram-Positive Bacterial Infections, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, medicine.diagnostic_test, biology, business.industry, Retrospective cohort study, General Medicine, Endocarditis, Bacterial, Middle Aged, medicine.disease, biology.organism_classification, Infective endocarditis, Cohort, Female, business, Colorectal Neoplasms
Abstract

Objective: To investigate the rate of colorectal neoplasms (CRNs) in patients who have Enterococcus faecalis infective endocarditis (EFIE) with available colonoscopies and to assess whether this is associated with the identification of a focus the infection. Patients and Methods: Retrospective analysis of data from a prospective multicenter study involving 35 centers who are members of the Grupo de Apoyo para el Manejo de la Endocarditis en Espana [Support Group for the Management of Infective Endocarditis in Spain] cohort. A specific set of queries regarding information on colonoscopy and histopathology of colorectal diseases was sent to each participating center. Four-hundred sixty-seven patients with EFIE were included from January 1, 2008, to December 31, 2017, from whom data on colonoscopy performance and results were available in 411 patients. Results: One hundred forty-two (34.5%) patients had a colonoscopy close to the EFIE episode. The overall rate of colorectal diseases was 70.4% (100 of 142), whereas the prevalence of CRN (advanced adenomas and colorectal carcinoma) was 14.8% (21 of 142), with no significant differences between the group of EFIE of unknown focus and that with an identified focus. Conclusion: Our study adds to prior evidence suggesting a much higher rate of CRN among patients with EFIE than in the general population of the same age and sex. In addition, our findings suggest that this phenomenon might take place both in EFIE with an unknown and an identified source of infection.

Published
2019

10. Infarct transmurality as a criterion for first-line endo-epicardial substrate–guided ventricular tachycardia ablation in ischemic cardiomyopathy

Author

Teresa M. de Caralt, Diego Penela, Marta Sitges, Roger Borràs, José T. Ortiz, Lluís Mont, Juan Fernández-Armenta, Juan Acosta, Rosario J. Perea, Francesca Vassanelli, David Andreu, Guillermina Fita, Josep Brugada, Antonio Berruezo, and Viatcheslav Korshunov

Subjects
Epicardial Mapping, Male, medicine.medical_specialty, medicine.medical_treatment, Myocardial Infarction, Infarction, 030204 cardiovascular system & hematology, Ventricular tachycardia, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Cardiac magnetic resonance imaging, Physiology (medical), Internal medicine, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, Aged, Proportional Hazards Models, Ischemic cardiomyopathy, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, Implantable cardioverter-defibrillator, Ablation, Treatment Outcome, Ventricular fibrillation, Catheter Ablation, Tachycardia, Ventricular, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Endocardium, Follow-Up Studies
Abstract

Background There is no consensus on the appropriate indications for the epicardial approach in substrate ablation of post–myocardial infarction (MI) ventricular tachycardia (VT). Objective The purpose of this study was to investigate whether infarct transmurality (IT) could identify patients who would benefit from a combined first-line endo-epicardial approach. Methods Before ablation, IT was assessed by contrast-enhanced cardiac magnetic resonance imaging (hyperenhancement ≥75% of the wall thickness in ≥1 segment), echocardiography (dyskinesia/akinesia + hyperrefringency + wall thinning), computed tomography (wall thinning), or scintigraphy (transmural necrosis). Prospectively from January 2011, an endocardial approach was used in patients with subendocardial MI (group 1) and a combined endo-epicardial approach in patients with transmural MI (group 2). Outcomes in both groups were compared with those in patients with transmural MI and only endocardial approach due to previous cardiac surgery or procedure performed before January 2011 (group 3). The primary end point was VT/ventricular fibrillation recurrence-free survival. Results Ninety patients (92.2% men; mean age 67.4 ± 9.8 years) undergoing VT substrate ablation were included: group 1, n=34; group 2, n=24; group 3, n=32. During a mean follow-up duration of 22.5 ± 13.7 months, 5 patients in group 1 (14.7%), 3 patients in group 2 (12.5%), and 13 patients in group 3 (40.6%) had VT recurrences ( P = .011). Time to recurrence was the shortest in group 3 (log-rank, P = .018). The endocardial approach in patients with transmural MI was associated with an increased risk of recurrence (hazard ratio 4.01; 95% confidence interval 1.41–11.3; P = .009). Conclusion The endocardial approach in patients with transmural MI undergoing VT substrate ablation is associated with an increased risk of recurrence. IT may be a useful criterion for the selection of a first-line combined endo-epicardial approach.

Published
2016

11. Infective Endocarditis in Patients With Bicuspid Aortic Valve or Mitral Valve Prolapse

Author

Isabel Zegri-Reiriz, Arístides de Alarcón, Patricia Muñoz, Manuel Martínez Sellés, Victor González-Ramallo, Jose M. Miro, Carles Falces, Claudia Gonzalez Rico, Xabier Kortajarena Urkola, José Antonio Lepe, Regino Rodriguez Alvarez, Jose Maria Reguera Iglesias, Enrique Navas, Fernando Dominguez, Pablo Garcia-Pavia, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre Lima, José Aramendi, Elena Bereciartua, María José Blanco, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Josune Goikoetxea, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodrigo, David Rodríguez, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, María Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, María del Mar Alonso, Beatriz Castro, Dácil García Rosado, Mª del Carmen Durán, Mª Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, Antonio Plata Ciezar, José Mª Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, José María Miró, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan Manuel Pericás, José Luis Pomar, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Daniel Celemín, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Ana Fernández Cruz, Ana García Mansilla, María Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Mercedes Marín, Manuel Martínez-Sellés, María Cruz Menárguez, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Maricela Valerio, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Fernando Domínguez, Pablo García-Pavía, Jesús González Mirelis, Beatriz Orden, Antonio Ramos, Marta Cobo-Marcos, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Oliva, Alejandro del Río, Soledad Ruiz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Emilio García, Juan Luis Haro, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, Ángel Luis Fernández, Amparo Martínez, Arturo Prieto, Benito Regueiro, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, Gloria García Domínguez, Antonio Sánchez-Porto, José Mª Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, María Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Pilar Egea Serrano, José Joaquín Hernández Roca, Ivan Keituqwa Yañez, Ana Peláez Ballesta, Víctor Soriano, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Mª Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Mª Pilar Palacián Ruiz, Juan Carlos Porres, Begoña Alcaraz Vidal, Nazaret Cobos Trigueros, María Jesús Del Amor Espín, José Antonio Giner Caro, Roberto Jiménez Sánchez, Amaya Jimeno Almazán, Alejandro Ortín Freire, Monserrat Viqueira González, Pere Pericás Ramis, Mª Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Mª Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, and Juan Carlos Segura Luque

Subjects
Adult, Male, medicine.medical_specialty, bicuspid aortic valve, Enfermedad cardiovascular, Heart Valve Diseases, 030204 cardiovascular system & hematology, Intracardiac injection, 03 medical and health sciences, Tratamiento médico, 0302 clinical medicine, Bicuspid aortic valve, Bicuspid Aortic Valve Disease, medicine, Mitral valve prolapse, Endocarditis, Humans, In patient, 030212 general & internal medicine, Registries, Antibiotic prophylaxis, Antibióticos, Aged, Endocarditis infecciosa, Mitral Valve Prolapse, antibiotic prophylaxis, business.industry, Incidence (epidemiology), Antibiotic Prophylaxis, Middle Aged, medicine.disease, Surgery, Infective endocarditis, Aortic Valve, Válvulas cardíacas, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background: There is little information concerning infective endocarditis (IE) in patients with bicuspid aortic valve (BAV) or mitral valve prolapse (MVP). Currently, IE antibiotic prophylaxis (IEAP) is not recommended for these conditions. Objectives: This study sought to describe the clinical and microbiological features of IE in patients with BAV and MVP and compare them with those of IE patients with and without IEAP indication, to determine the potential benefit of IEAP in these conditions. Methods: This analysis involved 3,208 consecutive IE patients prospectively included in the GAMES (Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España) registry at 31 Spanish hospitals. Patients were classified as high-risk IE with IEAP indication (high-risk group; n = 1,226), low- and moderate-risk IE without IEAP indication (low/moderate-risk group; n = 1,839), and IE with BAV (n = 54) or MVP (n = 89). Results: BAV and MVP patients had a higher incidence of viridans group streptococci IE than did high-risk group and low/moderate-risk group patients (35.2% and 39.3% vs. 12.1% and 15.0%, respectively; all p < 0.01). A similar pattern was seen for IE from suspected odontologic origin (14.8% and 18.0% vs. 5.8% and 6.0%; all p < 0.01). BAV and MVP patients had more intracardiac complications than did low/moderate-risk group (50% and 47.2% vs. 30.6%, both p < 0.01) patients and were similar to high-risk group patients. Conclusions: IE in patients with BAV and MVP have higher rates of viridans group streptococci IE and IE from suspected odontologic origin than in other IE patients, with a clinical profile similar to that of high-risk IE patients. Our findings suggest that BAV and MVP should be classified as high-risk IE conditions and the case for IEAP should be reconsidered. Sin financiación 18.639 JCR (2018) Q1, 3/136 Cardiac & Cardiovascular Systems 9.280 SJR (2018) Q1, 1/365 Cardiology and Cardiovascular Medicine No data IDR 2018 UEM

Published
2018

12. Extraction of implantable cardiac devices: the role of transesophageal echocardiography monitoring

Author

Carmen Gomar, I. Rovira Canudas, R. Navarro, M.J. Arguis, L.E. Mendoza Vasquez, Guillermina Fita, C. Ibañez, M.J. Carretero, P. Matute, J.M. Perdomo, and Elena Sandoval

Subjects
medicine.medical_specialty, business.industry, Regurgitation (circulation), medicine.disease, Pericardial effusion, Inhalation anesthesia, Surgery, Transvenous lead, Patient safety, Anesthesiology and Pain Medicine, Blood pressure, medicine, Arterial line, Cardiology and Cardiovascular Medicine, business, Lead (electronics), human activities
Abstract

Introduction Background: Data for the utility of continuous trans-esophageal echocardiography (TEE) monitoring during trans venous lead extraction remain scarce. Removal of the implanted transvenous lead system can be a significantly complex procedure, facing main complications. Our objective: the retrospective assessment of the TEE in the monitoring during trans venous lead extraction of implantable cardiac devices (pacemaker and implantable cardiac defibrillator). Methods From November 2013 to November 2018 the transvenous lead extraction of 93 leads in 50 patients was reviewed. Lead extraction techniques combined traction and mechanical approach by the same surgeon. Extraction procedures were performed under general anesthesia either total intravenous or inhalation anesthesia. Invasive arterial line blood pressure and continuous TEE monitoring were performed. TEE images of different projections were acquired and stored before and immediately after the extraction of each lead. Results From the 50 patients (mean age 58.9 years, 64% male, 1.86% lead per patient) which had the following indication: lead dysfunction (24%), upgrade (8%), infection (54%), or other (14%). The lead extraction was complete for 69 out of 93 leads (74.19%), partial extraction was for 24 leads out of 93 leads (25.80%). General anesthesia by total intravenous (30%) and inhalation anesthesia (70%). New TEE findings following TEE were observed in 7 of 50 cases (14%). Two cases which had new mild tricuspid regurgitation without the need of re-intervention, new appearance or worsening of tricuspid regurgitation in three cases which needed non-emergency re-intervention and pericardial effusion in two cases. No cases needed rescue surgery. In all other cases, TEE findings did not entail immediate diagnostic or therapeutic measures. Discussion New findings necessitating immediate therapeutic measures occurred zero cases, no mortality, yet all patients with new TEE findings had strict observational control. We suggest TEE monitoring during trans venous lead extraction, as it provides useful real-time information and should be standard of care monitoring during lead extraction, to guide trans operative and postoperative management. TEE presents some non-negligible risks associated with its use and is a costly procedure, such investment, however, may have a high return in terms of increased patient safety.

Published
2019

13. Adult congenital heart diseases: experience from a reference center

Author

Guillermina Fita, Carmen Gomar, M.J. Carretero, Irene Rovira, P. Morales, C. Ibañez, J.M. Perdomo, R. Navarro, M.J. Arguis, D. Pereda, A. Fernández, P. Matute, and S. Montserrat

Subjects
medicine.medical_specialty, education.field_of_study, Heart disease, business.industry, Population, medicine.disease, Surgery, Cardiac surgery, Stenosis, Anesthesiology and Pain Medicine, Bicuspid aortic valve, Right coronary artery, medicine.artery, cardiovascular system, medicine, Cardiology and Cardiovascular Medicine, education, business, Tetralogy of Fallot, Partial atrioventricular canal defect
Abstract

Introduction Adult congenital heart disease (ACHD) represents a growing population in many cardiac centers and it's a challenge for all physicians involved. Multidisciplinary teams integrated by cardiologists, echocardiographers, cardiac surgeons, cardiac anesthesiologists, radiologists and others, have been created in many hospitals to manage such patients (1). The objective was to describe the adult congenital cardiac population scheduled for cardiac surgery in our reference center. Methods We included all patients scheduled for cardiac surgery with a diagnosis of ACHD from January 2017 to May 2018. A retrospective review of medical records was performed for demographics, type of heart defect, intraoperative management, postoperative evolution, ICU length of stay and outcome at 30 days. Results A total of 1060 patients underwent elective cardiac surgery between the study period. Sixty-six patients (6.22%) had the diagnosis of ACHD. Mean age was 53.5±17 years [range 19 to 85 years], 63.6% were male and mean EuroSCORE II was 1.51 [range 0.5 to 5.41]. Type and number of diagnoses were: bicuspid aortic valve 45 patients, atrial septal defect 12 patients, congenital pulmonary stenosis 2 patients, congenital aortic stenosis 1 patient, sub-aortic membrane 1 patient, right coronary artery anomaly 1 patient, single ventricle 1 patient, tetralogy of Fallot 1 patient, Ebstein's anomaly 1 patient and partial atrioventricular canal defect 1 patient. Eight of the 45 patient with aortic bicuspid valve had associated aortic root aneurysm. All patients were monitored with transesophageal echocardiography (TEE). Twenty-five patients (37.8%) were extubated in the operating room. Nine patients (13.6%) required blood products. Percentage of postoperative complications were: arrhythmias (28.7%), renal dysfunction (15.1%), hemorrhage >500ml at 24h (10.6%), respiratory alterations (7.5 %), neurologic events (4.5%), intubation >24h (4.5%), re-operation (3.03 %) and gastrointestinal problems (1.51%). Mean ICU length of stay was 3.27 days [range 1 to 9 days]. There was no mortality at 30 days. Discussion The incidence of ACHD in this review was low and bicuspid aortic valve was the most common anomaly. Operative cardiac risk and age showed a wide range. In this small sample post-operative complications were lower than reported in the literature (2). As reference center for ACHD now the number of complex cases is increasing mainly by those diagnosed and treated in the childhood and coming for a second or third operation.

Published
2019

14. The Combination of Daptomycin and Fosfomycin Has Synergistic, Potent, and Rapid Bactericidal Activity against Methicillin-Resistant Staphylococcus aureus in a Rabbit Model of Experimental Endocarditis

Author

Cristina García-de-la-Mària, Oriol Gasch, Javier García-Gonzalez, Dolors Soy, Evelyn Shaw, Juan Ambrosioni, Manel Almela, Juan M. Pericàs, Adrián Tellez, Carlos Falces, Marta Hernandez-Meneses, Elena Sandoval, Eduard Quintana, Barbara Vidal, Jose M. Tolosana, David Fuster, Jaume Llopis, Miquel Pujol, Asuncion Moreno, Francesc Marco, Jose M. Miró, Adrian Téllez, Marta Hernández-Meneses, Cristina García de la Mària, Yolanda Armero, Javier García-González, Climent Casals, Jordi Vila, Juan C. Paré, Daniel Pereda, Ramon Cartañá, Salvador Ninot, Manel Azqueta, Marta Sitges, José L. Pomar, Manuel Castella, José M. Tolosana, José Ortiz, Guillermina Fita, Irene Rovira, Jose Ramírez, Mercè Brunet, and Pedro Castro

Subjects
0301 basic medicine, Methicillin-Resistant Staphylococcus aureus, medicine.drug_class, 030106 microbiology, Antibiotics, Microbiologia, Fosfomycin, medicine.disease_cause, Microbiology, 03 medical and health sciences, 0302 clinical medicine, Cloxacillin, Daptomycin, medicine, polycyclic compounds, Endocarditis, Animals, Humans, Pharmacology (medical), Experimental Therapeutics, 030212 general & internal medicine, Pharmacology, business.industry, Drug Synergism, Endocarditis, Bacterial, biochemical phenomena, metabolism, and nutrition, medicine.disease, bacterial infections and mycoses, Methicillin-resistant Staphylococcus aureus, Anti-Bacterial Agents, Infectious Diseases, Staphylococcus aureus, Vancomycin, lipids (amino acids, peptides, and proteins), Female, Rabbits, business, medicine.drug
Abstract

We investigated whether the addition of fosfomycin or cloxacillin to daptomycin provides better outcomes in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) experimental aortic endocarditis in rabbits. Five MRSA strains were used to perform in vitro time-kill studies using standard (10 6 ) and high (10 8 ) inocula. Combined therapy was compared to daptomycin monotherapy treatment in the MRSA experimental endocarditis model. A human-like pharmacokinetics model was applied, and the equivalents of cloxacillin at 2 g/4 h, fosfomycin at 2 g/6 h, and daptomycin at 6 to 10 mg/kg/day were administered intravenously. A combination of daptomycin and either fosfomycin or cloxacillin was synergistic in the five strains tested at both inocula. A bactericidal effect was detected in four of five strains tested with both combinations. The MRSA-277 strain (vancomycin MIC, 2 μg/ml) was used for the experimental endocarditis model. Daptomycin plus fosfomycin significantly improved the efficacy of daptomycin monotherapy at 6 mg/kg/day in terms of both the proportion of sterile vegetations (100% versus 72%, P = 0.046) and the decrease in the density of bacteria within the vegetations ( P = 0.025). Daptomycin plus fosfomycin was as effective as daptomycin monotherapy at 10 mg/kg/day (100% versus 93%, P = 1.00) and had activity similar to that of daptomycin plus cloxacillin when daptomycin was administered at 6 mg/kg/day (100% versus 88%, P = 0.48). Daptomycin nonsusceptibility was not detected in any of the isolates recovered from vegetations. In conclusion, for the treatment of MRSA experimental endocarditis, the combination of daptomycin plus fosfomycin showed synergistic and bactericidal activity.

Published
2017

15. Importancia de la ecocardiografía transesofágica intraoperatoria en la decisión quirúrgica en cirugía cardiaca

Author

I. Gómez, Irene Rovira, D. Tresandi, M.J. Arguis, P. Matute, C. Roux, Guillermina Fita, F. Emperador, and Carmen Gomar

Subjects
Anesthesiology and Pain Medicine, business.industry, Medicine, Critical Care and Intensive Care Medicine, business, Humanities
Abstract

Resumen Objetivo Determinar la importancia de la ecocardiografia transesofagica (ECOTE) intraoperatoria en la decision quirurgica en pacientes intervenidos de cirugia cardiaca. Pacientes y metodo Estudio prospectivo observacional en pacientes de cirugia cardiaca intervenidos desde enero de 2009 hasta mayo de 2012, a los que se monitorizo con ECOTE por el anestesiologo responsable. Los datos recogidos fueron: 1) tipo de cirugia; 2) diagnostico ecocardiografico preoperatorio (ECO basal); 3) diagnostico ecocardiografico antes de entrar en circulacion extracorporea (CEC) (ECOTE pre-CEC); 4) si habia diferencias entre la ECO basal y la ECOTE pre-CEC (hallazgo nuevo pre-CEC) y si estas diferencias modificaban la cirugia planeada, y 5) diagnostico ecocardiografico despues de la desconexion de CEC (hallazgo no esperado pos-CEC) y si estos hallazgos ecocardiograficos pos-CEC hacian reinstaurarla. Para el analisis de datos se utilizo el programa de software SPSS®. Resultados El total de pacientes estudiados fue de 1.273; la monitorizacion con ECOTE mostro «hallazgos nuevos pre-CEC» en 98 pacientes (7,7%) y en 43,8% de estos modifico la cirugia programada; de estos hallazgos, los mas frecuentes fueron alteraciones de la valvula mitral que no habian sido diagnosticadas, lo que determino la sustitucion o reparacion de la misma que no estaba programada. La incidencia de «hallazgos no esperados pos-CEC» fue del 6,2% (79 pacientes), y de estos, en el 46,8% se requirio reinstaurar la CEC y modificar la cirugia realizada. Las reparaciones valvulares fallidas y las protesis valvulares disfuncionantes fueron las causas principales que motivaron la reentrada en CEC. En los 42 pacientes restantes, con «hallazgos no esperados pos-CEC», no hubo cambios en la conducta quirurgica, ya que se considero que el hallazgo ecocardiografico no era lo suficientemente significativo como para reinstaurar la CEC y revisar o cambiar el procedimiento quirurgico. Conclusion En cirugia cardiaca, la monitorizacion intraoperatoria con ECOTE por el anestesiologo aporta informacion importante antes y despues de la CEC que modifico el manejo quirurgico.

Published
2015

16. The importance of intraoperative transesophageal echocardiography in the surgical decision in cardiac surgery

Author

I. Gómez, M.J. Arguis, Irene Rovira, Carmen Gomar, Guillermina Fita, D. Tresandi, P. Matute, C. Roux, and F. Emperador

Subjects
medicine.medical_specialty, business.industry, Extracorporeal circulation, General Medicine, Surgery, Cardiac surgery, law.invention, surgical procedures, operative, medicine.anatomical_structure, Circulacion extracorporea, law, Mitral valve, medicine, Cardiopulmonary bypass, In patient, business, circulatory and respiratory physiology
Abstract

Objective To determine the importance of intraoperative transesophageal echocardiography (IOTEE) in the surgical decision in patients undergoing cardiac surgery. Patients and method Prospective observational study of patients undergoing cardiac surgery from January 2009 to May 2012, which was monitored with IOTEE by the anaesthesiologist in charge. The data collected were: (1) type of surgery; (2) preoperative echocardiographic diagnosis (baseline ECHO); (3) echocardiographic diagnosis before entering cardiopulmonary bypass (CPB) (pre-CPB IOTEE); (4) any differences between the baseline ECHO and the pre-CPB IOTEE (new pre-CPB finding) and whether these differences modified the planned surgery, and (5) echocardiographic diagnosis after disconnection of CPB (unexpected post-CPB finding) and whether these post-CPB echocardiographic findings led to reinstating it. The software program SPSS ® was used for data analysis. Results The total number of patients studied was 1273. Monitoring with IOTEE showed “new pre-CPB” findings in 98 patients (7.7%), and 43.8% of these led to a change in the scheduled surgery. Of these findings, the most frequent were abnormalities of the mitral valve that had not been diagnosed, and which led to a replacement or repair that had not been scheduled. The incidence of “unexpected post-CPB findings” was 6.2% (79 patients), and 46.8% of those required reinstating the CPB and modifying the surgery performed. The failed valve repairs and dysfunctional valve prostheses were the main causes that led to re-entry into CPB. In the remaining 42 patients, with “unexpected post-CPB findings”, there were no changes in the surgical procedure as the echocardiographic findings were not considered to be significant enough to re-establish CPB and revise or change the surgical procedure. Conclusion Intraoperative monitoring with IOTEE by the anaesthesiologist during surgery provides important information before and after the CPB that resulted in modifying surgical management.

Published
2015

17. Manejo perioperatorio de la fibrilación auricular

Author

M.J. Arguis, R. Navarro, Carmen Gomar, A. Ruiz, C. Roux, Sergi Sabaté, L. Mont, P. Matute, Irene Rovira, J. Galán, Pilar Sierra, A. Regueiro, Guillermina Fita, and E. Arbelo

Subjects
Anesthesiology and Pain Medicine, business.industry, Medicine, Critical Care and Intensive Care Medicine, business, Humanities
Abstract

Resumen La fibrilacion auricular es una complicacion frecuente en el periodo perioperatorio, y cuando aparece se incrementa el riesgo de morbimortalidad perioperatoria debido a ACV, tromboembolismo, fallo cardiaco, IAM, hemorragia debida a anticoagulacion y reingresos hospitalarios. En el presente articulo se recogen las recomendaciones para el manejo de la fibrilacion auricular perioperatoria basandose en las ultimas Guias de Practica Clinica de la fibrilacion auricular publicadas por la Sociedad Europea de Cardiologia y la Sociedad Espanola de Cardiologia, prestando atencion tanto a su optimizacion preoperatoria, como al manejo del episodio agudo perioperatorio. En este sentido se incluyen las ultimas recomendaciones para control de la frecuencia cardiaca, control del ritmo y anticoagulacion.

Published
2014

18. Coagulation management in patient with heparin induced thrombocytopenia undergoing heart transplantation: is ROTEM helpful?

Author

Elena Sandoval, Carmen Gomar, M.J. Arguis, Irene Rovira, A. Carramiñana, Eduard Quintana, G.S. Angeles, M.J. Carretero, R. Navarro, P. Matute, Annabel Blasi, Guillermina Fita, C. Ibañez, and J.M. Perdomo

Subjects
Prothrombin time, medicine.diagnostic_test, business.industry, Activated clotting time, Heparin, medicine.disease, Argatroban, Anesthesiology and Pain Medicine, Heparin-induced thrombocytopenia, Anesthesia, medicine, Coagulation testing, Fresh frozen plasma, Cardiology and Cardiovascular Medicine, business, Partial thromboplastin time, medicine.drug
Abstract

Introduction Heparin induced thrombocytopenia (HIT) is frequent in patients under extracorporeal membrane oxygenation (ECMO) or ventricular assist device support (VAD). Therapeutic plasma exchange (TPE) and use of direct thrombin inhibitors (DTI) as argatroban have proven to be useful. However, monitoring its effect can be difficult as activated clotting time (ACT) or standard coagulation tests (prothrombin time (PT) and activated partial thromboplastin time (aPTT)) lack enough reliability. Coagulation assessment during surgery may be challenging, especially during heart transplantation (HT) where there is narrow margin to metabolize DTI. Methods A 51-year-old male presented a myocardial infarction with cardiac arrest and arrhythmic storm requiring support with ECMO and VAD. The patient needed HT and was anticoagulated with intravenous argatroban for 3 weeks before surgery because of HIT (31000 thrombocytes/μL). Four TPE were performed and four intravenous doses of specific gammaglobulin (1g/kg) were given achieving negative values of anti-PF-4 antibodies. Argatroban infusion was stopped 6 hours before surgery. Results The coagulation test pre-surgery showed 98000 thrombocytes/μL, PT 39%, aPTT 55,1s fibrinogen 3,5g/L, haemoglobin 93g/L. Intraoperative anticoagulation was established with full dose unfractionated heparin and tranexamic acid was given (20mg/kg bolus+6mg/kg/h infusion). After coming off by-pass, anticoagulation was reverted with protamine and 2 units of PRBC, 1000mL fresh frozen plasma (FFP), two platelet pools and 1200IU 4-factor-prothrombin-complex-concentrate (PCC; Prothromplex®: 1200IU factor II, 1000IU factor VII, 1200IU factor IX and 1200IU factor X) were administered empirically. Despite being ACT back to baseline, significant diffuse bleeding was clinically noticed. ROTEM was performed showing prolonged EXTEM, INTEM and HEPTEM clotting time (CT). A second dose of PCC was administered and one unit of PRBC was transfused. Because no improvement was noticed, a second ROTEM was performed showing increased CT in all tests, with no heparin contribution (table 1). A litre of FFP was then administered with significant reduction of bleeding, allowing for chest closure. No further significant blood loss was observed in intensive care. The patient was weaned from mechanical ventilation on day 4 and discharged from the ward after 21 days. No thrombotic/bleeding events were noticed during the hospital stay. Discussion ROTEM was useful detecting coagulation factors deficiency in an appropriate time. Unexpected prolongation of CT after PCC administration may suggest residual thrombin inhibition by argatroban, that was neutralized with FFP administration.

Published
2019

19. Left atrial dissection: taken from darkness by transoesophageal echocardiography

Author

Irene Rovira, A. Carramiñana, Guillermina Fita, Carmen Gomar, M.J. Arguis, M.J. Carretero, P. Matute, D. Pereda, J.M. Perdomo Linares, R. Navarro, María Marcela López, C. Ibañez, and Elena Sandoval

Subjects
Mitral valve repair, medicine.medical_specialty, Mitral regurgitation, business.industry, medicine.medical_treatment, Mitral valve replacement, medicine.disease, Intensive care unit, law.invention, Surgery, Dissection, Anesthesiology and Pain Medicine, Aortic valve replacement, law, cardiovascular system, Cardiopulmonary bypass, Medicine, Cardiology and Cardiovascular Medicine, business, Complication
Abstract

Introduction Left atrial dissection (LATD) is an infrequent (incidence 0.16%) however serious condition (mortality 13.8%). Methods The authors present three-LATD between 2016 and 2018 (from 2475 cardiac-surgery cases). Results Case 1 - A 57-year-old female with severe mitral regurgitation (P2 prolapse) was admitted for elective mitral valve repair (MVr). After two unsuccessful MVr attempts due to systolic anterior motion, a mitral valve replacement (MVR) was performed. LATD was diagnosed on the transoesophageal echocardiography (TOE). Conservative approach was decided based on the patient stability. However, LATD increased on the TOE and surgical treatment was required. She was successfully weaned form cardiopulmonary bypass (CPB) and transferred to the intensive care unit (ICU) stable on inotropes. Unfortunately, the patient died thirteen days after surgery due to airway and respiratory complications. A post-mortem study confirmed the patency of cardiac sutures. Case 2 - A 74-year-old male with severe mitral regurgitation (P2-P3 prolapse) was admitted for elective mitral valve repair and pulmonary vein ablation. A LATD associated to intra and peri- annular leaks was diagnosed on the post- repair TOE. Surgical treatment on CPB was required. The LATD was repaired and MVR was performed. The patient was weaned form CPB and transferred to the ICU on Right-Ventricular Assistance Device (RVAD) and inotropes due to RV failure. He was successfully weaned from RVAD and then discharged from hospital two months after the initial surgery. Case 3 - A 85-year-old female with severe aortic and moderate mitral regurgitation was admitted for elective aortic valve replacement and MVr. A LATD was diagnosed on the post-CPB TOE without affecting pulmonary-vein drainage or left atrial filling. Conservative approach was decided based on patient's stability. Consecutive TOE controls showed no changes. Therefore, he was transferred to the ICU and discharged from hospital one month after surgery. Discussion As in the authors’ three-case series, this infrequent cardiac-surgery complication has been mainly related to mitral valve surgery (56.3%). Treatment depends on patients’ clinical status, left-atrial filing impairment and LATD progression on TOE. Both surgical and conservative treatments have been reported successfully. Therefore, TOE is paramount in order to diagnosed and deal with this condition.

Published
2019

20. Validated Risk Score for Predicting 6-Month Mortality in Infective Endocarditis

Author

Lawrence P. Park, Vivian H. Chu, Gail Peterson, Athanasios Skoutelis, Tatjana Lejko‐Zupa, Emilio Bouza, Pierre Tattevin, Gilbert Habib, Ren Tan, Javier Gonzalez, Javier Altclas, Jameela Edathodu, Claudio Querido Fortes, Rinaldo Focaccia Siciliano, Orathai Pachirat, Souha Kanj, Andrew Wang, Liliana Clara, Marisa Sanchez, José Casabé, Claudia Cortes, Francisco Nacinovich, Pablo Fernandez Oses, Ricardo Ronderos, Adriana Sucari, Jorge Thierer, Silvia Kogan, Denis Spelman, Eugene Athan, Owen Harris, Karina Kennedy, David Gordon, Lito Papanicolas, Tony Korman, Despina Kotsanas, Robyn Dever, Phillip Jones, Pam Konecny, Richard Lawrence, David Rees, Suzanne Ryan, Michael P. Feneley, John Harkness, Jeffrey Post, Porl Reinbott, Rainer Gattringer, Franz Wiesbauer, Adriana Ribas Andrade, Ana Cláudia Passos de Brito, Armenio Costa Guimarães, Max Grinberg, Alfredo José Mansur, Tania Mara Varejao Strabelli, Marcelo Luiz Campos Vieira, Regina Aparecida de Medeiros Tranchesi, Marcelo Goulart Paiva, Auristela de Oliveira Ramos, Clara Weksler, Giovanna Ferraiuoli, Wilma Golebiovski, Cristiane Lamas, James A. Karlowsky, Yoav Keynan, Andrew M. Morris, Ethan Rubinstein, Sandra Braun Jones, Patricia Garcia, Alberto Fica, Rodrigo Montagna Mella, Ricardo Fernandez, Liliana Franco, Astrid Natalia Jaramillo, Bruno Barsic, Suzana Bukovski, Vladimir Krajinovic, Ana Pangercic, Igor Rudez, Josip Vincelj, Tomas Freiberger, Jiri Pol, Barbora Zaloudikova, Zainab Ashour, Amani El Kholy, Marwa Mishaal, Dina Osama, Hussien Rizk, Neijla Aissa, Corentine Alauzet, Francois Alla, Catherine Campagnac, Thanh Doco‐Lecompte, Christine Selton‐Suty, Jean‐Paul Casalta, Pierre‐Edouard Fournier, Didier Raoult, Franck Thuny, Francois Delahaye, Armelle Delahaye, Francois Vandenesch, Erwan Donal, Pierre Yves Donnio, Erwan Flecher, Christian Michelet, Matthieu Revest, Florent Chevalier, Antoine Jeu, Jean Paul Rémadi, Dan Rusinaru, Christophe Tribouilloy, Yvette Bernard, Catherine Chirouze, Bruno Hoen, Joel Leroy, Patrick Plesiat, Christoph Naber, Carl Neuerburg, Bahram Mazaheri, Sophia Athanasia, Ioannis Deliolanis, Helen Giamarellou, Tsaganos Thomas, Efthymia Giannitsioti, Elena Mylona, Olga Paniara, Konstantinos Papanicolaou, John Pyros, Konstantinos Papanikolaou, Gautam Sharma, Johnson Francis, Lathi Nair, Vinod Thomas, Krishnan Venugopal, Margaret M. Hannan, John P. Hurley, Amos Cahan, Dan Gilon, Sarah Israel, Maya Korem, Jacob Strahilevitz, Emanuele Durante‐Mangoni, Irene Mattucci, Daniela Pinto, Federica Agrusta, Alessandra Senese, Enrico Ragone, Riccardo Utili, Enrico Cecchi, Francesco De Rosa, Davide Forno, Massimo Imazio, Rita Trinchero, Paolo Grossi, Mariangela Lattanzio, Antonio Toniolo, Antonio Goglio, Annibale Raglio, Veronica Ravasio, Marco Rizzi, Fredy Suter, Giampiero Carosi, Silvia Magri, Liana Signorini, Zeina Kanafani, Souha S. Kanj, Ahmad Sharif‐Yakan, Imran Abidin, Syahidah Syed Tamin, Eduardo Rivera Martínez, Gabriel Israel Soto Nieto, Jan T.M. van der Meer, Stephen Chambers, David Holland, Arthur Morris, Nigel Raymond, Kerry Read, David R. Murdoch, Stefan Dragulescu, Adina Ionac, Cristian Mornos, O.M. Butkevich, Natalia Chipigina, Ozerecky Kirill, Kulichenko Vadim, Tatiana Vinogradova, Magid Halim, Yee‐Yun Liew, Ru‐San Tan, Mateja Logar, Manica Mueller‐Premru, Patrick Commerford, Anita Commerford, Eduan Deetlefs, Cass Hansa, Mpiko Ntsekhe, Manuel Almela, Yolanda Armero, Manuel Azqueta, Ximena Castañeda, Carlos Cervera, Carlos Falces, Cristina Garcia‐de‐la‐Maria, Guillermina Fita, Jose M. Gatell, Magda Heras, Jaime Llopis, Francesc Marco, Carlos A. Mestres, José M. Miró, Asuncion Moreno, Salvador Ninot, Carlos Paré, Juan M. Pericas, Jose Ramirez, Irene Rovira, Marta Sitges, Ignasi Anguera, Bernat Font, Joan Raimon Guma, Javier Bermejo, Miguel Angel Garcia Fernández, Victor Gonzalez‐Ramallo, Mercedes Marín, Patricia Muñoz, Miguel Pedromingo, Jorge Roda, Marta Rodríguez‐Créixems, Jorge Solis, Benito Almirante, Nuria Fernandez‐Hidalgo, Pilar Tornos, Arístides de Alarcón, Ricardo Parra, Eric Alestig, Magnus Johansson, Lars Olaison, Ulrika Snygg‐Martin, Pimchitra Pachirat, Burabha Pussadhamma, Vichai Senthong, Anna Casey, Tom Elliott, Peter Lambert, Richard Watkin, Christina Eyton, John L. Klein, Suzanne Bradley, Carol Kauffman, Roger Bedimo, G. Ralph Corey, Anna Lisa Crowley, Pamela Douglas, Laura Drew, Vance G. Fowler, Thomas Holland, Tahaniyat Lalani, Daniel Mudrick, Zaniab Samad, Daniel Sexton, Martin Stryjewski, Christopher W. Woods, Stamatios Lerakis, Robert Cantey, Lisa Steed, Dannah Wray, Stuart A. Dickerman, Hector Bonilla, Joseph DiPersio, Sara‐Jane Salstrom, John Baddley, Mukesh Patel, Amy Stancoven, Donald Levine, Jonathan Riddle, Michael Rybak, Christopher H. Cabell, Khaula Baloch, Christy C. Dixon, Tina Harding, Marian Jones‐Richmond, Bob Sanderford, Judy Stafford, Kevin Anstrom, Arnold S. Bayer, A. W. Karchmer, Daniel J. Sexton, Vivian Chu, David T. Durack, Susannah Eykyn, Phillipe Moreillon, Duke University Medical Center, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Fonction, structure et inactivation d'ARN bactériens, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Jonchère, Laurent, Universitat de Barcelona, Mazaheri, Bahram (Beitragende*r), Naber, Christoph (Beitragende*r), and Neuerburg, Carl (Beitragende*r)

Subjects
Male, Infeccions quirúrgiques, Surgical wound infection, Medizin, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, Clinical Studies, Registries, 030212 general & internal medicine, Original Research, Framingham Risk Score, Endocarditis, Hazard ratio, Middle Aged, Prognosis, infection, mortality, prognosis, surgery, valves, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Infective endocarditis, Cohort, Female, Mortality/Survival, Cardiology and Cardiovascular Medicine, Risk assessment, Infection, Cohort study, Adult, medicine.medical_specialty, Lower risk, Risk Assessment, Sensitivity and Specificity, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Mortalitat, medicine, Humans, Infectious Endocarditis, Mortality, Propensity Score, Aged, Models, Statistical, Cirurgia, business.industry, Proportional hazards model, Reproducibility of Results, medicine.disease, Surgery, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Valvular Heart Disease, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

Background Host factors and complications have been associated with higher mortality in infective endocarditis ( IE ). We sought to develop and validate a model of clinical characteristics to predict 6‐month mortality in IE . Methods and Results Using a large multinational prospective registry of definite IE (International Collaboration on Endocarditis [ ICE ]–Prospective Cohort Study [ PCS ], 2000–2006, n=4049), a model to predict 6‐month survival was developed by Cox proportional hazards modeling with inverse probability weighting for surgery treatment and was internally validated by the bootstrapping method. This model was externally validated in an independent prospective registry ( ICE ‐ PLUS , 2008–2012, n=1197). The 6‐month mortality was 971 of 4049 (24.0%) in the ICE ‐ PCS cohort and 342 of 1197 (28.6%) in the ICE ‐ PLUS cohort. Surgery during the index hospitalization was performed in 48.1% and 54.0% of the cohorts, respectively. In the derivation model, variables related to host factors (age, dialysis), IE characteristics (prosthetic or nosocomial IE , causative organism, left‐sided valve vegetation), and IE complications (severe heart failure, stroke, paravalvular complication, and persistent bacteremia) were independently associated with 6‐month mortality, and surgery was associated with a lower risk of mortality (Harrell's C statistic 0.715). In the validation model, these variables had similar hazard ratios (Harrell's C statistic 0.682), with a similar, independent benefit of surgery (hazard ratio 0.74, 95% CI 0.62–0.89). A simplified risk model was developed by weight adjustment of these variables. Conclusions Six‐month mortality after IE is ≈25% and is predicted by host factors, IE characteristics, and IE complications. Surgery during the index hospitalization is associated with lower mortality but is performed less frequently in the highest risk patients. A simplified risk model may be used to identify specific risk subgroups in IE .

Published
2016

21. Encuesta de hemostasia y transfusión perioperatoria en cirugía cardiaca: ¿cómo actuamos los anestesiólogos?

Author

Guillermina Fita, A. Fló, Misericordia Basora, J.C. Reverter, P. Panigua, and H. Litvan

Subjects
Course of action, Anesthesiology and Pain Medicine, business.industry, Medicine, Critical Care and Intensive Care Medicine, business, Neuromuscular Blockers, Humanities
Abstract

Resumen Objetivo Conocer el control perioperatorio de la hemostasia, la practica transfusional y su grado de protocolizacion en pacientes intervenidos de cirugia cardiaca en diferentes hospitales de Espana. Metodo Se elaboro un cuestionario dirigido a facultativos de Anestesiologia y Reanimacion. Los datos, en referencia a los 12 meses previos a la encuesta, se recogieron desde el 1 de julio al 20 de septiembre de 2007. Resultados Se registraron datos de 34 centros, de los cuales el 70% manifestaron no disponer de protocolos o guias sobre el control de la hemostasia en cirugia cardiaca. El 44% de centros desconocian el porcentaje de pacientes que habian sido transfundidos. Un 47% de los centros transfunde mas del 75% de los pacientes. Las pruebas estandar en el preoperatorio fueron el recuento de plaquetas, el tiempo parcial de tromboplastina activado y el tiempo de protombina. El tratamiento preoperatorio con acido acetilsalicilico y clopidogrel era suspendido antes de la cirugia en 15 (44%) y 25 (73%) centros, respectivamente. En caso de resistencia a la heparina, se administraban dosis adicionales de heparina, asociando plasma o antitrombina en el 29% y 12% respectivamente. En UCI/Reanimacion, solo un centro utilizaba tromboelastografia y otro centro utilizaba PFA-100 (analizador de la funcion plaquetaria). Conclusiones La hemostasia, la coagulacion perioperatoria y los criterios transfusionales varian ampliamente en los hospitales consultados. Existen pocas guias y su seguimiento no es amplio. El porcentaje de pacientes transfundidos es elevado, aunque este dato no es siempre conocido. Las nuevas tecnologias no han tenido una amplia implantacion.

Published
2010

22. Transoesophageal echocardiography accurately detects cardiac output variation

Author

Guillermina Fita, Irene Rovira, Carlos Paré, P. Matute, Víctor M. Parra, and Carmen Gomar

Subjects
Male, medicine.medical_specialty, Cardiac output, Thermodilution, Population, Ventricular outflow tract obstruction, Sodium Chloride, Doppler echocardiography, Sensitivity and Specificity, law.invention, law, Monitoring, Intraoperative, Internal medicine, medicine, Cardiopulmonary bypass, Humans, Ventricular outflow tract, Prospective Studies, Cardiac Output, Cardiac Surgical Procedures, education, Aged, Echocardiography, Doppler, Pulsed, education.field_of_study, Cardiopulmonary Bypass, medicine.diagnostic_test, Receiver operating characteristic, business.industry, Reproducibility of Results, Middle Aged, Cardiac surgery, Anesthesiology and Pain Medicine, ROC Curve, Elective Surgical Procedures, cardiovascular system, Cardiology, Female, medicine.symptom, business, Echocardiography, Transesophageal
Abstract

BACKGROUND AND OBJECTIVE: Intraoperative Doppler ultrasound can be used to measure cardiac output by transoesophageal echocardiography. Recently, its reliability, when compared to the thermodilution technique, has been questioned. The purpose of this study was to compare intraoperative changes in cardiac output measured by echo-Doppler and by thermodilution in cardiac surgery. We also assessed the agreement between the techniques. METHODS: Fifty cardiac surgical patients (38 male, 12 female, mean age of 63.4 +/- 14.3 yr) were prospectively included after approval by the Ethics Committee of the Institution. Cardiac output was assessed by thermodilution, with 10 mL saline at 12 degrees C, and simultaneously and blindly by echo-Doppler in deep transgastric view with pulsed wave Doppler at the level of the left ventricular outflow tract. Matched thermodilution cardiac output and echo-Doppler cardiac output measurements were taken three times at the end of expiration, both pre- and post-cardiopulmonary bypass. RESULTS: Echo-Doppler measurements were obtained in 44 patients (88%). In three patients, Doppler recordings could not be obtained adequately, and three developed left ventricular outflow tract obstruction after bypass. Bland-Altman analysis revealed a bias of 0.015 L min(-1), with narrow limits of agreement (-1.21 to 1.22 L min(-1)) and 29.1% error. Echo-Doppler was accurate (92% sensitivity and 71% specificity, P = 0.008 by receiver operating characteristic curves) for detecting more than 10% of change in thermodilution cardiac output. There were no complications related to the study. CONCLUSIONS: The agreement between cardiac output by echo-Doppler and by thermodilution is clinically acceptable and transoesophageal echocardiography is a reliable tool to assess significant cardiac output changes in a population of selected patients.

Published
2008

23. Complicaciones graves de tipo mecánico asociadas al catéter de arteria pulmonar en cirugía cardiovascular y torácica

Author

Guillermina Fita, B. Tena, P. Matute, Carmen Gomar, Jiménez Mj, J. Fontanals, C. Roux, and Irene Rovira

Subjects
Gynecology, Catheterization swan ganz, medicine.medical_specialty, Anesthesiology and Pain Medicine, business.industry, Medicine, Lung surgery, Critical Care and Intensive Care Medicine, business, Swan Ganz Catheter
Abstract

Resumen Objetivos A pesar de la discusion sobre la utilidad del cateter de arteria pulmonar (CAP) en el manejo del paciente critico, se sigue utilizando frecuentemente y es conveniente tener en cuenta tambien sus posibles complicaciones. El objetivo del estudio es revisar las complicaciones mecanicas graves o potencialmente graves asociadas a CAP ocurridos en nuestro centro en los ultimos 15 anos. Pacientes y metodos Se ha realizado un estudio observacional retrospectivo sobre los pacientes sometidos a cirugia vascular, cardiaca y toracica en los que se coloco un CAP, considerandose las complicaciones graves de origen mecanico. Resultados Se incluyeron 7.540 pacientes, detectandose nueve casos de complicaciones graves entre los que se incluyen cinco rupturas de arteria pulmonar, tres de ellas con resultado de muerte; una perforacion de vena mamaria interna; un nudo; un acodamiento y un atrapamiento del cateter en la sutura quirurgica. Conclusiones Esto supone una incidencia de 0,12%, menor a la publicada. Aunque la frecuencia de estas complicaciones es baja, su aparicion inesperada obliga a estar alerta ante su posible aparicion, con una cuidadosa seleccion de los pacientes en que se emplea el CAP y especial vigilancia de los signos clinicos y radiologicos caracteristicos de complicaciones.

Published
2008

24. Levosimendan as an adjunctive therapy to MitraClip implantation in patients with severe mitral regurgitation and left ventricular dysfunction

Author

Mónica Masotti, Marco Hernández, Victoria Martin-Yuste, Xavier Freixa, Rut Andrea, Guillermina Fita, Manel Sabaté, Gustavo Jimenez, Ander Regueiro, Irene Tatjer, Marta Sitges, M. Farrero, and Salvatore Brugaletta

Subjects
Adult, Male, medicine.medical_specialty, Vasodilator Agents, 030204 cardiovascular system & hematology, Severity of Illness Index, 03 medical and health sciences, Ventricular Dysfunction, Left, 0302 clinical medicine, Internal medicine, Severity of illness, medicine, Combined Modality Therapy, Humans, In patient, Simendan, Aged, Ultrasonography, Heart Valve Prosthesis Implantation, Mitral regurgitation, business.industry, MitraClip, Hydrazones, Mitral Valve Insufficiency, Levosimendan, Middle Aged, Pyridazines, Vasodilator agents, PERCUTANEOUS MITRAL REPAIR, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, medicine.drug
Published
2015

25. Impact of early valve surgery on outcome of Staphylococcus aureus prosthetic valve infective endocarditis: analysis in the International Collaboration of Endocarditis-Prospective Cohort Study

Author

Richard Watkin, Pierre-Edouard Fournier, David R. Murdoch, Yoav Keynan, Florent Chevalier, Tania Mara Varejão Strabelli, Imran Zainal Abidin, Denis Spelman, Roger Bedimo, Jeffrey J. Post, Francesc Marco, Alan C Street, Claudio Querido Fortes, Francisco Nacinovich, Antonio Goglio, Stephen T. Chambers, Fredy Suter, Claire Sorel, Alessandro Tebini, Phillip Jones, Robyn Dever, Emilio Bouza, G. Ralph Corey, Karina Kennedy, Alfredo José Mansur, Nigel Raymond, Guillermina Fita, Martin E. Stryjewski, Joan R. Guma, Asunción Moreno, John W. Baddley, Johnson Francis, Magnus Johansson, José H. Casabé, Margaret M. Hannan, Krishnan Venugopal, Thanh Doco-Lecompte, Jacob Strahilevitz, Annibale Raglio, Carl Neuerburg, Vichai Senthong, Cass Hansa, Ana Pangerčić, Adina Ionac, Vladimir Krajinović, Christine Selton-Suty, Marwa Mishaal, Mateja Logar, Erwan Donal, Elena Mylona, Clara Weksler, Joseph Di Persio, Antoine Jeu, Pilar Tornos, Konstantinos Papanicolaou, François Vandenesch, Tom S.J. Elliott, Jan van der Meer, Patricia Muñoz, Regina Aparecida De Medeiros Tranchesi, Lathi Nair, Dannah Wray, Arnold S. Bayer, Pamela Konecny, David L. Gordon, Gilbert Habib, Armênio Costa Guimarães, Alberto Fica, Mercedes Marín, Francesco Giuseppe De Rosa, Marian Jones-Richmond, Marcelo Luiz Campos Vieira, Max Grinberg, Luis Afonso, Khaula Baloch, Pimchitra Pachirat, Anna Lisa Crowley, Marie Line Erpelding, Miguel Pedromingo, Daniel W. Mudrick, John Harkness, Barbora Zaloudikova, Christophe Tribouilloy, Cristina Garcia-de-la-Maria, Kerry Read, Athanasios Skoutelis, Marco Rizzi, Michael J. Rybak, Ioannis Deliolanis, Stuart Dickerman, Carol A. Kauffman, John L Klein, Suzanne Ryan, Christopher W. Woods, Gautam Sharma, Silvia Magri, Susannah J. Eykyn, Veronica Ravasio, Auristela De Oliveira Ramos, J. Leroy, Bruno Baršić, Burabha Pussadhamma, Jameela Edathodu, Franck Thuny, Eduan Deetlefs, Yvette Bernard, Rinaldo Focaccia Siciliano, Lito E. Papanicolas, Salvador Ninot, Nuria Fernández-Hidalgo, Zaniab Samad, Arístides de Alarcón, Neijla Aissa, Claudia Cortés, Thomas L. Holland, Tina Harding, Tania A. Baban, Irene Rovira, Ethan Rubinstein, Jorge Solis, Maya Korem, Giampiero Carosi, Marie Francoise Tripodi, Andrew Wang, Orathai Pachirat, Davide Forno, Ana Cláudia Passos De Brito, Catherine Campagnac, Anna L. Casey, Ana del Río, Gail E. Peterson, Carlos Falces, Christopher H. Cabell, François Delahaye, Emanuele Durante-Mangoni, Mattucci Irene, Despina Kotsanas, Javier Bermejo, Pierre Tattevin, Richard Lawrence, John Pyros, José M. Gatell, Jérémie Violette, Igor Rudez, Peter A. Lambert, Jean Paul Casalta, Jiri Pol, Kulichenko Vadim, Pablo Fernandez Oses, Ximena Castañeda, José Ramírez, Rita Trinchero, Sarah Israel, Mariangela Lattanzio, Eugene Athan, Arthur J. Morris, Bahram Mazaheri, Leeanne Grigg, Mohamad Yasmine, Adriana Andrade, Owen Harris, Syahidah Syed Tamin, Adolf W. Karchmer, Joan Pericas, Manica Mueller-Premru, Ozerecky Kirill, Eduardo Rivera Martínez, Christina Eyton, Josip Vincelj, Marisa Santos, Marisa Sanchez, David T. Durack, Dan Gilon, Marcelo Goulart Paiva, G. Ferraiuoli, Susanna Cuccurullo, Chipigina Ns, Lars Olaison, Patrick Plésiat, Michael P. Feneley, Amy B. Stancoven, Efthymia Giannitsioti, Cristiane da Cruz Lamas, Silvia Kogan, Kevin J. Anstrom, Manuel Almela, Liliana Clara, Stamatios Lerakis, Massimo Imazio, Rainer Gattringer, Javier Altclas, Wilma F. Golebiovski, Cristian Mornos, Damon P. Eisen, Pierre-Yves Donnio, Bernat Font, Eric Alestig, Liana Signorini, Sandra Braun Jones, Pamela S. Douglas, Helen Giamarellou, Gabriel Israel Soto Nieto, Tatjana Lejko-Zupanc, Benito Almirante, Dan Rusinaru, Anita Commerford, Yolanda Armero, Donald P. Levine, Mukesh Patel, M. Azqueta, Mpiko Ntsekhe, Phillipe Moreillon, Matthieu Revest, Adriana Sucari, Ashour Zainab, Olga Paniara, Víctor González-Ramallo, Miguel Ángel García Fernández, Ricardo Parra, Christoph Naber, Hector Bonilla, John P. Hurley, Rodrigo Montagna Mella, James A. Karlowsky, Lisa L. Steed, Armelle Delahaye, Marta Rodríguez-Créixems, José M. Miró, Enrico Cecchi, Enrico Ragone, Catherine Chirouze, J. Roda, David Holland, Marta Sitges, Luh Nah Lum, Patricia García, Thomas Redick, Theresa Kulman, Paul A. Pappas, Carlos Paré, Riccardo Utili, Stefan Dragulescu, Robert Cantey, Paolo Grossi, Vivian H. Chu, Porl Reinbott, Bruno Hoen, Amani El Kholy, Judy Stafford, Tomáš Freiberger, Hussien Rizk, Corentine Alauzet, Ricardo Ronderos, Ru San Tan, Christian Michelet, Suzanne F. Bradley, R. Casillo, Thomas Tsaganos, M. Cereceda, Laura A. Drew, Magid Halim, François Alla, Tahaniyat Lalani, Carlos A. Mestres, David Rees, Sara Jane Salstrom, O. M. Butkevich, Patrick J. Commerford, Ignasi Anguera, Franz Wiesbauer, Ulrika Snygg-Martin, Lawrence P. Park, Didier Raoult, Tony M. Korman, Giovanni Dialetto, Zeina Kanafani, Antonio Toniolo, Suzana Bukovski, Christy C. Dixon, Tatiana Vinogradova, Jorge Thierer, Souha S. Kanj, Vinod Thomas, Daniel J. Sexton, Vance G. Fowler, Andrew M. Morris, S. Athanasia, Ren Tan, Carlos Cervera, Chirouze, C, Alla, F, Fowler VG, Jr, Sexton, Dj, Corey, Gr, Chu, Vh, Wang, A, Erpelding, Ml, DURANTE MANGONI, Emanuele, Fernández Hidalgo, N, Giannitsioti, E, Hannan, Mm, Lejko Zupanc, T, Miró, Jm, Muñoz, P, Murdoch, Dr, Tattevin, P, Tribouilloy, C, Hoen, B., Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Duke University Medical Center, Monaldi Hospital, Mater Hospitals, University Medical Center Ljubljana, Institut d'Investigacions Biomèdiques August Pi i Sunyer ( IDIBAPS ), Universitat de Barcelona ( UB ), Clinical Microbiology and Infectious Diseases Department, Universidad Complutense de Madrid [Madrid] ( UCM ), Department of Pathology, University of Otago, Microbiology Unit, Canterbury Health Laboratories, Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou, Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne ( UPJV ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), University of Otago [Dunedin, Nouvelle-Zélande], Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, Service des maladies infectieuses et réanimation médicale [Rennes], Hôpital Pontchaillou-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)

Subjects
Male, diagnosis, International Cooperation, Medizin, blood culture, Cohort Studies, surgery, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Prospective Studies, Prospective cohort study, Endocarditis, Mortality rate, heart valve, Middle Aged, Staphylococcal Infections, Heart Valves, prosthetic valve, 3. Good health, Treatment Outcome, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infective endocarditis, Cohort, endocarditis, Female, Cohort study, Adult, Microbiology (medical), Staphylococcus aureus, medicine.medical_specialty, Endocarditis, Staphylococcus aureus, heart valve, combined treatment, blood culture, clinical microbiology, etiology, diagnosis, Prosthesis-Related Infections, etiology, Staphylococcal infections, Internal medicine, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, 1-year mortality, Prosthetic valve, Surgery, Aged, Humans, Survival Analysis, medicine, combined treatment, clinical microbiology, Proportional hazards model, business.industry, medicine.disease, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Background - The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration on Endocarditis-Prospective Cohort Study. Methods - Participants were enrolled between June 2000 and December 2006. Cox proportional hazards modeling that included surgery as a time-dependent covariate and propensity adjustment for likelihood to receive cardiac surgery was used to evaluate the impact of EVS and 1-year all-cause mortality on patients with definite left-sided S. aureus PVIE and no history of injection drug use. Results - EVS was performed in 74 of the 168 (44.3%) patients. One-year mortality was significantly higher among patients with S. aureus PVIE than in patients with non-S. aureus PVIE (48.2% vs 32.9%; P = .003). Staphylococcus aureus PVIE patients who underwent EVS had a significantly lower 1-year mortality rate (33.8% vs 59.1%; P = .001). In multivariate, propensity-adjusted models, EVS was not associated with 1-year mortality (risk ratio, 0.67 [95% confidence interval, .39-1.15]; P = .15). Conclusions - In this prospective, multinational cohort of patients with S. aureus PVIE, EVS was not associated with reduced 1-year mortality. The decision to pursue EVS should be individualized for each patient, based upon infection-specific characteristics rather than solely upon the microbiology of the infection causing PVIE.

Published
2015

26. 218-03: Infarct transmurality as a criterion for first-line endo-epicardial substrate–guided ventricular tachycardia ablation in ischemic cardiomyopathy

Author

Viatcheslav Korshunov, Teresa M. de Caralt, Francesca Vassanelli, Jose Ortiz, Lluís Mont, Marta Sitges, Diego Penela, Antonio Berruezo, Juan Fernández-Armenta, Borras Roger, Guillermina Fita, David Andreu, Josep Brugada, Rosario J. Perea, and Juan Carlos Acosta

Subjects
medicine.medical_specialty, Ischemic cardiomyopathy, Ventricular tachycardia ablation, business.industry, Physiology (medical), Internal medicine, First line, medicine, Cardiology, Substrate (chemistry), Cardiology and Cardiovascular Medicine, business
Published
2016

27. [Neuropsychological dysfunction after cardiac surgery: Cerebral saturation and bispectral index: A longitudinal study]

Author

Víctor M, Parra, Marc, Sadurní, Marta, Doñate, Irene, Rovira, Carmen, Roux, José, Ríos, Teresa, Boget, and Guillermina, Fita

Subjects
Male, Electroencephalography, Length of Stay, Middle Aged, Intensive Care Units, Oxygen Consumption, Postoperative Complications, Cerebrovascular Circulation, Monitoring, Intraoperative, Humans, Anesthesia, Female, Coronary Artery Bypass, Cognition Disorders, Epidemiologic Methods, Aged
Abstract

Neuropsychological dysfunction is a major cause of morbidity and mortality after cardiac surgery.To evaluate if intraoperative cerebral desaturation and depth of anesthesia measured by bispectral index are related to postoperative cognitive dysfunction in cardiac surgery.Prospective study in patients undergoing elective cardiac surgery with cardiopulmonary bypass. A comprehensive neuropsychological assessment was applied preoperatively and 3 months after surgery. Postoperative dysfunction was defined as a decrease of at least one standard deviation in two or more neuropsychological tests. Cerebral oxygenation and bispectral index were continuously recorded and corrected throughout surgery. Cerebral oxygenation data were analyzed by the mean value and at three thresholds: 50%, 40% and25% of the basal value. Bispectral index was analyzed at threshold of 45.Fifty-six patients were initially enrolled and 48 completed the study. Nine of these (18.8 %) presented postoperative cognitive dysfunction. Mean cerebral saturation and bispectral index data were not different among the patients with or without cognitive dysfunction. There was no association between cerebral desaturation and bispectral index with changes in neurocognitive tests or with length of stay in the intensive care unit. A significant but weak correlation was found between baseline Ray-neurocognitive score and intensive care unit stay (rho = -0.46; P = 0.001).We did not find a significant association between cerebral desaturation and depth of anesthesia with postoperative cognitive decline in this population of patients.

Published
2012

28. Disfunción cognitiva después de cirugía cardiaca: Saturación cerebral e índice biespectral: estudio longitudinal

Author

Marta Doñate, Teresa Boget, Guillermina Fita, Víctor M. Parra, Carmen Roux, Irene Rovira, José A Ríos, and Marc Sadurní

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Cardiopulmonary bypass, Mean value, General Medicine, law.invention, Cardiac surgery, Thoracic surgery, Anesthesia, general, Cognition, law, Cardiothoracic surgery, Anesthesia, Bispectral index, medicine, In patient, Neuropsychological assessment, Prospective cohort study, business
Abstract

Background: Neuropsychological dysfunction is a major cause of morbidity and mortality after cardiac surgery. Aim: To evaluate if intraoperative cerebral desatu-ration and depth of anesthesia measured by bispectral index are related to postoperative cognitive dysfunction in cardiac surgery. Material and Methods: Prospective study in patients undergoing elective cardiac surgery with cardiopulmonary bypass. A comprehensive neuropsychological assessment was applied preoperatively and 3 months after surgery. Postoperative dysfunction was defined as a decrease of at least one standard deviation in two or more neuropsychological tests. Cerebral oxygenation and bispectral index were continuously recorded and corrected throughout surgery. Cerebral oxygenation data were analyzed by the mean value and at three thresholds: 50%, 40% and < 25% of the basal value. Bispectral index was analyzed at threshold of 45. Results: Fifty-six patients were initially enrolled and 48 completed the study. Nine of these (18.8 %) presented postoperative cognitive dysfunction. Mean cerebral saturation and bispectral index data were not different among the patients with or without cognitive dysfunction. There was no association between cerebral desaturation and bispectral index with changes in neurocognitive tests or with length of stay in the intensive care unit. A significant but weak correlation was found between baseline Ray-neurocognitive score and intensive care unit stay (rho = -0.46; P = 0.001). Conclusions: We did not find a significant association between cerebral desaturation and depth of anesthesia with postoperative cognitive decline in this population of patients.

Published
2011

29. Role of echocardiogram in decision making for surgery in endocarditis

Author

José M. Miró, Carlos-A. Mestres, M. Azqueta, and Guillermina Fita

Subjects
medicine.medical_specialty, business.industry, Disease, medicine.disease, Surgical planning, Duke criteria, law.invention, Surgery, Infectious Diseases, law, Infective endocarditis, medicine, Cardiopulmonary bypass, Endocarditis, business, Surgical treatment
Abstract

Infective endocarditis is a serious disease that carries significant morbidity and mortality. Adequate treatment is based on a high degree of clinical suspicion, accurate microbiologic diagnosis, and high-quality imaging. Echocardiography has been shown to be a fundamental tool for diagnosis and management. Currently accepted Duke criteria include blood cultures and echocardiography. Transthoracic and transesophageal echocardiography play a critical role in the decision-making process, especially when surgical treatment is contemplated. Because infective endocarditis is considered a medical and surgical disease, and considering that the current rate of surgery is about 50%, echocardiography has definite value in preoperative diagnosis and surgical planning, intraoperative confirmation of lesions and quality of repair or replacement before and after cardiopulmonary bypass, and postoperative assessment.

Published
2011

30. Unexpected postoperative course after right pneumonectomy

Author

Carlos A. Montero, Miguel Catalán, Emilio Canalis, Josep Maria Gimferrer, Guillermina Fita, and Mireia Serra

Subjects
Pulmonary and Respiratory Medicine, Male, Reoperation, medicine.medical_specialty, Hernia, Lung Neoplasms, Digoxin, Heart Diseases, medicine.medical_treatment, Critical Care and Intensive Care Medicine, Amiodarone, Pneumonectomy, Heart Rate, Carcinoma, Non-Small-Cell Lung, medicine, Humans, Cardiopulmonary resuscitation, Heart Atria, Herniorrhaphy, business.industry, Cardiac Pacing, Artificial, Atrial fibrillation, Middle Aged, medicine.disease, Surgery, Radiography, Ventricular fibrillation, Cardiology and Cardiovascular Medicine, business, Atrioventricular block, Anti-Arrhythmia Agents, medicine.drug
Abstract

(CHEST 2000; 117:1184 ‐1185) A 58-year-old male patient with noncomplicated alcoholic liver disease presented with a right upper parahilar pulmonary mass after minor blunt chest trauma. After an appropriate workup, nonsmall cell carcinoma of the lung was diagnosed. A right intrapericardial pneumonectomy was performed. A silastic chest drain with no negative pressure was left connected to a compensatory postpneumonectomy system. The patient was extubated 30 min after the operation. A few minutes later while in the recovery room, the patient developed atrial fibrillation with fast heart rate of 150 beats/min. Digoxin and amiodarone were started. Shortly thereafter, ventricular fibrillation required a 300-J/s direct current shock. The patient was intubated again, and cardiopulmonary resuscitation was performed. Complete atrioventricular block developed, and a percu

Published
2000

31. Effects of inhaled nitric oxide in a patient with pulmonary hypertension and left heart failure secondary to a giant left atrial myxoma

Author

Guillermina Fita, Carmen Gomar, Ramón Cartañá, Irene Rovira, and Soraya Suarez

Subjects
medicine.medical_specialty, Heart disease, Hypertension, Pulmonary, Vasodilator Agents, Nitric Oxide, Nitric oxide, Heart Neoplasms, chemistry.chemical_compound, Internal medicine, Administration, Inhalation, medicine, Humans, Aged, Heart Failure, business.industry, Respiratory disease, Hemodynamics, Myxoma, medicine.disease, Pulmonary hypertension, Anesthesiology and Pain Medicine, chemistry, Echocardiography, Anesthesia, Heart failure, Cardiology, Female, Left Atrial Myxoma, Cardiology and Cardiovascular Medicine, Complication, business
Published
2000

32. Adverse reactions to vancomycin prophylaxis in cardiac surgery

Author

Mulet J, Guillermina Fita, M. González, Carmen Gomar, Pacheco M, Nalda Ma, and R. Valero

Subjects
Adult, Heart Defects, Congenital, medicine.medical_specialty, Premedication, Bronchospasm, Vancomycin, medicine, Humans, Cardiac Surgical Procedures, Coronary Artery Bypass, Antibiotic prophylaxis, Child, Adverse effect, Aged, business.industry, Incidence (epidemiology), Infant, Perioperative, Middle Aged, Cardiac surgery, Surgery, Anesthesiology and Pain Medicine, Child, Preschool, Heart Valve Prosthesis, Anesthesia, Drug Eruptions, Hypotension, medicine.symptom, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Several adverse effects of vancomycin have been reported. The aim of this study was to assess the incidence of adverse responses to antibiotic prophylaxis with vancomycin in cardiac surgical patients. Prospectively, 116 consecutive patients (106 adults and 10 children) undergoing cardiac surgical procedures in this institution from January to June 1990 were studied. After the anesthetic induction, vancomycin, 1 g in adults and 10 mg/kg in children, was intravenously administered over 30 minutes. The infusion rate was slowed if any adverse effect was observed. As a control group, 10 similar patients were evaluated during the same period of 30 minutes after anesthetic induction but prior to vancomycin administration and surgical stimulation. Thirty-one patients (26.72%) developed an adverse effect, mainly hypotension (29 patients, 25%), which was considered severe in 15 patients (12.93%). Seven patients (6.03%) developed a maculopapular erythema that was associated with hypotension (Red-Man's syndrome) in 5 patients and with bronchospasm in 1 patient. The incidence of adverse reactions in children (20%) was similar to the overall incidence. Only 1 patient in the control group (10%) developed hypotension during the period studied. The incidence of adverse reactions was not related to age, body weight, vancomycin dose administered per kilogram body weight, type of surgical procedure, or associated disease. Mean duration of the infusion was similar in patients with and without adverse responses (34.60 +/- 12.41 minutes and 37.38 +/- 14.55 minutes, respectively). It is concluded that perioperative prophylaxis with vancomycin in cardiac surgery produces a high and unpredictable risk of significant hypotension.

Published
1991

33. Platelet function during cardiac surgery and cardiopulmonary bypass with low-dose aprotinin

Author

Misericordia Basora, Gines Escolar, Mauricio Pacheco, Guillermina Fita, Edwing Rodriguez, Antonio Ordinas, and Carmen Gomar

Subjects
Blood Platelets, Male, Antifibrinolytic, Platelet Aggregation, medicine.drug_class, Platelet Glycoprotein GPIIb-IIIa Complex, Postoperative Hemorrhage, Hemostatics, law.invention, chemistry.chemical_compound, Aprotinin, law, medicine, Cardiopulmonary bypass, Humans, Platelet, Blood Transfusion, Single-Blind Method, Platelet activation, Prospective Studies, Cardiac Surgical Procedures, Ristocetin, Arachidonic Acid, Cardiopulmonary Bypass, business.industry, Platelet Count, Middle Aged, Platelet Activation, Adenosine Diphosphate, P-Selectin, Anesthesiology and Pain Medicine, chemistry, Anesthesia, Hemostasis, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Objective: To determine whether two low-dose regimens of aprotinin influence platelet function. Design: Prospective, randomized, single-blinded trial. Setting: University teaching hospital performing 600 cardiac operations per year. Participants: Fifty-nine patients scheduled for cardiac surgery undergoing cardiopulmonary bypass (CPB) of expected duration of 60 minutes or more. Interventions: Patients were randomized into three groups. Group C (control) included 21 patients who did not receive aprotinin. In group A2, 17 patients received 14,286 kallikrein inhibitor units (KIU)/kg (2 mg/kg) of aprotinin before surgery, followed by a continuous infusion of 7,143 KIU/kg/h (1 mg/kg/h) until the end of surgery. In group A4, 19 patients received 28,572 KIU/kg (4 mg/kg) of aprotinin before surgery, followed by the same infusion. Measurements and Main Results: Postoperative bleeding and transfusion requirements were significantly less in group A4. Changes in platelet number and function were similar in the three groups. Platelet aggregation was assessed in four periods: before CPB (T1), post-CPB (T2), and 2 hours (T3) and 4 hours (T4) after CPB. Platelet aggregation induced by adenosine diphosphate, 1 and 2 μmol/L; ristocetin, 1 mg/mL; and arachadonic acid (AA), 1.4 mmol/L, decreased at T2 (p < 0.001) in all groups, and for the ristocetin and AA groups, remained at less than baseline values at T3 and T4. In five patients from each group, platelet receptors for glycoprotein IIb-IIIa (GPIIb-IIIa) and expression of platelet activation markers, guanosine monophosphate 140 (GMP-140) and lysosomal protein, were measured by flow cytometry before and after CPB. Modifications in the expression of GPIIb-IIIa were always modest and without statistical significance. Platelet activation markers, GMP-140 or lysosomal protein, nearly doubled from baseline to post-CPB only in the A4 group, whereas they remained stable in both other groups (statistically not significant). Conclusion: The two regimens of aprotinin, both considered low dosage, did not exert a protective effect on platelet function. Neither dose produced changes in platelet GPIIb-IIIa or platelet activation markers. However, bleeding and transfusion needs were decreased.

Published
1999

37. Treatment of hyperhidrosis by transthoracic endoscopic sympathectomy

Author

Guillermina Fita, Irene Rovira, C. Roux, Carmen Gomar, M. J. Jiménez, P. Matute, and M. A. Callejas

Subjects
medicine.medical_specialty, Anesthesiology and Pain Medicine, Sympathectomy, Hyperhidrosis, business.industry, medicine.medical_treatment, medicine, medicine.symptom, business, Surgery
Published
2004

43. Post-operative analgesia in patients undergoing cardio-thoracic surgery

Author

M. J. Jiménez, R. Pujol, M. Sadurní, Guillermina Fita, A. Faulí, and E. Chabás

Subjects
medicine.medical_specialty, Anesthesiology and Pain Medicine, business.industry, Cardiothoracic surgery, General surgery, Medicine, In patient, Post operative, business, Surgery
Published
2006

45. Apnoeic oxygenation in complex tracheal surgery

Author

Guillermina Fita, M. Sadurní, J. M. Gimferrer, M. Tió, E. Martínez, Carmen Gomar, Irene Rovira, P. Macchiarini, and M. J. Jiménez

Subjects
Anesthesiology and Pain Medicine, business.industry, Anesthesia, Tracheal surgery, Medicine, business, Apnoeic oxygenation
Published
2006

48. Reduction of pulmonary function after resection: less than expected in COPD patients

Author

Irene Rovira, J. M. Gimferrer, Carmen Gomar, J. Fernandez, M. J. Jiménez, J. A. Barberá, N. de Riva, and Guillermina Fita

Subjects
medicine.medical_specialty, Anesthesiology and Pain Medicine, Copd patients, business.industry, Internal medicine, medicine.medical_treatment, medicine, Cardiology, business, Reduction (orthopedic surgery), Pulmonary function testing, Resection
Published
2004

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