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2. In-hospital and 6-month outcomes in patients with COVID-19 supported with extracorporeal membrane oxygenation (EuroECMO-COVID): a multicentre, prospective observational study

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Lorusso, R, De Piero, M, Mariani, S, Di Mauro, M, Folliguet, T, Taccone, F, Camporota, L, Swol, J, Wiedemann, D, Belliato, M, Broman, L, Vuylsteke, A, Kassif, Y, Scandroglio, A, Fanelli, V, Gaudard, P, Ledot, S, Barker, J, Boeken, U, Maier, S, Kersten, A, Meyns, B, Pozzi, M, Pedersen, F, Schellongowski, P, Kirali, K, Barrett, N, Riera, J, Mueller, T, Belohlavek, J, Lo Coco, V, Van der Horst, I, Van Bussel, B, Schnabel, R, Delnoij, T, Bolotin, G, Lorini, L, Schmiady, M, Schibilsky, D, Kowalewski, M, Pinto, L, Silva, P, Kornilov, I, Blandino Ortiz, A, Vercaemst, L, Finney, S, Roeleveld, P, Di Nardo, M, Hennig, F, Antonini, M, Davidson, M, Jones, T, Staudinger, T, Mair, P, Kilo, J, Krapf, C, Erbert, K, Peer, A, Bonaros, N, Kotheletner, F, Krenner Mag, N, Shestakova, L, Hermans, G, Dauwe, D, Meersseman, P, Stockman, B, Nobile, L, Lhereux, O, Nrasseurs, A, Creuter, J, De Backer, D, Giglioli, S, Michiels, G, Foulon, P, Raes, M, Rodrigus, I, Allegaert, M, Jorens, P, Debeucklare, G, Piagnerelli, M, Biston, P, Peperstraete, H, Vandewiele, K, Germay, O, Vandeweghe, D, Havrin, S, Bourgeois, M, Lagny, M, Alois, G, Lavios, N, Misset, B, Courcelle, R, Timmermans, P, Yilmaz, A, Vantomout, M, Lehaen, J, Jassen, A, Guterman, H, Strauven, M, Lormans, P, Verhamme, B, Vandewaeter, C, Bonte, F, Vionne, D, Balik, M, Blaha, J, Lips, M, Othal, M, Bursa, F, Spacek, R, Christensen, S, Jorgensen, V, Sorensen, M, Madsen, S, Puss, S, Beljantsev, A, Saiydoun, G, Fiore, A, Colson, P, Bazalgette, F, Capdevila, X, Kollen, S, Muller, L, Obadia, J, Dubien, P, Ajrhourh, L, Guinot, P, Zarka, J, Besserve, P, Malfertheiner, M, Dreier, E, Heinze, B, Akhyari, P, Lichtenberg, A, Aubin, H, Assman, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Ruslan, N, Haverich, A, Thielmann, M, Brenner, T, Ruhpawar, A, Benk, C, Czerny, M, Staudacher, D, Beyersdorf, F, Kalbhenn, J, Henn, P, Popov, A, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Lotz, G, Sonntagbauer, M, Winkels, H, Fichte, J, Stohr, R, Kalverkamp, S, Karagiannidis, C, Schafer, S, Svetlitchny, A, Hopf, H, Jarczak, D, Groesdonk, H, Rommer, M, Hirsch, J, Kaehny, C, Soufleris, D, Gavriilidis, G, Pontikis, K, Kyriakopoulou, M, Kyriakoudi, A, O'Brien, S, Conrick-Martin, I, Carton, E, Makhoul, M, Ben-Ari, J, Hadash, A, Kogan, A, Kassif Lerner, R, Abu-Shakra, A, Matan, M, Balawona, A, Kachel, E, Altshuler, R, Galante, O, Fuchs, L, Almog, Y, Ishay, Y, Lichter, Y, Gal-oz, A, Carmi, U, Nini, A, Soroksky, A, Dekel, H, Rozman, Z, Tayem, E, Ilgiyaev, E, Hochman, Y, Miltau, D, Rapoport, A, Eden, A, Kompanietz, D, Yousif, M, Golos, M, Grazioli, L, Ghitti, D, Loforte, A, Di Luca, D, Baiocchi, M, Pacini, D, Cappai, A, Meani, P, Mondino, M, Russo, C, Ranucci, M, Fina, D, Cotza, M, Ballotta, A, Landoni, G, Nardelli, P, Fominski, E, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Livigni, S, Silengo, D, Arena, G, Sovatzis, S, Degani, A, Riccardi, M, Milanesi, E, Raffa, G, Martucci, G, Arcadipane, A, Panarello, G, Chiarini, G, Cattaneo, S, Puglia, C, Benussi, S, Foti, G, Giani, M, Bombino, M, Costa, M, Rona, R, Avalli, L, Donati, A, Carozza, R, Gasparri, F, Carsetti, A, Piciche, M, Marinello, A, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Russo, E, Agnoletti, V, Rociola, R, Milano, A, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Giordano, G, Carelli, S, Grieco, D, Dell'Anna, A, Antonelli, M, Ramoni, E, Zulueta, J, Del Giglio, M, Petracca, S, Bertini, P, Guarracino, F, De Simone, L, Angeletti, P, Forfori, F, Taraschi, F, Quintiliani, V, Samalavicius, R, Jankuviene, A, Scupakova, N, Urbonas, K, Kapturauskas, J, Soerensen, G, Suwalski, P, Linhares Santos, L, Marques, A, Miranda, M, Teixeira, S, Salgueiro, A, Pereira, F, Ketskalo, M, Tsarenko, S, Shilova, A, Afukov, I, Popugaev, K, Minin, S, Shelukhin, D, Malceva, O, Gleb, M, Skopets, A, Kornelyuk, R, Kulikov, A, Okhrimchuk, V, Turchaninov, A, Petrushin, M, Sheck, A, Mekulov, A, Ciryateva, S, Urusov, D, Gorjup, V, Golicnik, A, Goslar, T, Ferrer, R, Martinez-Martinez, M, Argudo, E, Palmer, N, De Pablo Sanchez, R, Juan Higuera, L, Arnau Blasco, L, Marquez, J, Sbraga, F, Fuset, M, De Gopegui, P, Claraco, L, De Ayala, J, Peiro, M, Ricart, P, Martinez, S, Chavez, F, Fabra, M, Sandoval, E, Toapanta, D, Carraminana, A, Tellez, A, Ososio, J, Milan, P, Rodriguez, J, Andoni, G, Gutierrez, C, Perez de la Sota, E, Eixeres-Esteve, A, Garcia-Maellas, M, Gutierrez-Gutierrez, J, Arboleda-Salazar, R, Santa Teresa, P, Jaspe, A, Garrido, A, Castaneda, G, Alcantara, S, Martinez, N, Perez, M, Villanueva, H, Vidal Gonzalez, A, Paez, J, Santon, A, Perez, C, Lopez, M, Rubio Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Munoz, J, Alcalde, I, Onieva, F, Gimeno Costa, R, Perez, F, Madrid, I, Gordon, M, Albacete Moreno, C, Perez, D, Lopez, N, Martinenz, D, Blanco-Schweizer, P, Diez, C, Prieto, A, Renedo, G, Bustamante, E, Cicuendez, R, Citores, R, Boado, V, Garcia, K, Voces, R, Domezain, M, Nunez Martinez, J, Vicente, R, Martin, D, Andreu, A, Gomez Casal, V, Chico, I, Menor, E, Vara, S, Gamacho, J, Perez-Chomon, H, Javier Gonzales, F, Barrero, I, Martin-Villen, L, Fernandez, E, Mendoza, M, Navarro, J, Colomina Climent, J, Gonzales-Perez, A, Muniz-Albaceita, G, Amado, L, Rodriguez, R, Ruiz, E, Eiras, M, Grins, E, Magnus, R, Kanetoft, M, Eidevald, M, Watson, P, Vogt, P, Steiger, P, Aigner, T, Weber, A, Grunefelder, J, Kunz, M, Grapow, M, Aymard, T, Reser, D, Agus, G, Consiglio, J, Haenggi, M, Hansjoerg, J, Iten, M, Doeble, T, Zenklusen, U, Bechtold, X, Faedda, G, Iafrate, M, Rohjer, A, Bergamaschi, L, Maessen, J, Reis Miranda, D, Endeman, H, Gommers, D, Meuwese, C, Maas, J, Van Gijlswijk, M, Van Berg, R, Candura, D, Van der Linden, M, Kant, M, Van der Heijden, J, Scholten, E, Van Belle-van Haren, N, Lagrand, W, Vlaar, A, De Jong, S, Cander, B, Sargin, M, Ugur, M, Kaygin, M, Daly, K, Agnew, N, Head, L, Kelly, L, Anoma, G, Russell, C, Aquino, V, Scott, I, Flemming, L, Gillon, S, Moore, O, Gelandt, E, Auzinger, G, Patel, S, Loveridge, R, Lorusso R., De Piero M. E., Mariani S., Di Mauro M., Folliguet T., Taccone F. S., Camporota L., Swol J., Wiedemann D., Belliato M., Broman L. M., Vuylsteke A., Kassif Y., Scandroglio A. M., Fanelli V., Gaudard P., Ledot S., Barker J., Boeken U., Maier S., Kersten A., Meyns B., Pozzi M., Pedersen F. M., Schellongowski P., Kirali K., Barrett N., Riera J., Mueller T., Belohlavek J., Lo Coco V., Van der Horst I. C. C., Van Bussel B. C. T., Schnabel R. M., Delnoij T., Bolotin G., Lorini L., Schmiady M. O., Schibilsky D., Kowalewski M., Pinto L. F., Silva P. E., Kornilov I., Blandino Ortiz A., Vercaemst L., Finney S., Roeleveld P. P., Di Nardo M., Hennig F., Antonini M. V., Davidson M., Jones T. J., Staudinger T., Mair P., Kilo J., Krapf C., Erbert K., Peer A., Bonaros N., Kotheletner F., Krenner Mag N., Shestakova L., Hermans G., Dauwe D., Meersseman P., Stockman B., Nobile L., Lhereux O., Nrasseurs A., Creuter J., De Backer D., Giglioli S., Michiels G., Foulon P., Raes M., Rodrigus I., Allegaert M., Jorens P., Debeucklare G., Piagnerelli M., Biston P., Peperstraete H., Vandewiele K., Germay O., Vandeweghe D., Havrin S., Bourgeois M., Lagny M. -G., Alois G., Lavios N., Misset B., Courcelle R., Timmermans P. J., Yilmaz A., Vantomout M., Lehaen J., Jassen A., Guterman H., Strauven M., Lormans P., Verhamme B., Vandewaeter C., Bonte F., Vionne D., Balik M., Blaha J., Lips M., Othal M., Bursa F., Spacek R., Christensen S., Jorgensen V., Sorensen M., Madsen S. A., Puss S., Beljantsev A., Saiydoun G., Fiore A., Colson P., Bazalgette F., Capdevila X., Kollen S., Muller L., Obadia J. -F., Dubien P. -Y., Ajrhourh L., Guinot P. G., Zarka J., Besserve P., Malfertheiner M. V., Dreier E., Heinze B., Akhyari P., Lichtenberg A., Aubin H., Assman A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Ruslan N., Haverich A., Thielmann M., Brenner T., Ruhpawar A., Benk C., Czerny M., Staudacher D. L., Beyersdorf F., Kalbhenn J., Henn P., Popov A. -F., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Lotz G., Sonntagbauer M., Winkels H., Fichte J., Stohr R., Kalverkamp S., Karagiannidis C., Schafer S., Svetlitchny A., Hopf H. -B., Jarczak D., Groesdonk H., Rommer M., Hirsch J., Kaehny C., Soufleris D., Gavriilidis G., Pontikis K., Kyriakopoulou M., Kyriakoudi A., O'Brien S., Conrick-Martin I., Carton E., Makhoul M., Ben-Ari J., Hadash A., Kogan A., Kassif Lerner R., Abu-Shakra A., Matan M., Balawona A., Kachel E., Altshuler R., Galante O., Fuchs L., Almog Y., Ishay Y. S., Lichter Y., Gal-oz A., Carmi U., Nini A., Soroksky A., Dekel H., Rozman Z., Tayem E., Ilgiyaev E., Hochman Y., Miltau D., Rapoport A., Eden A., Kompanietz D., Yousif M., Golos M., Grazioli L., Ghitti D., Loforte A., Di Luca D., Baiocchi M., Pacini D., Cappai A., Meani P., Mondino M., Russo C. F., Ranucci M., Fina D., Cotza M., Ballotta A., Landoni G., Nardelli P., Fominski E. V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Livigni S., Silengo D., Arena G., Sovatzis S. S., Degani A., Riccardi M., Milanesi E., Raffa G., Martucci G., Arcadipane A., Panarello G., Chiarini G., Cattaneo S., Puglia C., Benussi S., Foti G., Giani M., Bombino M., Costa M. C., Rona R., Avalli L., Donati A., Carozza R., Gasparri F., Carsetti A., Piciche M., Marinello A., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Russo E., Agnoletti V., Rociola R., Milano A. D., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Giordano G., Carelli S., Grieco D. L., Dell'Anna A. M., Antonelli M., Ramoni E., Zulueta J., Del Giglio M., Petracca S., Bertini P., Guarracino F., De Simone L., Angeletti P. M., Forfori F., Taraschi F., Quintiliani V. N., Samalavicius R., Jankuviene A., Scupakova N., Urbonas K., Kapturauskas J., Soerensen G., Suwalski P., Linhares Santos L., Marques A., Miranda M., Teixeira S., Salgueiro A., Pereira F., Ketskalo M., Tsarenko S., Shilova A., Afukov I., Popugaev K., Minin S., Shelukhin D., Malceva O., Gleb M., Skopets A., Kornelyuk R., Kulikov A., Okhrimchuk V., Turchaninov A., Petrushin M., Sheck A., Mekulov A., Ciryateva S., Urusov D., Gorjup V., Golicnik A., Goslar T., Ferrer R., Martinez-Martinez M., Argudo E., Palmer N., De Pablo Sanchez R., Juan Higuera L., Arnau Blasco L., Marquez J. A., Sbraga F., Fuset M. P., De Gopegui P. R., Claraco L. M., De Ayala J. A., Peiro M., Ricart P., Martinez S., Chavez F., Fabra M., Sandoval E., Toapanta D., Carraminana A., Tellez A., Ososio J., Milan P., Rodriguez J., Andoni G., Gutierrez C., Perez de la Sota E., Eixeres-Esteve A., Garcia-Maellas M. T., Gutierrez-Gutierrez J., Arboleda-Salazar R., Santa Teresa P., Jaspe A., Garrido A., Castaneda G., Alcantara S., Martinez N., Perez M., Villanueva H., Vidal Gonzalez A., Paez J., Santon A., Perez C., Lopez M., Rubio Lopez M. I., Gordillo A., Naranjo-Izurieta J., Munoz J., Alcalde I., Onieva F., Gimeno Costa R., Perez F., Madrid I., Gordon M., Albacete Moreno C. L., Perez D., Lopez N., Martinenz D., Blanco-Schweizer P., Diez C., Prieto A., Renedo G., Bustamante E., Cicuendez R., Citores R., Boado V., Garcia K., Voces R., Domezain M., Nunez Martinez J. M., Vicente R., Martin D., Andreu A., Gomez Casal V., Chico I., Menor E. M., Vara S., Gamacho J., Perez-Chomon H., Javier Gonzales F., Barrero I., Martin-Villen L., Fernandez E., Mendoza M., Navarro J., Colomina Climent J., Gonzales-Perez A., Muniz-Albaceita G., Amado L., Rodriguez R., Ruiz E., Eiras M., Grins E., Magnus R., Kanetoft M., Eidevald M., Watson P., Vogt P. R., Steiger P., Aigner T., Weber A., Grunefelder J., Kunz M., Grapow M., Aymard T., Reser D., Agus G., Consiglio J., Haenggi M., Hansjoerg J., Iten M., Doeble T., Zenklusen U., Bechtold X., Faedda G., Iafrate M., Rohjer A., Bergamaschi L., Maessen J., Reis Miranda D., Endeman H., Gommers D., Meuwese C., Maas J., Van Gijlswijk M. J., Van Berg R. N., Candura D., Van der Linden M., Kant M., Van der Heijden J. J., Scholten E., Van Belle-van Haren N., Lagrand W. K., Vlaar A. P., De Jong S., Cander B., Sargin M., Ugur M., Kaygin M. A., Daly K., Agnew N., Head L., Kelly L., Anoma G., Russell C., Aquino V., Scott I., Flemming L., Gillon S., Moore O., Gelandt E., Auzinger G., Patel S., Loveridge R., Lorusso, R, De Piero, M, Mariani, S, Di Mauro, M, Folliguet, T, Taccone, F, Camporota, L, Swol, J, Wiedemann, D, Belliato, M, Broman, L, Vuylsteke, A, Kassif, Y, Scandroglio, A, Fanelli, V, Gaudard, P, Ledot, S, Barker, J, Boeken, U, Maier, S, Kersten, A, Meyns, B, Pozzi, M, Pedersen, F, Schellongowski, P, Kirali, K, Barrett, N, Riera, J, Mueller, T, Belohlavek, J, Lo Coco, V, Van der Horst, I, Van Bussel, B, Schnabel, R, Delnoij, T, Bolotin, G, Lorini, L, Schmiady, M, Schibilsky, D, Kowalewski, M, Pinto, L, Silva, P, Kornilov, I, Blandino Ortiz, A, Vercaemst, L, Finney, S, Roeleveld, P, Di Nardo, M, Hennig, F, Antonini, M, Davidson, M, Jones, T, Staudinger, T, Mair, P, Kilo, J, Krapf, C, Erbert, K, Peer, A, Bonaros, N, Kotheletner, F, Krenner Mag, N, Shestakova, L, Hermans, G, Dauwe, D, Meersseman, P, Stockman, B, Nobile, L, Lhereux, O, Nrasseurs, A, Creuter, J, De Backer, D, Giglioli, S, Michiels, G, Foulon, P, Raes, M, Rodrigus, I, Allegaert, M, Jorens, P, Debeucklare, G, Piagnerelli, M, Biston, P, Peperstraete, H, Vandewiele, K, Germay, O, Vandeweghe, D, Havrin, S, Bourgeois, M, Lagny, M, Alois, G, Lavios, N, Misset, B, Courcelle, R, Timmermans, P, Yilmaz, A, Vantomout, M, Lehaen, J, Jassen, A, Guterman, H, Strauven, M, Lormans, P, Verhamme, B, Vandewaeter, C, Bonte, F, Vionne, D, Balik, M, Blaha, J, Lips, M, Othal, M, Bursa, F, Spacek, R, Christensen, S, Jorgensen, V, Sorensen, M, Madsen, S, Puss, S, Beljantsev, A, Saiydoun, G, Fiore, A, Colson, P, Bazalgette, F, Capdevila, X, Kollen, S, Muller, L, Obadia, J, Dubien, P, Ajrhourh, L, Guinot, P, Zarka, J, Besserve, P, Malfertheiner, M, Dreier, E, Heinze, B, Akhyari, P, Lichtenberg, A, Aubin, H, Assman, A, Saeed, D, Thiele, H, Baumgaertel, M, Schmitto, J, Ruslan, N, Haverich, A, Thielmann, M, Brenner, T, Ruhpawar, A, Benk, C, Czerny, M, Staudacher, D, Beyersdorf, F, Kalbhenn, J, Henn, P, Popov, A, Iuliu, T, Muellenbach, R, Reyher, C, Rolfes, C, Lotz, G, Sonntagbauer, M, Winkels, H, Fichte, J, Stohr, R, Kalverkamp, S, Karagiannidis, C, Schafer, S, Svetlitchny, A, Hopf, H, Jarczak, D, Groesdonk, H, Rommer, M, Hirsch, J, Kaehny, C, Soufleris, D, Gavriilidis, G, Pontikis, K, Kyriakopoulou, M, Kyriakoudi, A, O'Brien, S, Conrick-Martin, I, Carton, E, Makhoul, M, Ben-Ari, J, Hadash, A, Kogan, A, Kassif Lerner, R, Abu-Shakra, A, Matan, M, Balawona, A, Kachel, E, Altshuler, R, Galante, O, Fuchs, L, Almog, Y, Ishay, Y, Lichter, Y, Gal-oz, A, Carmi, U, Nini, A, Soroksky, A, Dekel, H, Rozman, Z, Tayem, E, Ilgiyaev, E, Hochman, Y, Miltau, D, Rapoport, A, Eden, A, Kompanietz, D, Yousif, M, Golos, M, Grazioli, L, Ghitti, D, Loforte, A, Di Luca, D, Baiocchi, M, Pacini, D, Cappai, A, Meani, P, Mondino, M, Russo, C, Ranucci, M, Fina, D, Cotza, M, Ballotta, A, Landoni, G, Nardelli, P, Fominski, E, Brazzi, L, Montrucchio, G, Sales, G, Simonetti, U, Livigni, S, Silengo, D, Arena, G, Sovatzis, S, Degani, A, Riccardi, M, Milanesi, E, Raffa, G, Martucci, G, Arcadipane, A, Panarello, G, Chiarini, G, Cattaneo, S, Puglia, C, Benussi, S, Foti, G, Giani, M, Bombino, M, Costa, M, Rona, R, Avalli, L, Donati, A, Carozza, R, Gasparri, F, Carsetti, A, Piciche, M, Marinello, A, Danzi, V, Zanin, A, Condello, I, Fiore, F, Moscarelli, M, Nasso, G, Speziale, G, Sandrelli, L, Montalto, A, Musumeci, F, Circelli, A, Russo, E, Agnoletti, V, Rociola, R, Milano, A, Pilato, E, Comentale, G, Montisci, A, Alessandri, F, Tosi, A, Pugliese, F, Giordano, G, Carelli, S, Grieco, D, Dell'Anna, A, Antonelli, M, Ramoni, E, Zulueta, J, Del Giglio, M, Petracca, S, Bertini, P, Guarracino, F, De Simone, L, Angeletti, P, Forfori, F, Taraschi, F, Quintiliani, V, Samalavicius, R, Jankuviene, A, Scupakova, N, Urbonas, K, Kapturauskas, J, Soerensen, G, Suwalski, P, Linhares Santos, L, Marques, A, Miranda, M, Teixeira, S, Salgueiro, A, Pereira, F, Ketskalo, M, Tsarenko, S, Shilova, A, Afukov, I, Popugaev, K, Minin, S, Shelukhin, D, Malceva, O, Gleb, M, Skopets, A, Kornelyuk, R, Kulikov, A, Okhrimchuk, V, Turchaninov, A, Petrushin, M, Sheck, A, Mekulov, A, Ciryateva, S, Urusov, D, Gorjup, V, Golicnik, A, Goslar, T, Ferrer, R, Martinez-Martinez, M, Argudo, E, Palmer, N, De Pablo Sanchez, R, Juan Higuera, L, Arnau Blasco, L, Marquez, J, Sbraga, F, Fuset, M, De Gopegui, P, Claraco, L, De Ayala, J, Peiro, M, Ricart, P, Martinez, S, Chavez, F, Fabra, M, Sandoval, E, Toapanta, D, Carraminana, A, Tellez, A, Ososio, J, Milan, P, Rodriguez, J, Andoni, G, Gutierrez, C, Perez de la Sota, E, Eixeres-Esteve, A, Garcia-Maellas, M, Gutierrez-Gutierrez, J, Arboleda-Salazar, R, Santa Teresa, P, Jaspe, A, Garrido, A, Castaneda, G, Alcantara, S, Martinez, N, Perez, M, Villanueva, H, Vidal Gonzalez, A, Paez, J, Santon, A, Perez, C, Lopez, M, Rubio Lopez, M, Gordillo, A, Naranjo-Izurieta, J, Munoz, J, Alcalde, I, Onieva, F, Gimeno Costa, R, Perez, F, Madrid, I, Gordon, M, Albacete Moreno, C, Perez, D, Lopez, N, Martinenz, D, Blanco-Schweizer, P, Diez, C, Prieto, A, Renedo, G, Bustamante, E, Cicuendez, R, Citores, R, Boado, V, Garcia, K, Voces, R, Domezain, M, Nunez Martinez, J, Vicente, R, Martin, D, Andreu, A, Gomez Casal, V, Chico, I, Menor, E, Vara, S, Gamacho, J, Perez-Chomon, H, Javier Gonzales, F, Barrero, I, Martin-Villen, L, Fernandez, E, Mendoza, M, Navarro, J, Colomina Climent, J, Gonzales-Perez, A, Muniz-Albaceita, G, Amado, L, Rodriguez, R, Ruiz, E, Eiras, M, Grins, E, Magnus, R, Kanetoft, M, Eidevald, M, Watson, P, Vogt, P, Steiger, P, Aigner, T, Weber, A, Grunefelder, J, Kunz, M, Grapow, M, Aymard, T, Reser, D, Agus, G, Consiglio, J, Haenggi, M, Hansjoerg, J, Iten, M, Doeble, T, Zenklusen, U, Bechtold, X, Faedda, G, Iafrate, M, Rohjer, A, Bergamaschi, L, Maessen, J, Reis Miranda, D, Endeman, H, Gommers, D, Meuwese, C, Maas, J, Van Gijlswijk, M, Van Berg, R, Candura, D, Van der Linden, M, Kant, M, Van der Heijden, J, Scholten, E, Van Belle-van Haren, N, Lagrand, W, Vlaar, A, De Jong, S, Cander, B, Sargin, M, Ugur, M, Kaygin, M, Daly, K, Agnew, N, Head, L, Kelly, L, Anoma, G, Russell, C, Aquino, V, Scott, I, Flemming, L, Gillon, S, Moore, O, Gelandt, E, Auzinger, G, Patel, S, Loveridge, R, Lorusso R., De Piero M. E., Mariani S., Di Mauro M., Folliguet T., Taccone F. S., Camporota L., Swol J., Wiedemann D., Belliato M., Broman L. M., Vuylsteke A., Kassif Y., Scandroglio A. M., Fanelli V., Gaudard P., Ledot S., Barker J., Boeken U., Maier S., Kersten A., Meyns B., Pozzi M., Pedersen F. M., Schellongowski P., Kirali K., Barrett N., Riera J., Mueller T., Belohlavek J., Lo Coco V., Van der Horst I. C. C., Van Bussel B. C. T., Schnabel R. M., Delnoij T., Bolotin G., Lorini L., Schmiady M. O., Schibilsky D., Kowalewski M., Pinto L. F., Silva P. E., Kornilov I., Blandino Ortiz A., Vercaemst L., Finney S., Roeleveld P. P., Di Nardo M., Hennig F., Antonini M. V., Davidson M., Jones T. J., Staudinger T., Mair P., Kilo J., Krapf C., Erbert K., Peer A., Bonaros N., Kotheletner F., Krenner Mag N., Shestakova L., Hermans G., Dauwe D., Meersseman P., Stockman B., Nobile L., Lhereux O., Nrasseurs A., Creuter J., De Backer D., Giglioli S., Michiels G., Foulon P., Raes M., Rodrigus I., Allegaert M., Jorens P., Debeucklare G., Piagnerelli M., Biston P., Peperstraete H., Vandewiele K., Germay O., Vandeweghe D., Havrin S., Bourgeois M., Lagny M. -G., Alois G., Lavios N., Misset B., Courcelle R., Timmermans P. J., Yilmaz A., Vantomout M., Lehaen J., Jassen A., Guterman H., Strauven M., Lormans P., Verhamme B., Vandewaeter C., Bonte F., Vionne D., Balik M., Blaha J., Lips M., Othal M., Bursa F., Spacek R., Christensen S., Jorgensen V., Sorensen M., Madsen S. A., Puss S., Beljantsev A., Saiydoun G., Fiore A., Colson P., Bazalgette F., Capdevila X., Kollen S., Muller L., Obadia J. -F., Dubien P. -Y., Ajrhourh L., Guinot P. G., Zarka J., Besserve P., Malfertheiner M. V., Dreier E., Heinze B., Akhyari P., Lichtenberg A., Aubin H., Assman A., Saeed D., Thiele H., Baumgaertel M., Schmitto J. D., Ruslan N., Haverich A., Thielmann M., Brenner T., Ruhpawar A., Benk C., Czerny M., Staudacher D. L., Beyersdorf F., Kalbhenn J., Henn P., Popov A. -F., Iuliu T., Muellenbach R., Reyher C., Rolfes C., Lotz G., Sonntagbauer M., Winkels H., Fichte J., Stohr R., Kalverkamp S., Karagiannidis C., Schafer S., Svetlitchny A., Hopf H. -B., Jarczak D., Groesdonk H., Rommer M., Hirsch J., Kaehny C., Soufleris D., Gavriilidis G., Pontikis K., Kyriakopoulou M., Kyriakoudi A., O'Brien S., Conrick-Martin I., Carton E., Makhoul M., Ben-Ari J., Hadash A., Kogan A., Kassif Lerner R., Abu-Shakra A., Matan M., Balawona A., Kachel E., Altshuler R., Galante O., Fuchs L., Almog Y., Ishay Y. S., Lichter Y., Gal-oz A., Carmi U., Nini A., Soroksky A., Dekel H., Rozman Z., Tayem E., Ilgiyaev E., Hochman Y., Miltau D., Rapoport A., Eden A., Kompanietz D., Yousif M., Golos M., Grazioli L., Ghitti D., Loforte A., Di Luca D., Baiocchi M., Pacini D., Cappai A., Meani P., Mondino M., Russo C. F., Ranucci M., Fina D., Cotza M., Ballotta A., Landoni G., Nardelli P., Fominski E. V., Brazzi L., Montrucchio G., Sales G., Simonetti U., Livigni S., Silengo D., Arena G., Sovatzis S. S., Degani A., Riccardi M., Milanesi E., Raffa G., Martucci G., Arcadipane A., Panarello G., Chiarini G., Cattaneo S., Puglia C., Benussi S., Foti G., Giani M., Bombino M., Costa M. C., Rona R., Avalli L., Donati A., Carozza R., Gasparri F., Carsetti A., Piciche M., Marinello A., Danzi V., Zanin A., Condello I., Fiore F., Moscarelli M., Nasso G., Speziale G., Sandrelli L., Montalto A., Musumeci F., Circelli A., Russo E., Agnoletti V., Rociola R., Milano A. D., Pilato E., Comentale G., Montisci A., Alessandri F., Tosi A., Pugliese F., Giordano G., Carelli S., Grieco D. L., Dell'Anna A. M., Antonelli M., Ramoni E., Zulueta J., Del Giglio M., Petracca S., Bertini P., Guarracino F., De Simone L., Angeletti P. M., Forfori F., Taraschi F., Quintiliani V. N., Samalavicius R., Jankuviene A., Scupakova N., Urbonas K., Kapturauskas J., Soerensen G., Suwalski P., Linhares Santos L., Marques A., Miranda M., Teixeira S., Salgueiro A., Pereira F., Ketskalo M., Tsarenko S., Shilova A., Afukov I., Popugaev K., Minin S., Shelukhin D., Malceva O., Gleb M., Skopets A., Kornelyuk R., Kulikov A., Okhrimchuk V., Turchaninov A., Petrushin M., Sheck A., Mekulov A., Ciryateva S., Urusov D., Gorjup V., Golicnik A., Goslar T., Ferrer R., Martinez-Martinez M., Argudo E., Palmer N., De Pablo Sanchez R., Juan Higuera L., Arnau Blasco L., Marquez J. A., Sbraga F., Fuset M. P., De Gopegui P. R., Claraco L. M., De Ayala J. A., Peiro M., Ricart P., Martinez S., Chavez F., Fabra M., Sandoval E., Toapanta D., Carraminana A., Tellez A., Ososio J., Milan P., Rodriguez J., Andoni G., Gutierrez C., Perez de la Sota E., Eixeres-Esteve A., Garcia-Maellas M. T., Gutierrez-Gutierrez J., Arboleda-Salazar R., Santa Teresa P., Jaspe A., Garrido A., Castaneda G., Alcantara S., Martinez N., Perez M., Villanueva H., Vidal Gonzalez A., Paez J., Santon A., Perez C., Lopez M., Rubio Lopez M. I., Gordillo A., Naranjo-Izurieta J., Munoz J., Alcalde I., Onieva F., Gimeno Costa R., Perez F., Madrid I., Gordon M., Albacete Moreno C. L., Perez D., Lopez N., Martinenz D., Blanco-Schweizer P., Diez C., Prieto A., Renedo G., Bustamante E., Cicuendez R., Citores R., Boado V., Garcia K., Voces R., Domezain M., Nunez Martinez J. M., Vicente R., Martin D., Andreu A., Gomez Casal V., Chico I., Menor E. M., Vara S., Gamacho J., Perez-Chomon H., Javier Gonzales F., Barrero I., Martin-Villen L., Fernandez E., Mendoza M., Navarro J., Colomina Climent J., Gonzales-Perez A., Muniz-Albaceita G., Amado L., Rodriguez R., Ruiz E., Eiras M., Grins E., Magnus R., Kanetoft M., Eidevald M., Watson P., Vogt P. R., Steiger P., Aigner T., Weber A., Grunefelder J., Kunz M., Grapow M., Aymard T., Reser D., Agus G., Consiglio J., Haenggi M., Hansjoerg J., Iten M., Doeble T., Zenklusen U., Bechtold X., Faedda G., Iafrate M., Rohjer A., Bergamaschi L., Maessen J., Reis Miranda D., Endeman H., Gommers D., Meuwese C., Maas J., Van Gijlswijk M. J., Van Berg R. N., Candura D., Van der Linden M., Kant M., Van der Heijden J. J., Scholten E., Van Belle-van Haren N., Lagrand W. K., Vlaar A. P., De Jong S., Cander B., Sargin M., Ugur M., Kaygin M. A., Daly K., Agnew N., Head L., Kelly L., Anoma G., Russell C., Aquino V., Scott I., Flemming L., Gillon S., Moore O., Gelandt E., Auzinger G., Patel S., and Loveridge R.

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation. Methods: EuroECMO-COVID is a prospective, multicentre, observational study developed by the European Extracorporeal Life Support Organization. This study was based on data from patients aged 16 years or older who received ECMO support for refractory COVID-19 during the first wave of the pandemic—from March 1 to Sept 13, 2020—at 133 centres in 21 countries. In-hospital mortality and mortality 6 months after ECMO initiation were the primary outcomes. Mixed-Cox proportional hazards models were used to investigate associations between patient and management-related variables (eg, patient demographics, comorbidities, pre-ECMO status, and ECMO characteristics and complications) and in-hospital deaths. Survival status at 6 months was established through patient contact or institutional charts review. This study is registered with ClinicalTrials.gov, NCT04366921, and is ongoing. Findings: Between March 1 and Sept 13, 2020, 1215 patients (942 [78%] men and 267 [22%] women; median age 53 years [IQR 46–60]) were included in the study. Median ECMO duration was 15 days (IQR 8–27). 602 (50%) of 1215 patients died in hospital, and 852 (74%) patients had at least one complication. Multiorgan failure was the leading cause of death (192 [36%] of 528 patients who died with available data). In mixed-Cox analyses, age of 60 years or older, use of inotropes and vasopressors before ECMO initiation, chronic renal failure, and time from intubation to ECMO initiation of 4 days or more were associated with higher in-hospital mortality. 613 patients

Published
2023

4. Role of age and comorbidities in mortality of patients with infective endocarditis

Author

Armiñanzas, C., Fariñas-Alvarez, C., Zarauza, J., Muñoz, P., González Ramallo, V., Martínez Sellés, M., Miró Meda, J.M., Pericás, J.M., Goenaga, M.Á., Ojeda Burgos, G., Rodríguez Álvarez, R., Castelo Corral, L., Gálvez-Acebal, J., Martínez Marcos, F.J., Fariñas, M.C., Fernández Sánchez, F., Noureddine, M., Rosas, G., de la Torre Lima, J., Aramendi, J., Bereciartua, E., Blanco, M.J., Blanco, R., Boado, M.V., Campaña Lázaro, M., Crespo, A., Goikoetxea, J., Iruretagoyena, J.R., Irurzun Zuazabal, J., López-Soria, L., Montejo, M., Nieto, J., Rodrigo, D., Rodríguez, D., Rodríguez, R., Vitoria, Y., Voces, R., García López, M.V., Georgieva, R.I., Ojeda, G., Rodríguez Bailón, I., Ruiz Morales, J., Cuende, A.M., Echeverría, T., Fuerte, A., Gaminde, E., Idígoras, P., Iribarren, J.A., Izaguirre Yarza, A., Kortajarena Urkola, X., Reviejo, C., Carrasco, R., Climent, V., Llamas, P., Merino, E., Plazas, J., Reus, S., Álvarez, N., Bravo-Ferrer, J.M., Castelo, L., Cuenca, J., Llinares, P., Miguez Rey, E., Rodríguez Mayo, M., Sánchez, E., Sousa Regueiro, D., Martínez, F.J., Alonso, M.D.M., Castro, B., García Rosado, D., Durán, M.D.C., Miguel Gómez, M.A., Lacalzada, J., Nassar, I., Plata Ciezar, A., Reguera Iglesias, J.M., Asensi Álvarez, V., Costas, C., de la Hera, J., Fernández Suárez, J., Iglesias Fraile, L., León Arguero, V., López Menéndez, J., Mencia Bajo, P., Morales, C., Moreno Torrico, A., Palomo, C., Paya Martínez, B., Rodríguez Esteban, Á., Rodríguez García, R., Telenti Asensio, M., Almela, M., Ambrosioni, J., Azqueta, M., Brunet, M., Bodro, M., Cartañá, R., Falces, C., Fita, G., Fuster, D., García de la Mària, C., Hernández-Meneses, M., Llopis Pérez, J., Marco, F., Miró, J.M., Moreno, A., Nicolás, D., Ninot, S., Quintana, E., Paré, C., Pereda, D., Pomar, J.L., Ramírez, J., Rovira, I., Sandoval, E., Sitges, M., Soy, D., Téllez, A., Tolosana, J.M., Vidal, B., Vila, J., Adán, I., Bermejo, J., Bouza, E., Celemín, D., Cuerpo Caballero, G., Delgado Montero, A., Fernández Cruz, A., García Mansilla, A., García Leoni, M.E., Kestler Hernández, M., Hualde, A.M., Marín, M., Martínez-Sellés, M., Menárguez, M.C., Rincón, C., Rodríguez-Abella, H., Rodríguez-Créixems, M., Pinilla, B., Pinto, Á., Valerio, M., Vázquez, P., Verde Moreno, E., Antorrena, I., Loeches, B., Martín Quirós, A., Moreno, M., Ramírez, U., Rial Bastón, V., Romero, M., Saldaña, A., Agüero Balbín, J., Amado, C., Armiñanzas Castillo, C., Arnaiz García, A., Cobo Belaustegui, M., Fariñas-Álvarez, C., Gómez Izquierdo, R., García, I., González-Rico, C., Gutiérrez-Cuadra, M., Gutiérrez Díez, J., Pajarón, M., Parra, J.A., Sarralde, A., Teira, R., Domínguez, F., García Pavía, P., González, J., Orden, B., Ramos, A., Centella, T., Hermida, J.M., Moya, J.L., Martín-Dávila, P., Navas, E., Oliva, E., del Río, A., Ruiz, S., Hidalgo Tenorio, C., Almendro Delia, M., Araji, O., Barquero, J.M., Calvo Jambrina, R., de Cueto, M., Gálvez Acebal, J., Méndez, I., Morales, I., and Matamala Adell, M.

Abstract

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups

Published
2020

8. 481 Mass compromising left atrium

Author

Rodrigo Carbonero, D, primary, Estandia, U, additional, Perez, P M, additional, Perez, C, additional, Voces, R, additional, Cortes, A, additional, and Panera, E, additional

Published
2020
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9. Antimicrobial management of Tropheryma whipplei endocarditis: the Spanish Collaboration on Endocarditis (GAMES) experience

Author

Garcia-Alvarez L, Sanz M, Marin M, Farinas M, Montejo M, Goikoetxea J, Garcia R, de Alarcon A, Almela M, Fernandez-Hidalgo N, Socas M, Goenaga M, Navas E, Vicioso L, Oteo J, Adan I, Sanchez F, Noureddine M, Rosas G, Lima J, Aramendi J, Bereciartua E, Boado M, Lazaro M, Goiti J, Hernandez J, Iruretagoyena J, Zuazabal J, Lopez-Soria L, Perez P, Rodriguez R, Voces R, Lopez M, Georgieva R, Solero M, Bailon I, Morales J, Cuende A, Echeverria T, Fuerte A, Gaminde E, Idigoras P, Iribarren J, Yarza A, Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Alvarez N, Bravo-Ferrer J, Castelo L, Cuenca J, Llinares P, Rey E, Mayo M, Sanchez E, Regueiro D, Martinez F, Alonso M, Castro B, Marrero D, Duran M, Gomez M, La Calzada J, Nassar I, Ciezar A, Iglesias J, Alvarez V, Costas C, de la Hera J, Suarez J, Fraile L, Arguero V, Menendez J, Bajo P, Morales C, Torrico A, Palomo C, Martinez B, Esteban A, Asensio M, Ambrosioni J, Armero Y, Azqueta M, Brunet M, Cartana R, Falces C, Fita G, Fuster D, de la Maria C, Gatell J, Perez J, Manzardo C, Marco F, Miro J, Moreno A, Ninot S, Quintana E, Pare C, Pereda D, Pericas J, Pomar J, Ramirez J, Rovira I, Sitges M, Soy D, Tellez A, Vidal B, Vila J, Bermejo J, Bouza E, Cuerpo G, de Egea V, Eworo A, Cruz A, Leoni M, del Vecchio M, Ramallo V, Hernandez M, Martinez-Selles M, Menarguez M, Munoz P, Rincon C, Rodriguez-Abella H, Rodriguez-Creixems M, Pinilla B, Pinto A, Valerio M, Moreno E, Antorrena I, Loeches B, Moreno M, Ramirez U, Baston V, Romero M, Saldana A, Castillo C, Arnaiz A, Berrazueta J, Bellisco S, Belaustegui M, Duran R, Farinas-Alvarez C, Mazarrasa C, Izquierdo R, Rico C, Diez J, Pajaron M, Parra J, Teira R, Zarauza J, Pavia P, Gonzalez J, Orden B, Ramos A, Gonzalez E, Centella T, Hermida J, Moya J, Martin-Davila P, Oliva E, del Rio A, Ruiz S, Tenorio C, de Castro A, de Cueto M, Gallego P, Acebal J, Bano J, Garcia E, Haro J, Lepe J, Lopez F, Luque R, Alonso L, Azcarate P, Gutierrez J, Blanco J, de Benito N, Gurgui M, Pacho C, Pericas R, Pons G, Alvarez M, Fernandez A, Martinez A, Prieto A, Regueiro B, Tijeira E, Vega M, Blasco A, Mollar J, Arana J, Uriarte O, Lopez A, de Zarate Z, Matos J, Nacle M, Sanchez-Porto A, Vallejo L, Leal J, Vazquez E, Torres A, Blazquez A, Valenzuela G, Alonso A, Aramburu J, Calvo F, Rodriguez A, Tarabini-Castellani P, Galvez E, Bellido C, Pau J, Sepulveda M, Sierra P, Iqbal-Mirza S, Alcolea E, Serrano P, Roca J, Escobar E, Monje A, Cabrera V, Garcia D, Luna C, Morcillo J, Seco M, and Spanish Collaboration Endocarditis

Abstract

Objectives: Tropheryma whipplei has been detected in 3.5% of the blood culture-negative cases of endocarditis in Spain. Experience in the management of T. whipplei endocarditis is limited. Here we report the long-term outcome of the treatment of previously reported patients who were diagnosed with infective endocarditis (IE) caused by T. whipplei from the Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en Espana (GAMES) and discuss potential options for antimicrobial therapy for IE caused by T. whipplei. Patients and methods: Seventeen patients with T. whipplei endocarditis were recruited between 2008 and 2014 in 25 Spanish hospitals. Patients were classified according to the therapeutic regimen: ceftriaxone and trimethoprim/sulfamethoxazole, doxycycline + hydroxychloroquine and other treatment options. Results: Follow-up data were obtained from 14 patients. The median follow-up was 46.5months. All patients completed the antibiotic treatment prescribed, with a median duration of 13months. Six patients were treated with ceftriaxone and trimethoprim/sulfamethoxazole (median duration 13months), four with doxycycline + hydroxychloroquine (median duration 13.8months) and four with other treatment options (median duration 22.3months). The follow-up after the end of the treatments was between 5 and 84months (median 24months). Conclusions: All treatment lines were effective and well tolerated. Therapeutic failures were not detected during the treatment. None of the patients died or experienced a relapse during the follow-up. Only six patients received antibiotic treatment in accordance with guidelines. These data suggest that shorter antimicrobial treatments could be effective.

Published
2019

10. Mitral valve repair in infective endocarditis is not inferior to valve replacement: results from a Spanish nationwide prospective registry

Author

Cuerpo G, Valerio M, Pedraz A, Rodriguez-Abella H, Mestres C, Obrador E, Gonzalez-Calle A, Alvarez R, Garcia P, Bouza E, Sanchez F, Noureddine M, Rosas G, Lima J, Aramendi J, Bereciartua E, Blanco M, Blanco R, Boado M, Lazaro M, Crespo A, Goikoetxea J, Iruretagoyena J, Zuazabal J, Lopez-Soria L, Montejo M, Nieto J, Rodrigo D, Rodriguez D, Rodriguez R, Vitoria Y, Voces R, Lopez M, Georgieva R, Ojeda G, Bailon I, Morales J, Cuende A, Echeverria T, Fuerte A, Gaminde E, Goenaga M, Idigoras P, Iribarren J, Yarza A, Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Alvarez N, Bravo-Ferrer J, Castelo L, Cuenca J, Llinares P, Rey E, Mayo M, Sanchez E, Regueiro D, Martinez F, Alonso M, Castro B, Rosado D, Duran M, Gomez M, Lacalzada J, Nassar I, Ciezar A, Iglesias J, Alvarez V, Costas C, de la Hera J, Suarez J, Fraile L, Arguero V, Menendez J, Bajo P, Morales C, Torrico A, Palomo C, Martinez B, Esteban A, Garcia R, Asensio M, Almela M, Ambrosioni J, Azqueta M, Brunet M, Bodro M, Cartana R, Falces C, Fita G, Fuster D, de la Maria C, Hernandez-Meneses M, Perez J, Marco F, Miro J, Moreno A, Nicolas D, Ninot S, Quintana E, Pare C, Pereda D, Pericas J, Pomar J, Ramirez J, Rovira I, Sandoval E, Sitges M, Soy D, Tellez A, Tolosana J, Vidal B, Vila J, Adan I, Bermejo J, Celemin D, Caballero G, Pinto A, Montero A, Cruz A, Mansilla A, Leoni M, Ramallo V, Hernandez M, Hualde A, Marin M, Martinez-Selles M, Menarguez M, Munoz P, Rincon C, Rodriguez-Creixems M, Pinilla B, Vazquez P, Moreno E, Antorrena I, Loeches B, Quiros A, Moreno M, Ramirez U, Baston V, Romero M, Saldana A, Balbin J, Castillo C, Arnaiz A, Revillas F, Belaustegui M, Farinas M, Farinas-Alvarez C, Izquierdo R, Garcia I, Rico C, Gutierrez-Cuadra M, Diez J, Pajaron M, Parra J, Teira R, Zarauza J, Dominguez F, Pavia P, Gonzalez J, Orden B, Ramos A, Centella T, Hermida J, Moya J, Martin-Davila P, Navas E, Oliva E, del Rio A, Ruiz S, Tenorio C, Delia M, Araji O, Barquero J, Jambrina R, de Cueto M, Acebal J, Mendez I, Morales I, Lopez-Cortes L, de Alarcon A, Garcia E, Haro J, Lepe J, Lopez F, Luque R, Alonso L, Azcarate P, Gutierrez J, Blanco J, Villegas A, Garcia-Alvarez L, Oteo J, Sanz M, de Benito N, Gurgui M, Pacho C, Pericas R, Pons G, Alvarez M, Fernandez A, Martinez A, Prieto A, Regueiro B, Tijeira E, Vega M, Blasco A, Mollar J, Arana J, Uriarte O, Lopez A, de Zarate Z, Matos J, Dominguez G, Sanchez-Porto A, Leal J, Vazquez E, Torres A, Blazquez A, Valenzuela G, Alonso A, Aramburu J, Calvo F, Rodriguez A, Tarabini-Castellani P, Galvez E, Bellido C, Pau J, Sepulveda M, Sierra P, Iqbal-Mirza S, Alcolea E, Yanez I, Ballesta A, Escobar E, Monje A, Cabrera V, Garcia D, Asenjo M, Luna C, Morcillo J, Seco M, Gelabert A, Guallar C, Abad N, Mangas P, Adell M, Ruiz M, Porres J, Trigueros N, Espin M, Caro J, Sanchez R, Almazan A, Freire A, Gonzalez M, Ramis P, Bordes E, Bonet L, Munera M, Garaizabal E, Luque J, and GAMEs Study Grp

Subjects
Infectious endocarditis, Mitral valve reparation, Cardiac surgery, Mitral valve replacement
Abstract

IntroductionInfective endocarditis (IE) still carries high morbidity and mortality and frequently requires surgery. The benefit of mitral valve repair (MVr) in the setting of IE is yet to be proven. The goal of this study was to assess the results of MVr in patients with IE after a minimum follow-up of 1year.MethodsThis study is based on a Spanish nationwide prospective registry that included patients operated on for native mitral valve IE. The collaborating Institutions pooled their pre-, peri-, and postoperative data into the database of the GAMES group [Grupo de Apoyo al Manejo de la EndocarditiS (Group for support and management of infective endocarditis)].ResultsData from 27 hospitals were recorded and 3524 cases of active IE identified between 2008 and 2016. There were 1513 cases of mitral IE, of which 898 involved native valves. Of these, 437 patients underwent surgical treatment, and 369 completed the 1-year follow-up. The valve was repaired in 68 cases (18.4%). Preoperative groups were comparable (EuroSCORE MVr 7.7 vs MVR 8.0; p=ns). Mortality in the repair group was inferior to that in the replacement group (16.2% vs 27.2%, p=0.058). At 1year, mortality remained higher in the replacement group: 3.7% vs 2.9%. Relapse of the infection was slightly more frequent in the repair group (7.1% vs 3.7%; p=ns), although this did not lead to higher rates of reintervention (MVr/MVR: 2.9% vs 4.9%).ConclusionMVr is an attractive option for specific patients with IE and does not seem to negatively impact on relapses.

Published
2019

11. Outpatient Parenteral Antibiotic Treatment for Infective Endocarditis: A Prospective Cohort Study From the GAMES Cohort

Author

Llopis J, Gonzalez-Ramallo V, Goenaga M, Garcia-Leoni M, Farinas M, Oteo J, Carrizo E, Reguera-Iglesias J, Hidalgo-Tenorio C, Sanchez F, Noureddine M, Rosas G, Lima J, Blanco R, Boado M, Lazaro M, Crespo A, Goikoetxea J, Iruretagoyena J, Zuazabal J, Lopez-Soria L, Montejo M, Nieto J, Rodrigo D, Rodriguez R, Vitoria Y, Voces R, Lopez M, Georgieva R, Ojeda G, Bailon I, Morales J, Cuende A, Echeverria T, Fuerte A, Gaminde E, Idigoras P, Iribarren J, Yarza A, Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Alvarez N, Bravo-Ferrer J, Castelo L, Cuenca J, Llinares P, Rey E, Mayo M, Sanchez E, Regueiro D, Martinez F, Alonso M, Castro B, Rosado D, Duran M, Gomez M, Lacalzada J, Nassar I, Ciezar A, Iglesias J, Alvarez V, Costas C, de la Hera J, Suarez J, Fraile L, Arguero V, Menendez J, Bajo P, Morales C, Torrico A, Palomo C, Martinez B, Esteban A, Garcia R, Asensio M, Almela M, Ambrosioni J, Azqueta M, Brunet M, Bodro M, Cartana R, Falces C, Fita G, Fuster D, de la Maria C, Garcia-Valls L, Hernandez-Meneses M, Perez J, Marco F, Miro J, Moreno A, Nicolas D, Ninot S, Quintana E, Pare C, Pereda D, Pericas J, Pomar J, Ramirez J, Rovira I, Sandoval E, Sala M, Sitges M, Soy D, Tellez A, Tolosana J, Vidal B, Vila J, Adan I, Bermejo J, Bouza E, Celemin D, Caballero G, Montero A, Cruz A, Mansilla A, Leoni M, Ramallo V, Hernandez M, Hualde A, Marin M, Martinez-Selles M, Menarguez M, Munoz P, Rincon C, Rodriguez-Abella H, Rodriguez-Creixems M, Pinilla B, Pinto A, Valerio M, Vazquez P, Moreno E, Antorrena I, Loeches B, Quiros A, Moreno M, Ramirez U, Baston V, Romero M, Saldana A, Balbin J, Castillo C, Arnaiz A, Revillas F, Belaustegui M, Farinas-Alvarez C, Izquierdo R, Garcia I, Rico C, Gutierrez-Cuadra M, Diez J, Pajaron M, Parra J, Teira R, Zarauza J, Dominguez F, Pavia P, Gonzalez J, Orden B, Ramos A, Centella T, Hermida J, Moya J, Martin-Davila P, Navas E, Oliva E, del Rio A, Stuart J, Rodriguez S, Tenorio C, Delia M, Araji O, Barquero J, Jambrina R, de Cueto M, Acebal J, Mendez I, Morales I, Lopez-Cortes L, de Alarcon A, Garcia E, Haro J, Lepe J, Lopez F, Luque R, Alonso L, Azcarate P, Gutierrez J, Blanco J, Garcia-Alvarez L, Sanz M, de Benito N, Gurgui M, Pacho C, Pericas R, Pons G, Alvarez M, Fernandez A, Martinez A, Prieto A, Regueiro B, Tijeira E, Vega M, Blasco A, Mollar J, Arana J, Uriarte O, Lopez A, de Zarate Z, Matos J, Dominguez G, Sanchez-Porto A, Leal J, Vazquez E, Torres A, Blazquez A, Valenzuela G, Alonso A, Aramburu J, Calvo F, Rodriguez A, Tarabini-Castellani P, Galvez E, Bellido C, Pau J, Sepulveda M, Sierra P, Iqbal-Mirza S, Alcolea E, Serrano P, Roca J, Yanez I, Ballesta A, Soriano V, Escobar E, Monje A, Cabrera V, Garcia D, Asenjo M, Luna C, Morcillo J, Seco M, Gelabert A, Guallar C, Abad N, Mangas P, Adell M, Ruiz M, Porres J, Trigueros N, Espin M, Caro J, Sanchez R, Almazan A, Freire A, Gonzalez M, Ramis P, Blanco M, Bordes E, Bonet L, Munera M, Garaizabal E, Luque J, and Spanish Collaboration Endocarditis

Subjects
infective endocarditis, readmission, outpatient parenteral antibiotic treatment, outcomes, hospitalization
Abstract

Background. Outpatient parenteral antibiotic treatment (OPAT) has proven efficacious for treating infective endocarditis (IE). However, the 2001 Infectious Diseases Society of America (IDSA) criteria for OPAT in IE are very restrictive. We aimed to compare the outcomes of OPAT with those of hospital-based antibiotic treatment (HBAT). Methods. Retrospective analysis of data from a multicenter, prospective cohort study of 2000 consecutive IE patients in 25 Spanish hospitals (2008-2012) was performed. Results. A total of 429 patients (21.5%) received OPAT, and only 21.7% fulfilled IDSA criteria. Males accounted for 70.5%, median age was 68 years (interquartile range [IQR], 56-76), and 57% had native-valve IE. The most frequent causal microorganisms were viridans group streptococci (18.6%), Staphylococcus aureus (15.6%), and coagulase-negative staphylococci (14.5%). Median length of antibiotic treatment was 42 days (IQR, 32-54), and 44% of patients underwent cardiac surgery. One-year mortality was 8% (42% for HBAT; P < .001), 1.4% of patients relapsed, and 10.9% were readmitted during the first 3 months after discharge (no significant differences compared with HBAT). Charlson score (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04-1.42; P = .01) and cardiac surgery (OR, 0.24; 95% CI, .09-.63; P = .04) were associated with 1-year mortality, whereas aortic valve involvement (OR, 0.47; 95% CI, .22-.98; P = .007) was the only predictor of 1-year readmission. Failing to fulfill IDSA criteria was not a risk factor for mortality or readmission. Conclusions. OPAT provided excellent results despite the use of broader criteria than those recommended by IDSA. OPAT criteria should therefore be expanded.

Published
2019

12. Effect of the type of surgical indication on mortality in patients with infective endocarditis who are rejected for surgical intervention

Author

Ramos-Martinez A, Calderon-Parra J, Miro J, Farinas M, Goenaga M, Marcos F, Vinuesa D, Sanchez F, Noureddine M, Rosas G, Lima J, Aramendi J, Blanco M, Blanco R, Boado M, Lazaro M, Crespo A, Goikoetxea J, Iruretagoyena J, Zuazabal J, Lopez-Soria L, Montejo M, Nieto J, Rodrigo D, Rodriguez D, Rodriguez R, Vitoria Y, Voces R, Lopez M, Georgieva R, Ojeda G, Bailon I, Morales J, Cuende A, Echeverria T, Fuerte A, Gaminde E, Idigoras P, Iribarren J, Yarza A, Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Alvarez N, Bravo-Ferrer J, Castelo L, Cuenca J, Llinares P, Rey E, Mayo M, Sanchez E, Regueiro D, Martinez F, Alonso M, Castro B, Rosado D, Duran M, Gomez M, Lacalzada J, Nassar I, Ciezar A, Iglesias J, Alvarez V, Costas C, de la Hera J, Suarez J, Fraile L, Arguero V, Menendez J, Bajo P, Morales C, Torrico A, Palomo C, Martinez B, Esteban A, Garcia R, Asensio M, Almela M, Ambrosioni J, Azqueta M, Brunet M, Bodro M, Cartana R, Falces C, Fita G, Fuster D, de la Maria C, Hernandez-Meneses M, Perez J, Marco F, Moreno A, Nicolas D, Ninot S, Quintana E, Pare C, Pereda D, Pericas J, Pomar J, Ramirez J, Rovira I, Sandoval E, Sitges M, Soy D, Tellez A, Tolosana J, Vidal B, Vila J, Adan I, Bermejo J, Bouza E, Celemin D, Caballero G, Montero A, Cruz A, Mansilla A, Leoni M, Ramallo V, Hernandez M, Hualde A, Marin M, Martinez-Selles M, Menarguez M, Munoz P, Rincon C, Rodriguez-Abella H, Rodriguez-Creixems M, Pinilla B, Pinto A, Valerio M, Vazquez P, Moreno E, Antorrena I, Loeches B, Quiros A, Moreno M, Ramirez U, Baston V, Romero M, Saldana A, Balbin J, Castillo C, Arnaiz A, de las Revillas F, Belaustegui M, Farinas-Alvarez C, Izquierdo R, Garcia I, Rico C, Gutierrez-Cuadra M, Diez J, Pajaron M, Parra J, Teira R, Zarauza J, Dominguez F, Pavia P, Gonzalez J, Orden B, Ramos A, Centella T, Hermida J, Moya J, Martin-Davila P, Navas E, Oliva E, del Rio A, Ruiz S, Tenorio C, Delia M, Araji O, Barquero J, Jambrina R, de Cueto M, Acebal J, Mendez I, Morales I, Lopez-Cortes L, de Alarcon A, Garcia E, Haro J, Lepe J, Lopez F, Luque R, Alonso L, Azcarate P, Gutierrez J, Blanco J, Villegas A, Garcia-Alvarez L, Oteo J, Sanz M, de Benito N, Gurgui M, Pacho C, Pericas R, Pons G, Alvarez M, Fernandez A, Martinez A, Prieto A, Regueiro B, Tijeira E, Vega M, Blasco A, Mollar J, Arana J, Uriarte O, Lopez A, de Zarate Z, Matos J, Gloria G, Antonio S, Leal J, Vazquez E, Torres A, Blazquez A, Valenzuela G, Alonso A, Aramburu J, Calvo F, Rodriguez A, Tarabini-Castellani P, Galvez E, Bellido C, Pau J, Sepulveda M, Sierra P, Iqbal-Mirza S, Alcolea E, Yanez I, Ballesta A, Escobar E, Monje A, Cabrera V, Garcia D, Asenjo M, Luna C, Morcillo J, Seco M, Villoslada A, Guallar A, Abad N, Mangas P, Adell M, Ruiz M, Porres J, Trigueros N, Espin M, Caro J, Sanchez R, Almazan A, Freire A, Gonzalez M, Ramis P, Bordes E, Bonet L, Munera M, Garaizabal E, Luque J, and Spanish Collaboration Endocarditis

Subjects
Endocarditis, Embolism, Heart failure, Bacteremia, Mortality
Abstract

Aim: To evaluate the effect of the type of surgical indication on mortality in infective endocarditis (IE) patients who are rejected for surgery. Methods and results: From January 2008 to December 2016, 2714 patients with definite left-sided IE were attended in the participating hospitals. One thousand six hundred and fifty-three patients (60.9%) presented surgical indications. Five hundred and thirty-eight patients (32.5%) presented surgical indications but received medical treatment alone. The indications for surgery in these patients were uncontrolled infection (366 patients, 68%), heart failure (168 patients, 31.3%) and prevention of embolism (148 patients, 27.6%). One hundred and thirty patients (24.2%) presented more than one indication. The mortality during hospital admission was 60% (323 patients). The in-hospital mortality of patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 75.6%, 61.4% and 54.7%, respectively (p < 0.001). Surgical indications due to heart failure (OR: 3.24; CI 95%: 1.99-5.9) or uncontrolled infection (OR: 1.83; CI 95%: 1.04-3.18) were independently associated with a fatal outcome during hospital admission. Mortality during the first year was 75.4%. The mortality during the first year in patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 85.9%, 76.7% and 72.7%, respectively (p = 0.016). Surgical indication due to heart failure (OR: 3.03; CI 95%: 1.53-5.98) were independently associated with fatal outcome during the first year. Conclusions: The type of surgical indication is associated with mortality in IE patients who are rejected for surgical intervention. (c) 2019 Elsevier B.V. All rights reserved.

Published
2019

15. Failure analysis of the fractured wires in sternal perichronal loops

Author

Chao, Jesús, Voces, R., Peña, Carmen, Chao, Jesús, Voces, R., and Peña, Carmen

Abstract

We report failure analysis of sternal wires in two cases in which a perichronal fixation technique was used to close the sternotomy. Various characteristics of the retrieved wires were compared to those of unused wires of the same grade and same manufacturer and with surgical wire specifications. In both cases, wire fracture was un-branched and transgranular and proceeded by a high cycle fatigue process, apparently in the absence of corrosion. However, stress anlysis indicates that the effective stress produced during strong coughing is lower than the yield strength. Our findings suggest that in order to reduce the risk for sternal dehiscence, the diameter of the wire used should be increased. © 2011 Elsevier Ltd.

Published
2011

21. TP45 243. Movimiento septal paradójico: inevitable o defecto de protección

Author

Voces, R., Pérez, P., Rodrigo, D., Vitoria, Y., Rey, E., and Boado, V.

Abstract

ObjetivoEl movimiento septal paradójico (MSP) es habitual, aunque no constante, en los enfermos intervenidos de cirugía cardíaca. Clásicamente se ha considerado la consecuencia inevitable de múltiples factores como la pericardiotomía. Intentaremos averiguar la influencia de la protección miocárdica en dicho hallazgo en los pacientes con cardiopatía isquémica.Material y métodosAnalizamos los enfermos intervenidos durante 2 años de revascularización coronaria, excluyendo aquellos que presentaran: infarto pre o postoperatorio, fracción de eyección anormal, MSP antes de la intervención. Clasificamos los enfermos según el tipo de protección miocárdica: a) sin clampaje aórtico, con o sin circulación extra-corpórea (CEC), y b) con clampaje aórtico, empleando cardioplejía anterógrada (CA) y/o retrograda (CR). Recogimos el valor de la troponina y CPK-MB a las 24h de la cirugía, y los ecocardiogramas postoperatorios antes de los 3 meses y el primer año.ResultadosRecopilamos 69 enfermos: grupo A sin clampaje 34 (49,27%), de ellos 31 (44,92%) sin CEC; grupo B con clampaje 35 (50,72%), de los cuales 5 (7,24%) CA, 24 (34,78%) CA y CR, 3 (4,34%) CR. El MSP apareció en 11 casos (32,35%) en el grupo sin clampaje y en 25 (71,42%) del gru-po con clampaje (p

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22. P28 248. Doble mamaria en pacientes con alto riesgo de complicación esternal

Author

Voces, R., Aramendi, J.I., Castellanos, E., Goiti, J., Llorente, A., and Rodríguez, M.A.

Abstract

ObjetivoEl empleo de dos mamarias ha demostrado mayor permeabilidad a largo plazo, aunque con un mayor riesgo de complicaciones esternales. Estudiaremos si la asociación de factores de riesgo (FR) de dehiscencia preoperatorios, especialmente la tríada obeso-EPOC/fumador-diabetes (OB-DM-EP) es motivo suficiente para descartar una revascularización con doble mamaria.Material y métodosAnalizamos enfermos sometidos sólo a revascularización coronaria durante 6 años según el número de mamarias: mamaria simple (MS) – doble mamaria (MD). Recopilamos sus FR: mujer, anciano, obeso, diabetes, EPOC, fumador, insuficiencia renal, enfermedad vascular periférica (EVP), shock preoperatorio, fracción de eyección (FE) deprimida, reintervención, técnica de disección. Definimos grupos de alto riesgo: a) tres o más FR, y b) tríada OB-DM-EP. Recopilando las complicaciones esternales y mortalidad.ResultadosEstudiamos 688 pacientes: MS 520 (75,58%), MD 168 (24,41%). Presencia tres o más FR: MS 149 (28,65%), MD 8,92% (p

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23. Oxigenación con membrana extracorpórea en el paciente COVID-19: resultados del Registro Español ECMO-COVID de la Sociedad Española de Cirugía Cardiovascular y Endovascular

Author

Castaño, Mario, Sbraga, Fabrizio, Perez de la Sota, Enrique, Arribas, José M., Camara, María-luisa, Voces, Roberto, Vigil-Escalera, Carlota, Rodríguez Lecoq, Rafael, Institut Català de la Salut, [Castaño M] Servicio de Cirugía Cardiaca, Hospital Universitario de León, León, Spain. [Sbraga S] Servicio de Cirugía Cardiaca, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain. [Pérez de la Sota E] Servicio de Cirugía Cardiaca, Hospital Universitario 12 de Octubre, Madrid, Spain. [Arribas JM] Servicio de Cirugía Cardiovascular, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain. [Cámara ML] Servicio de Cirugía Cardiaca, Hospital Germans Trias i Pujol, Badalona, Spain. [Voces R] Servicio de Cirugía Cardiaca, Hospital de Cruces, Barakaldo, Spain. [Vigil-Escalera C, Rodríguez-Lecoq R] Servei de Cirurgia Cardíaca, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
enfermedades respiratorias::trastornos respiratorios::insuficiencia respiratoria [ENFERMEDADES], Insuficiència respiratòria - Tractament, Avaluació de resultats (Assistència sanitària), virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], diagnóstico::pronóstico::resultado del tratamiento [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], Other subheadings::/therapy [Other subheadings], Diagnosis::Prognosis::Treatment Outcome [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Otros calificadores::/terapia [Otros calificadores], COVID-19 (Malaltia) - Complicacions, Respiratory Tract Diseases::Respiration Disorders::Respiratory Insufficiency [DISEASES]
Abstract

Oxigenación con membrana extracorpórea; COVID-19; Insuficiencia cardiaca Extracorporeal membrane oxygenation; COVID-19; Heart failure Oxigenació amb membrana extracorpòria; COVID-19; Insuficiència cardíaca Introducción y objetivos La oxigenación con membrana extracorpórea (ECMO) ha resultado ser una opción terapéutica en los pacientes con insuficiencia respiratoria o cardiaca severa por COVID-19. Las indicaciones y manejo de estos pacientes están aún por determinar. Nuestro objetivo es evaluar los resultados de la terapia ECMO en pacientes con COVID-19 incluidos en un registro prospectivo e intentar optimizar los resultados. Métodos En marzo de 2020 se inició un registro multicéntrico anónimo prospectivo de pacientes con COVID-19 tratados mediante ECMO veno-arterial (V-A) o veno-venosa (V-V). Se registraron las variables clínicas, analíticas y respiratorias preimplante, datos de implante y evolución de la terapia. El evento primario fue la mortalidad hospitalaria de cualquier causa y los eventos secundarios fueron la recuperación funcional y el evento combinado de recuperación funcional y mortalidad de cualquier causa a partir de los 3 meses de seguimiento tras el alta. Resultados Se analizó a un total de 365 pacientes procedentes de 25 hospitales, 347 V-V y 18 V-A (edad media de 52,7 y 49,4 años, respectivamente). Los pacientes con ECMO V-V fueron más obesos, presentaban menos fracaso orgánico diferente al pulmonar y precisaron menos terapia inotrópica previa al implante. El 33,3% y el 34,9% de los pacientes con ECMO V-A y V-V, respectivamente, fueron dados de alta del hospital (p = NS) y la mortalidad fue similar, del 56,2% y 50,9% de los casos respectivamente, la inmensa mayoría durante la ECMO y sobre todo por fracaso multiorgánico. El 14,0% (51 pacientes) permanecían ingresados. El seguimiento medio fue de 196 ± 101,7 días. En el análisis multivariante, resultaron protectores de evento primario en pacientes con ECMO V-V el peso corporal (OR 0,967; IC 95%: 0,95-0,99; p = 0,004) y la procedencia del propio hospital (OR 0,48; IC 95%: 0,27-0,88; p = 0,018), mientras que la edad (OR 1,063; IC 95%: 1,005-1,12; p = 0,032), la hipertensión arterial (3,593; IC 95%: 1,06-12,19; p = 0,04) y las complicaciones en ECMO globales (2,44; IC 95%: 0,27-0,88; p = 0,019), digestivas (OR 4,23, IC 95%: 1,27-14,07; p = 0,019) y neurológicas (OR 4,66; IC 95%: 1,39-15,62; p = 0,013) fueron predictores independientes de mortalidad. El único predictor independiente de aparición de los eventos secundarios resultó el momento de seguimiento del paciente. Conclusiones La terapia con ECMO permite supervivencias hospitalarias hasta del 50% en pacientes con COVID-19 grave. La edad, la hipertensión arterial y las complicaciones en ECMO son los predictores de mortalidad hospitalaria en pacientes con ECMO V-V. Un mayor peso corporal y la procedencia del propio hospital son factores protectores. La recuperación funcional solo se ve influida por el tiempo de seguimiento transcurrido tras el alta. La estandarización de los criterios de implante y manejo del paciente con COVID grave mejoraría los resultados y la futura investigación clínica. Background and aim: COVID-19 patients with severe heart or respiratory failure are potential candidates for extracorporeal membrane oxygenation (ECMO). Indications and management of these patients are unclear. Our aim is to describe the results of a prospective registry of COVID-19 patients treated with ECMO. Methods: An anonymous prospective registry of COVID-19 patients treated with veno-arterial (V-A) or veno-venous (V-V) ECMO was created on march 2020. Clinical, analytical and respiratory preimplantation variables, implantation data and post-implantation course data were recorded. The primary endpoint was all cause in-hospital mortality. Secondary events were functional recovery and the combined endpoint of mortality and functional recovery in patients followed at least 3 months after discharge. Results: Three hundred and sixty-six patients from 25 hospitals were analyzed, 347 V-V ECMO and 18 V-A ECMO patients (mean age 52.7 and 49.5 years respectively). Patients with V-V ECMO were more obese, had less frequently organ damage other than respiratory failure and needed less inotropic support; Thirty three percent of V-A ECMO and 34.9% of V-A ECMO were discharged (P = NS). Hospital mortality was non-significantly different, 56.2% versus 50.9% respectively, mainly during ECMO therapy and mostly due to multiorgan failure. Other 51 patients (14%) remained admitted. Mean follow-up was 196 ± 101.7 days (95%CI: 170.8-221.6). After logistic regression, body weight (OR 0.967, 95%CI: 0.95-0.99, P = 0.004) and ECMO implantation in the own centre (OR 0.48, 95%CI: 0.27-0.88, P = 0.018) were protective for hospital mortality. Age (OR 1.063, 95%CI: 1.005-1.12, P = 0.032), arterial hypertension (3.593, 95%CI: 1.06-12.19, P = 0.04) and global (2.44, 95%CI: 0.27-0.88, P = 0.019), digestive (OR 4,23, 95%CI: 1.27-14.07, P = 0.019) and neurological (OR 4.66, 95%CI: 1.39-15.62, P = 0.013) complications during ECMO therapy were independent predictors of primary endpoint occurrence. Only the post-discharge day at follow-up was independent predictor of both secondary endpoints occurrence. Conclusions: Hospital survival of severely ill COVID-19 patients treated with ECMO is near 50%. Age, arterial hypertension and ECMO complications are predictors of hospital mortality, and body weight and implantation in the own centre are protective. Functional recovery is only predicted by the follow-up time after discharge. A more homogeneous management of these patients is warranted for clinical results and future research optimization.

Published
2022

24. Cardiogenic shock code 2023. Expert document for a multidisciplinary organization that allows quality care.

Author

Martínez-Sellés M, Hernández-Pérez FJ, Uribarri A, Martín Villén L, Zapata L, Alonso JJ, Amat-Santos IJ, Ariza-Solé A, Barrabés JA, Barrio JM, Canteli Á, Alonso-Fernández-Gatta M, Corbí Pascual MJ, Díaz D, Crespo-Leiro MG, de la Torre-Hernández JM, Ferrera C, García González MJ, García-Carreño J, García-Guereta L, García Quintana A, Jorge Pérez P, González-Juanatey JR, López de Sá E, Sánchez PL, Monteagudo M, Palomo López N, Reyes G, Rosell F, Solla Buceta MA, Segovia-Cubero J, Sionis Green A, Stepanenko A, Iglesias Álvarez D, Viana Tejedor A, Voces R, Fuset Cabanes MP, Gimeno Costa JR, Díaz J, and Fernández-Avilés F

Subjects
Humans, Child, Shock, Cardiogenic therapy, Intra-Aortic Balloon Pumping, Treatment Outcome, Heart-Assist Devices, Extracorporeal Membrane Oxygenation
Abstract

Despite the efforts made to improve the care of cardiogenic shock (CS) patients, including the development of mechanical circulatory support (MCS), the prognosis of these patients continues to be poor. In this context, CS code initiatives arise, based on providing adequate, rapid, and quality care to these patients. In this multidisciplinary document we try to justify the need to implement the SC code, defining its structure/organization, activation criteria, patient flow according to care level, and quality indicators. Our specific purposes are: a) to present the peculiarities of this condition and the lessons of infarction code and previous experiences in CS; b) to detail the structure of the teams, their logistics and the bases for the management of these patients, the choice of the type of MCS, and the moment of its implantation, and c) to address challenges to SC code implementation, including the uniqueness of the pediatric SC code. There is an urgent need to develop protocolized, multidisciplinary, and centralized care in hospitals with a large volume and experience that will minimize inequity in access to the MCS and improve the survival of these patients. Only institutional and structural support from the different administrations will allow optimizing care for CS., (Copyright © 2022 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Published
2023
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25. Implementation of an In-House 3D Manufacturing Unit in a Public Hospital's Radiology Department.

Author

García RI, Jauregui I, Del Amo C, Gandiaga A, Rodriguez O, Margallo L, Voces R, Martin N, Gallego I, Minguez R, and Eguiraun H

Abstract

Objective: Three-dimensional printing has become a leading manufacturing technique in healthcare in recent years. Doubts in published studies regarding the methodological rigor and cost-effectiveness and stricter regulations have stopped the transfer of this technology in many healthcare organizations. The aim of this study was the evaluation and implementation of a 3D printing technology service in a radiology department., Methods: This work describes a methodology to implement a 3D printing service in a radiology department of a Spanish public hospital, considering leadership, training, workflow, clinical integration, quality processes and usability., Results: The results correspond to a 6-year period, during which we performed up to 352 cases, requested by 85 different clinicians. The training, quality control and processes required for the scaled implementation of an in-house 3D printing service are also reported., Conclusions: Despite the maturity of the technology and its impact on the clinic, it is necessary to establish new workflows to correctly implement them into the strategy of the health organization, adjusting it to the needs of clinicians and to their specific resources., Significance: This work allows hospitals to bridge the gap between research and 3D printing, setting up its transfer to clinical practice and using implementation methodology for decision support.

Published
2022
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26. Risk factors for mortality in patients with COVID-19 needing extracorporeal respiratory support.

Author

Riera J, Alcántara S, Bonilla C, Fortuna P, Blandino Ortiz A, Vaz A, Albacete C, Millán P, Ricart P, Boado MV, Ruiz de Gopegui P, Santa Teresa P, Sandoval E, Pérez-Chomón H, González-Pérez A, Duerto J, Gimeno R, Colomina J, Gómez V, Renedo G, Naranjo J, García MA, Rodríguez-Ruiz E, Silva PE, Pérez D, Veganzones J, Voces R, Martínez S, Blanco-Schweizer P, García M, Villanueva-Fernández H, Fuset MP, Luna SM, Martínez-Martínez M, Argudo E, Chiscano L, and Roncon-Albuquerque R Jr

Subjects
Humans, Retrospective Studies, Risk Factors, SARS-CoV-2, COVID-19, Extracorporeal Membrane Oxygenation, Respiratory Distress Syndrome, Respiratory Insufficiency therapy
Abstract

Competing Interests: Conflict of interest: The authors declare that they have no conflict of interest.

Published
2022
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27. Role of age and comorbidities in mortality of patients with infective endocarditis.

Author

Armiñanzas C, Fariñas-Alvarez C, Zarauza J, Muñoz P, González Ramallo V, Martínez Sellés M, Miró Meda JM, Pericás JM, Goenaga MÁ, Ojeda Burgos G, Rodríguez Álvarez R, Castelo Corral L, Gálvez-Acebal J, Martínez Marcos FJ, Fariñas MC, Fernández Sánchez F, Noureddine M, Rosas G, de la Torre Lima J, Aramendi J, Bereciartua E, Blanco MJ, Blanco R, Boado MV, Campaña Lázaro M, Crespo A, Goikoetxea J, Iruretagoyena JR, Irurzun Zuazabal J, López-Soria L, Montejo M, Nieto J, Rodrigo D, Rodríguez D, Rodríguez R, Vitoria Y, Voces R, García López MV, Georgieva RI, Ojeda G, Rodríguez Bailón I, Ruiz Morales J, Cuende AM, Echeverría T, Fuerte A, Gaminde E, Goenaga MÁ, Idígoras P, Iribarren JA, Izaguirre Yarza A, Kortajarena Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Álvarez N, Bravo-Ferrer JM, Castelo L, Cuenca J, Llinares P, Miguez Rey E, Rodríguez Mayo M, Sánchez E, Sousa Regueiro D, Martínez FJ, Alonso MDM, Castro B, García Rosado D, Durán MDC, Miguel Gómez MA, Lacalzada J, Nassar I, Plata Ciezar A, Reguera Iglesias JM, Asensi Álvarez V, Costas C, de la Hera J, Fernández Suárez J, Iglesias Fraile L, León Arguero V, López Menéndez J, Mencia Bajo P, Morales C, Moreno Torrico A, Palomo C, Paya Martínez B, Rodríguez Esteban Á, Rodríguez García R, Telenti Asensio M, Almela M, Ambrosioni J, Azqueta M, Brunet M, Bodro M, Cartañá R, Falces C, Fita G, Fuster D, García de la Mària C, Hernández-Meneses M, Llopis Pérez J, Marco F, Miró JM, Moreno A, Nicolás D, Ninot S, Quintana E, Paré C, Pereda D, Pericás JM, Pomar JL, Ramírez J, Rovira I, Sandoval E, Sitges M, Soy D, Téllez A, Tolosana JM, Vidal B, Vila J, Adán I, Bermejo J, Bouza E, Celemín D, Cuerpo Caballero G, Delgado Montero A, Fernández Cruz A, García Mansilla A, García Leoni ME, González Ramallo V, Kestler Hernández M, Hualde AM, Marín M, Martínez-Sellés M, Menárguez MC, Muñoz P, Rincón C, Rodríguez-Abella H, Rodríguez-Créixems M, Pinilla B, Pinto Á, Valerio M, Vázquez P, Verde Moreno E, Antorrena I, Loeches B, Martín Quirós A, Moreno M, Ramírez U, Rial Bastón V, Romero M, Saldaña A, Agüero Balbín J, Amado C, Armiñanzas Castillo C, Arnaiz García A, Cobo Belaustegui M, Fariñas MC, Fariñas-Álvarez C, Gómez Izquierdo R, García I, González-Rico C, Gutiérrez-Cuadra M, Gutiérrez Díez J, Pajarón M, Parra JA, Sarralde A, Teira R, Zarauza J, Domínguez F, García Pavía P, González J, Orden B, Ramos A, Centella T, Hermida JM, Moya JL, Martín-Dávila P, Navas E, Oliva E, Del Río A, Ruiz S, Hidalgo Tenorio C, Almendro Delia M, Araji O, Barquero JM, Calvo Jambrina R, de Cueto M, Gálvez Acebal J, Méndez I, Morales I, López-Cortés LE, de Alarcón A, García E, Haro JL, Lepe JA, López F, Luque R, Alonso LJ, Azcárate P, Azcona Gutiérrez JM, Blanco JR, García-Álvarez L, Oteo JA, Sanz M, de Benito N, Gurguí M, Pacho C, Pericas R, Pons G, Álvarez M, Fernández AL, Martínez A, Prieto A, Regueiro B, Tijeira E, Vega M, Canut Blasco A, Cordo Mollar J, Gainzarain Arana JC, García Uriarte O, Martín López A, Ortiz de Zárate Z, Urturi Matos JA, García Domínguez G, Sánchez-Porto A, Arribas Leal JM, García Vázquez E, Hernández Torres A, Blázquez A, de la Morena Valenzuela G, Alonso Á, Aramburu J, Calvo FE, Moreno Rodríguez A, Tarabini-Castellani P, Heredero Gálvez E, Maicas Bellido C, Largo Pau J, Sepúlveda MA, Toledano Sierra P, Iqbal-Mirza SZ, Cascales Alcolea E, Egea Serrano P, Hernández Roca JJ, Keituqwa Yañez I, Peláez Ballesta A, Soriano V, Moreno Escobar E, Peña Monje A, Sánchez Cabrera V, Vinuesa García D, Arrizabalaga Asenjo M, Cifuentes Luna C, Núñez Morcillo J, Pérez Seco MC, Villoslada Gelabert A, Aured Guallar C, Fernández Abad N, García Mangas P, Matamala Adell M, Palacián Ruiz MP, Porres JC, Alcaraz Vidal B, Cobos Trigueros N, Del Amor Espín MJ, Giner Caro JA, Jiménez Sánchez R, Jimeno Almazán A, Ortín Freire A, Viqueira González M, Pericás Ramis P, Ribas Blanco MÁ, Ruiz de Gopegui Bordes E, Vidal Bonet L, Bellón Munera MC, Escribano Garaizabal E, Tercero Martínez A, and Segura Luque JC

Subjects
Adult, Aged, Aged, 80 and over, Area Under Curve, Databases, Factual, Endocarditis etiology, Female, Heart Failure mortality, Hospital Mortality, Humans, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, ROC Curve, Risk Factors, Spain epidemiology, Staphylococcal Infections mortality, Age Factors, Comorbidity, Endocarditis mortality
Abstract

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality., Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk., Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32-3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39-1.88),and non-performed surgery (HR:1.64;95% CI:11.16-1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality., Conclusion: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group., (Copyright © 2019. Published by Elsevier B.V.)

Published
2019
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28. Elective implantation of covered stents for coarctation and recoarctation in adolescents and adults.

Author

Alcibar J, Blanco R, Fernandez L, Arriola J, Garcia K, Peña N, Inguanzo R, Voces R, Castellanos E, and Montes PM

Subjects
Adolescent, Adult, Aged, Aortic Coarctation diagnostic imaging, Female, Femoral Artery, Humans, Male, Middle Aged, Recurrence, Treatment Outcome, Ultrasonography, Young Adult, Aortic Coarctation surgery, Prosthesis Implantation methods, Stents
Abstract

Introduction and Objectives: Stent implantation is an effective therapy for aortic coarctation and recoarctation. However, in adolescents and adults, aortic wall rupture and dissection can occur, as well as aneurysms during follow-up. In order to reduce these complications, we electively implant covered stents., Methods: Since 2005, we have performed the procedure using femoral access in 17 patients (2 adolescents and 15 adults), 16 electively and 1 as a rescue procedure. We used the Mullins technique in all cases, implanting a NuMED(®) covered stent., Results: Good stent apposition was achieved in all 17 procedures; 8 patients required a distal flare. Gradient was reduced from 40 (16) mmHg to 2 (2) mmHg (P<.001) and lumen diameter increased from 4 (2) mm to 19 (3) mm (P<.001). Two exceptional cases are discussed: one patient with aortic wall rupture who underwent a rescue procedure using a stent within a covered stent and another patient with total obstruction and intercostal aneurysm in whom the outcome was fatal at 48 h postprocedure (autopsy is shown). Four-year clinical follow-up included Doppler echocardiography; an additional imaging technique was required in 13 patients. All patients recovered well and there were no complications., Conclusions: Covered stents are effective in treating coarctation and recoarctation in adolescents and adults, are the treatment of choice in patients with complex anatomy, and must be available in the operating room as a rescue device when implanting a conventional stent., (Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.)

Published
2013
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29. Failure analysis of the fractured wires in sternal perichronal loops.

Author

Chao J, Voces R, and Peña C

Subjects
Aged, Humans, Male, Stress, Mechanical, Surface Properties, Equipment Failure Analysis, Mechanical Phenomena, Sternotomy instrumentation, Suture Techniques instrumentation
Abstract

We report failure analysis of sternal wires in two cases in which a perichronal fixation technique was used to close the sternotomy. Various characteristics of the retrieved wires were compared to those of unused wires of the same grade and same manufacturer and with surgical wire specifications. In both cases, wire fracture was un-branched and transgranular and proceeded by a high cycle fatigue process, apparently in the absence of corrosion. However, stress anlysis indicates that the effective stress produced during strong coughing is lower than the yield strength. Our findings suggest that in order to reduce the risk for sternal dehiscence, the diameter of the wire used should be increased., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Published
2011
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30. Partial anomalous pulmonary venous connection to the superior vena cava.

Author

Aramendi JI, Rey E, Hamzeh G, Crespo A, Luis M, and Voces R

Subjects
Child, Humans, Vascular Surgical Procedures methods, Abnormalities, Multiple surgery, Pulmonary Veins abnormalities, Pulmonary Veins surgery, Vena Cava, Superior abnormalities, Vena Cava, Superior surgery
Abstract

We describe the surgical technique of reimplantation of the right superior pulmonary vein into the left atrium in 2 patients with partial anomalous pulmonary venous connection to the superior vena cava without atrial septal defect. A right axillary minithoracotomy is done through the fourth intercostal space. The pulmonary vein is detached from its origin in the superior vena cava. This is sutured with 6-0 reabsorbable polydioxanone suture (Ethicon, Somerville, NJ). A lateral clamp is applied to the left atrium, and the pulmonary vein is reimplanted. The patient is extubated in the operating room. Neither cardiopulmonary bypass nor blood transfusion was required. It is simple, safe, and reproducible., (Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Published
2011
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31. Off-pump supra-arterial myotomy for myocardial bridging.

Author

Crespo A, Aramendi JI, Hamzeh G, and Voces R

Subjects
Angina Pectoris etiology, Cardiopulmonary Bypass, Coronary Angiography, Coronary Artery Bypass, Off-Pump, Female, Humans, Male, Middle Aged, Myocardial Bridging complications, Myocardial Bridging diagnostic imaging, Treatment Outcome, Myocardial Bridging surgery
Abstract

We report the results of surgery and midterm outcome in two patients with symptomatic myocardial bridging who underwent off-pump supra-arterial myotomy. Both patients were operated upon through a median sternotomy. The anterior wall of the heart was exposed in the same manner as in off-pump CABG. The left anterior descending coronary artery is unroofed from its myocardial bridge with the aid of a heart stabilizer and a blower. Neither heparin nor blood transfusion was required. Both patients survived the operation and are asymptomatic. Postoperative coronary angiogram showed good resolution of the muscle bridge in one patient. We conclude that in symptomatic patients with myocardial bridging despite medical therapy, surgical myotomy can be considered an adequate therapy. It can be safely done off-pump.

Published
2008
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32. Anomalous origin of right coronary artery from left coronary sinus.

Author

Hamzeh G, Crespo A, Estarán R, Rodríguez MA, Voces R, and Aramendi JI

Subjects
Adult, Coronary Angiography, Coronary Sinus diagnostic imaging, Coronary Vessel Anomalies surgery, Follow-Up Studies, Humans, Middle Aged, Prognosis, Retrospective Studies, Severity of Illness Index, Tomography, X-Ray Computed, Vascular Surgical Procedures methods, Coronary Sinus abnormalities, Coronary Vessel Anomalies diagnostic imaging
Abstract

Anomalous aortic origin of the coronary arteries is uncommon but clinically significant. Manifestations vary from asymptomatic patients to those who present with angina pectoris, myocardial infarction, heart failure, syncope, arrhythmias, and sudden death. We describe 4 patients, aged 34 to 59 years, who were diagnosed with right coronary artery arising from the left sinus of Valsalva, confirmed by coronary angiography, which was surgically repaired. Three patients presented dyspnea and angina, and one with acute myocardial infarction. At operation, the right coronary artery was dissected at the take-off from the intramural course, and reimplanted into the right sinus of Valsalva. There was no mortality. One patient had associated coronary artery disease that required stent placement postoperatively. This reimplantation technique provides a good physiological and anatomical repair, eliminates a slit-like ostium, avoids compression of the coronary artery between the aorta and the pulmonary artery, and gives superior results to coronary artery bypass grafting or the unroofing technique.

Published
2008
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33. Right cervical aortic arch with aberrant left subclavian artery.

Author

Tjang YS, Aramendi JI, Crespo A, Hamzeh G, Voces R, and Rodríguez MA

Subjects
Aorta, Thoracic surgery, Aortic Diseases diagnosis, Aortic Diseases surgery, Diagnosis, Differential, Female, Humans, Infant, Newborn, Magnetic Resonance Imaging, Middle Aged, Subclavian Artery surgery, Tomography, X-Ray Computed, Vascular Surgical Procedures methods, Aorta, Thoracic abnormalities, Aortic Diseases congenital, Subclavian Artery abnormalities
Abstract

The combination of right cervical aortic arch, aberrant retroesophageal left subclavian artery originating from a Kommerell's diverticulum, and a ligamentum arteriosum, constitutes a rare form of vascular ring. Two patients aged 21 days and 54 years, who were diagnosed by multislice 3-dimensional computed tomography and magnetic resonance imaging, underwent surgical division of a vascular ring. The adult required resection of a Kommerell's aneurysm and subclavian artery reimplantation.

Published
2008
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34. Isolated pseudohypoplasia of the right ventricle.

Author

Pastor E, Aramendi JI, Luis M, Voces R, Rodríguez MA, and Galdeano JM

Subjects
Adult, Cardiac Catheterization, Child, Cyanosis etiology, Diastole, Humans, Radiography, Systole, Treatment Outcome, Ventricular Dysfunction, Right diagnostic imaging, Anemia, Aplastic etiology, Heart Septal Defects, Atrial surgery, Ventricular Dysfunction, Right physiopathology
Abstract

We present a case of a 12-year-old girl with severe cyanosis due to abnormal moderator band producing a hidden trabecular component of the right ventricle, mimicking isolated hypoplasia of the right ventricle. A marked hypoplasia was confirmed by echocardiography and catheterization. At operation an anomalously thickened moderator band obstructing the apical infundibulum was found. Repair consisted of a section of the moderator band and closure of the atrial septal defect. Postoperatively the right ventricle showed normal dimension and function.

Published
2007
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35. Partial hammock valve: surgical repair in adulthood.

Author

Aramendi JI, Rodríguez MA, Voces R, Pérez P, and Rodrigo D

Subjects
Age of Onset, Aged, Animals, Cattle, Chordae Tendineae abnormalities, Congenital Abnormalities diagnosis, Female, Fibrosis, Humans, Hypertension, Pulmonary etiology, Male, Middle Aged, Mitral Valve pathology, Mitral Valve surgery, Mitral Valve Insufficiency diagnosis, Mitral Valve Insufficiency epidemiology, Papillary Muscles abnormalities, Papillary Muscles surgery, Pericardium transplantation, Transplantation, Heterologous, Mitral Valve abnormalities, Mitral Valve Insufficiency etiology
Abstract

We describe a forme frustrée of hammock valve involving only the posterior mitral leaflet. Three adult patients were referred to surgery with the diagnosis of severe mitral regurgitation due to fibrosis of the posterior mitral leaflet. The final diagnosis was done intraoperatively. In all of them the posterior leaflet was attached to some accessory papillary muscles arranged en palisade, with three to four fused muscle heads producing restrictive leaflet motion in systole. Repair consisted in division of the papillary muscles, patch augmentation, and ring annuloplasty. This previously unreported lesion is congenital but manifests itself in adulthood.

Published
2006
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36. No patch technique for complete atrioventricular canal repair.

Author

Aramendi JI, Rodriguez MA, Luis T, and Voces R

Abstract

We describe our initial experience with a new technique, consisting in direct closure of the ventricular septal defect component of the AV canal, by directly attaching the common bridging leaflets to the crest of the ventricular septum with interrupted sutures. After closure of the cleft, the ostium primum defect was closed with a running suture suturing the border of the septum primum to the newly created AV valve annulus. Three patients were operated upon. There was no mortality. Mean ischemic time was 39 min and mean pump time 77 min. All patients remained in sinus rhythm. At follow-up only trivial or mild mitral regurgitation was observed. This new technique permits the repair of complete AV canal without the need for any patch. It is fast, simple and reproducible.

Published
2006
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37. Reversible tricuspid valve stenosis due to a metastatic dissemination of a noncardiac sarcoma.

Author

Uribe-Etxebarria N, Voces R, Rodriguez MA, Llorente A, Perez P, and Aramendi JI

Subjects
Heart Neoplasms complications, Heart Neoplasms surgery, Humans, Male, Middle Aged, Pericardial Effusion etiology, Pericardial Window Techniques, Pericardium pathology, Sarcoma complications, Sarcoma surgery, Tricuspid Valve Stenosis surgery, Heart Neoplasms secondary, Muscle Neoplasms pathology, Pericardial Effusion surgery, Sarcoma secondary, Tricuspid Valve Stenosis etiology
Abstract

Malignant disease is present in the pericardium of 1.5% to 20.6% of patients dying of malignant diseases as was examined postmortem. We present a case of a 57-year-old man with a history of Hodgkin's disease and a sarcoma of gluteus who presented with tachypnea, generalized weakness, and anasarca for 7 days. The echocardiogram revealed the presence of a significant pericardial thickening and localized pericardial effusion resulting from a tricuspid stenosis. A right anterior thoracotomy was performed, and a pericardiectomy (4 x 4 cm) was done. The histologic examination of the pericardium revealed the presence of a metastatic dissemination from a sarcoma. The cause for the clinical presentation and the treatment of malignant pericardial disease are discussed.

Published
2005
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38. [Clinical results of double versus single mammary artery myocardiac revascularization: 15 years of follow-up].

Author

López Rodríguez FJ, Voces R, Lima P, Reyes G, Silva J, Ruiz M, Rico M, González De Diego F, Fortuny R, Garrido G, González Santos JM, Albertos J, Fernández Calella D, and Vallejo JL

Subjects
Female, Follow-Up Studies, Humans, Internal Mammary-Coronary Artery Anastomosis mortality, Male, Middle Aged, Recurrence, Retrospective Studies, Time Factors, Internal Mammary-Coronary Artery Anastomosis methods
Abstract

Introduction: Use of the left internal mammary artery to bypass the left anterior descending coronary artery reduces cardiac events and increases survival. However, there is some controversy as to the benefits of using both mammary arteries., Objectives: To assess the long-term outcome of the use of both mammary arteries in comparison with the use of only one., Patients and Method: A retrospective cohort study with a mean follow-up of 9.0 +/- 4.2 years was performed including 108 patients consecutively revascularized using both mammary arteries (II) and 108 patients randomly chosen in whom one mammary artery (I) was used for this purpose., Results: Both groups were similar. There were no differences between the groups in operative morbidity or mortality. The survival at 10 years was similar (II: 84.61 +/- 4%; I: 85.18 +/- 3.8%), whereas recurrence of angina (II: 29.63 +/- 5.3%; I: 47.55 +/- 5.6%) (p = 0.012), the requirement for percutaneous angioplasty (II: 3.98 +/- 2%; I: 12.99 +/- 4.1%) (p = 0.009) and cardiologic events (II: 33.48 +/- 5.5%; I: 48.48 +/- 5.5%)(p = 0.022) were all lower in the group in which both mammary arteries were used. In the multivariate analysis, the use of both mammary arteries was an independent protective factor against angina recurrence (RR = 0.55), angioplasty (RR = 0.18) and cardiologic event (RR = 0.60)., Conclusions: The use of both mammary arteries for revascularization does not increase operative morbidity. Since this procedure acts as an independent factor against angina recurrence, angioplasty and cardiologic event

Published
2001
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