Publications (10)19.94 Total impact
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Article: Left atrial intramural haematoma associated with mitral annular calcification.
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ABSTRACT: Left atrial wall haematoma is a very uncommon entity, associated mainly to cardiac surgery, interventional procedures, or trauma. Spontaneous cases are supposed to be associated with left atrial wall pathology. We present a case of a 53-year-old male who was admitted for prolonged chest pain, with transthoracic and transesophagic echocardiography documentation of a left atrial mass in close proximity to a mitral annular calcification. Tissue characterization with cardiac magnetic resonance suggested the aetiology of the mass, which was confirmed histologically.European Heart Journal – Cardiovascular Imaging 12/2009; 11(5):E18. · 2.32 Impact Factor -
Article: An intracardiac ectopic thyroid mass.
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ABSTRACT: Ectopic thyroid tissue is a rare congenital anomaly that results from multiple events during development. The ectopic thyroid may lie in several human organs including the tongue and mediastinum. It is rarely seen as an intracardiac mass. We report the case of a patient with an intracardiac mass diagnosed by echocardiography. The pathology of the mass was compatible with ectopic thyroid tissue with no signs of malignancy.European Heart Journal – Cardiovascular Imaging 07/2009; 10(5):704-6. · 2.32 Impact Factor -
Article: Mitral valve repair surgery for traumatic rupture of the anterolateral papillary muscle.
Revista Espa de Cardiologia 01/2009; 61(12):1360-1. · 2.53 Impact Factor -
Article: [Severe tricuspidal insufficiency 20 years after an infectious endocarditis].
Medicina Clínica 02/2008; 130(1):40. · 1.38 Impact Factor -
Article: [Left atrium diameter: a simple echocardiographic parameter with high prognostic value in heart failure].
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ABSTRACT: Left atrium diameter (LAD) is a very simple and easy parameter to obtain by echocardiography. It is influenced by systolic and diastolic ventricular dysfunction and by the coexistence of mitral regurgitation. We evaluated LAD as a predictor of prognosis (2 year mortality) in a heart failure (HF) population admitted to an outpatient HF unit. We compared LAD (mm/m2) with other echocardiographic parameters (left ventricular ejection fraction, left ventricular end-diastolic and end-systolic diameters [mm/m2], mitral regurgitation, degree of diastolic dysfunction and pulmonary artery pressure). We studied 368 patients (73% men; mean age [standard deviation]: 65.2 [11] years; 60% of ischemic etiology). The mean left ventricular ejection fraction by echocardiography was 32.3% (13.1%). The majority of patients were in NYHA (New York Heart Association) class II (48%) or III (43%). Two years mortality was 20.6%. In the univariate analysis LAD (p < 0.001), left ventricular end-diastolic diameter (p < 0.001), left ventricular end-systolic diameter (p = 0.003), the degree of mitral regurgitation (p = 0.002) and the pattern of diastolic dysfunction (p = 0.004) showed a significant relationship with 2 years mortality, but not left ventricular ejection fraction and pulmonary pressure. In the echocardiographic multivariate analysis, only LAD remained significantly associated with mortality. In the multivariate analysis including important clinical parameters such as age, sex, etiology, time lapsed since symptoms onset, NYHA functional class, and the presence of diabetes, hypertension and atrial fibrillation, LAD remained as independent predictor of 2 years mortality. Patients with LAD less than 25 mm/m2 have a 10.9% mortality, whereas those with LAD equal or greater than 25 mm/m2 have a 30.1% mortality (p < 0.001). LAD was a good predictor of 2 years mortality, better than other echocardiographic parameters in patients of our outpatient HF unit and was independent of strong clinical parameters.Medicina Clínica 10/2007; 129(12):441-5. · 1.38 Impact Factor -
Article: [Temporary pacemakers: current use and complications].
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ABSTRACT: Temporary pacemakers (TP) are used in the emergency treatment of patients with severe bradyarrhythmia. They are often used in emergency situations and for older patients in poor general condition who are hemodynamically unstable and uncooperative. The aim of this study was to review and analyze the indications, incidence and type of complications associated with TP implanted in our center during a 6-year period. We analyzed significant clinical variables, indication, route of insertion, follow-up, complications, and duration of temporary pacing. A total of 568 TP were implanted, and 530 cases were available for review (mean age 74.8 [11] years). The main indications were symptomatic complete AV block (51%), prophylaxis for replacement with a definitive pacemaker (14.7%), blockage in the acute phase of myocardial infarction (12.6%), bradyarrhythmia due to drug intoxication (12.2%), symptomatic sick sinus syndrome (7.5%) and long QT interval or ventricular tachycardia (2.5%). The route of insertion was via the femoral vein in 99% of the cases. The duration of TP use was 4.2 days (range 1 to 31 days). A total of 369 patients (69.6%) required a permanent pacemaker. Complications: 34 patients died (6.4%), but only 3 deaths were attributable to TP implantation. Other severe complications were seen in 98 patients (18.5%). Malfunction of the TP occurred in 48 patients (9%) because of electrode displacement. Temporary pacemakers are used in older patients with extreme bradyarrhythmia and occasionally with acute myocardial infarction. Serious complications are not uncommon (22% of all patients), and can range from femoral hematoma to cardiac tamponade and even death (6%). In 9% of the patients the electrode needed to be repositioned because of failure of sensing or loss of ventricular capture.Revista Espa de Cardiologia 12/2004; 57(11):1045-52. · 2.53 Impact Factor -
Article: Giant thrombus trapped in foramen ovale with pulmonary embolus and stroke.
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ABSTRACT: We describe the case of a young man who, while he was in coma because of a traffic accident, had first a pulmonary embolus and immediately afterwards had a systemic (cerebral) embolus. A transesophageal echocardiographic image revealed a giant thrombi trapped in foramen ovale protruding in right and left ventricles, diagnosing, thus, a paradoxical embolism. The relationship between patent foramen ovale and pulmonary embolism has been reported in some series. Elevated right-chamber pressure caused by pulmonary hypertension could favor the establishment of a right-to-left shunt, causing, in some cases, paradoxical embolisms. We review the clinical implications.Journal of the American Society of Echocardiography 09/2004; 17(8):916-8. · 3.71 Impact Factor -
Article: Necrotizing vasculitis: a cause of aortic insufficiency and conduction system disturbance.
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ABSTRACT: Cardiac involvement in vasculitis syndromes is uncommon. We describe a 50-year-old male who presented with progressive dyspnea and myalgies. Echocardiogram revealed significant thickening of aortic root, aortic cusps, and anterior mitral valve leaflet, with severe aortic regurgitation that required aortic valve replacement. Furthermore, this patient suffered progressive atrioventricular block that needed implantation of a pacemaker. The study performed disclosed the presence of necrotizing vasculitis positive for perinuclear antineutrophil cytoplasmic antibody.Echocardiography 11/2003; 20(7):589-91. · 1.24 Impact Factor -
Article: [Predictive factors of abnormal dynamic intraventricular gradient after valve replacement in severe aortic stenosis].
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ABSTRACT: Dynamic intraventricular gradients (DIG) after valve replacement in severe aortic stenosis have been reported, although the incidence of DIG and clinical signs are still poorly understood.Aim. To evaluate the incidence of DIG)and determine risk factors and associated morbimortality. One hundred nine consecutive patients with severe aortic valve stenosis undergoing valve replacement were studied prospectively by echocardiography to detect the postoperative appearance of DIG, defined as a maximum flow velocity >/= 2.5 m/s. Sixteen patients (14.9%) developed postoperative DIG. Significant differences between the patients with or without DIG were found for ventricular diameter (left end-diastolic ventricular diameter (LEDVD) 43.2 vs. 47.7 mm, respectively, p < 0.001; left end-systolic ventricular diameter (LESVD) 21 vs. 29 mm, p < 0.001); left ventricular mass index (165 vs. 193 g/m(2), p < 0.05); mean aortic valve gradient (68 vs. 59 mmHg, p < 0.01),; ejection fraction (73 vs. 61%, p < 0.001). No significant differences were found with respect to ventricular wall thicknesses (septal 16.3 vs. 15.7; posterior 14.37 vs. 14.62), the presence of aortic insufficiency, or other postoperative factors (anemia, inotropic agents, etc.). DIG after aortic valve replacement to treat severe stenosis is not unusual (15%). DIG is usually found at a midventricular location, close to the septum. In patients with postoperative DIG the most common associated factors were small LEDVD, high ejection fractions and ratios of intraventricular septal to posterior wall ratios, high valve gradients and small left ventricular masses. Preoperative echocardiography can identify patients with a higher risk of developing DIG after aortic valve replacement.Revista Espa de Cardiologia 02/2002; 55(2):127-34. · 2.53 Impact Factor -
Article: Temporary Pacemakers: Current Use and Complications
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ABSTRACT: Introduction and objectiveTemporary pacemakers (TP) are used in the emergency treatment of patients with severe bradyarrhythmia. They are often used in emergency situations and for older patients in poor general condition who are hemodynamically unstable and uncooperative. The aim of this study was to review and analyze the indications, incidence, and type of complications associated with TP implanted in our center during a 6-year period.Patients and methodWe analyzed significant clinical variables, indication, route of insertion, follow-up, complications, and duration of temporary pacing.ResultsA total of 568 TP were implanted, and 530 cases were available for review (mean age 74.8 [11] years). The main indications were symptomatic complete AV block (51%), prophylaxis for replacement with a definitive pacemaker (14.7%), blockage in the acute phase of myo-cardial infarction (12.6%), bradyarrhythmia due to drug intoxication (12.2%), symptomatic sick sinus syndrome (7.5%), and long QT interval or ventricular tachycardia (2.5%). The route of insertion was via the femoral vein in 99% of the cases. The duration of TP use was 4.2 days (range, 1 to 31 days). A total of 369 patients (69.6%) required a permanent pacemaker. Complications: 34 patients died (6.4%), but only 3 deaths were attributable to TP implantation. Other severe complications were seen in 98 patients (18.5%). Malfunction of the TP occurred in 48 patients (9%) because of electrode displacement.ConclusionsTemporary pacemakers are used in older patients with extreme bradyarrhythmia and occasionally with acute myocardial infarction. Serious complications are not uncommon (22% of all patients), and can range from femoral hematoma to cardiac tamponade and even death (6%). In 9% of the patients the electrode needed to be repositioned because of failure of sensing or loss of ventricular capture.Introducción y objetivoLos marcapasos temporales (MT) permiten el tratamiento urgente de pacientes con bradiarritmias severas. Se los utiliza en las situaciones urgentes y con frecuencia en ancianos con estado general deteriorado, inestabilidad hemodinámica y escasa colaboración. El objetivo es revisar los MT implantados en nuestro centro en los últimos 6 años y analizar sus indicaciones, incidencia y tipo de complicaciones.Pacientes y métodoSe han analizado las variables clínicas significativas, la indicación, la vía de acceso, el seguimiento, las complicaciones y los días de manteni-miento del MT.ResultadosSe implantó un total de 568 MT y se pudo revisar 530 casos (edad, 74,8 ± 11 años). Las indicaciones para su implantación fueron: bloqueo auriculoventricular sintomático (51%) y profiláctico por recambio de generador (14,7%), bloqueo en la fase aguda del in-farto (12,6%), bradiarritmia por intoxicación medicamen-tosa (12,2%), enfermedad del nodo sinusal (7,5%) e in-tervalo QT largo o taquicardia ventricular (2,5%). Se colocaron por la vena femoral en el 99% de los casos. La duración del MT fue de 4,2 días (rango, 1-31 días). Requirieron un marcapasos definitivo 369 pacientes (69,6%). En cuanto a las complicaciones, se produjo el fallecimiento de 34 pacientes (6,4%), aunque sólo en 3 fue atribuible al MT. En 98 pacientes (18,5%) se observaron otras complicaciones severas, entre ellas, disfunción del MT en 48 pacientes (9%) por movilización del electrocatéter.ConclusionesLos MT se emplean con frecuencia en ancianos con bradiarritmia extrema y, en ocasiones, in-farto agudo de miocardio. Las complicaciones graves son frecuentes (22%) y se puede producir desde un hematoma femoral hasta un taponamiento cardíaco o incluso la muerte (6%). En un 9% de los casos, el electrodo debe ser recolocado por fallo del sensado o de la captura ventricular.Revista Española de Cardiología (English Edition).
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2002–2008
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Hospital Universitari Germans Trias i Pujol
Badalona, Catalonia, Spain
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