Luis Garcia Guereta

Luis Garcia Guereta
Hospital Universitario La Paz · Servicio de Cardiologia Pediatrica Hospital Universitario La Paz

MD, PhD

About

153
Publications
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1,210
Citations
Citations since 2017
43 Research Items
557 Citations
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2017201820192020202120222023020406080100120140
2017201820192020202120222023020406080100120140
2017201820192020202120222023020406080100120140

Publications

Publications (153)
Article
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 docume...
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Resumen Pese a los esfuerzos realizados para mejorar la atención al shock cardiogénico (SC), incluyendo el desarrollo de dispositivos de asistencia circulatoria mecánica (ACM), su pronóstico continúa siendo desfavorable. En este contexto surgen iniciativas de código SC, basadas en proporcionar una asistencia rápida y de calidad a estos pacientes. E...
Article
Introduction and objectives: The Index for Mortality Prediction After Cardiac Transplantation (IMPACT) score was derived and validated as a predictor of mortality after heart transplantation (HT). The primary objective of this work is to externally validate the IMPACT score in a contemporary Spanish cohort. Methods: Spanish Heart Transplant Regi...
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Background Maximal left ventricular wall thickness (MLVWT) is a risk factor for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). In adults, the severity of left ventricular hypertrophy has a nonlinear relationship with SCD, but it is not known whether the same complex relationship is seen in childhood. The aim of this study was to d...
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Background Up to one-half of childhood sarcomeric hypertrophic cardiomyopathy (HCM) presents before the age of 12 years, but this patient group has not been systematically characterized. Objectives The aim of this study was to describe the clinical presentation and natural history of patients presenting with nonsyndromic HCM before the age of 12 y...
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Resumen Introducción y objetivos Se actualizan las características y los resultados del trasplante cardiaco en España con los hallazgos de los procedimientos realizados en 2020. Métodos Se describen las características de receptores, donantes, procedimiento quirúrgico e inmunosupresión en el año 2020. Se analizan las tendencias de estas caracterí...
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Background Danon disease (DD) is a rare X-linked dominant cardioskeletal myopathy caused by mutations in the lysosome-associated membrane protein-2 (LAMP-2) gene that is usually lethal without cardiac transplantation. The purpose of this study is to characterize post-transplant outcomes in a large cohort of DD patients who underwent cardiac transpl...
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Resumen Introducción y objetivos El retrasplante cardiaco (ReTC) representa un tema controvertido actualmente. Nuestro objetivo es describir y analizar los resultados del ReTC en España. Métodos Análisis retrospectivo del Registro Español de Trasplante Cardiaco de 1984 a 2018. Se recogieron datos sobre donante, receptor, cirugía, inmunosupresión...
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(1) Background: Post-transplant lymphoproliferative disease (PTLD) is a significant complication of solid organ transplantation (SOT). However, there is lack of consensus in PTLD management. Our aim was to establish a present benchmark for comparison between international centers and between various organ transplant systems and modalities; (2) Meth...
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Introduction and objectives Heart retransplantation (ReHT) is controversial in the current era. The aim of this study was to describe and analyze the results of ReHT in Spain. Methods We performed a retrospective cohort analysis from the Spanish Heart Transplant Registry from 1984 to 2018. Data were collected on donors, recipients, surgical proced...
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Background: While the short- and median-term survival has improved considerably in patients with Fontan circulation, cardiac function and exercise capacity are still reduced and may deteriorate over time. Cardiac magnetic resonance (CMR) is the gold standard for the assessment of ventricular volume and function. Speckle-tracking echocardiography (...
Article
Male patients are at increased risk for developing malignancy post‐heart transplantation (HT); however, real incidence and prognosis in both genders remains unknown. The aim of this study was to assess differences in incidence and mortality related to malignancy between genders in a large cohort of HT patients. Incidence and mortality rates were ca...
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Introduction and objectives The present report describes the clinical characteristics and outcomes of heart transplants in Spain and updates the data to 2019. Methods We describe the clinical characteristics and outcomes of heart transplants performed in Spain in 2019, as well as trends in this procedure from 2010 to 2018. Results In 2019, 300 tr...
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Introduction The aims of this article are to analyse the neuropsychological changes in the medium–term in children subjected to aortic arch surgery using selective cerebral perfusion (SCP), as well as to detect any modifiable factors in the surgical technique that may contribute to minimising the subsequent neurological involvement. Material and m...
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The current pandemic SARS‐CoV‐2 virus has required an unusual allocation of resources that can negatively impact of chronically ill patients and high‐complexity procedures. Across the European reference network on pediatric transplantation (ERN‐TransplantChild) we conducted a survey to investigate the impact of the COVID‐19 outbreak on pediatric tr...
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Resumen Introducción y objetivos Se presentan las características clínicas y los resultados de los trasplantes cardiacos realizados en España con la actualización correspondiente a 2019. Métodos Se describen las características clínicas y los resultados de los trasplantes cardiacos realizados en 2019, así como las tendencias de estos en el period...
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Resumen Introducción Los objetivos son analizar las alteraciones neuropsicológicas a medio plazo de los niños intervenidos del arco aórtico mediante perfusión cerebral selectiva (PCS) y detectar posibles factores modificables en la técnica quirúrgica que pueden ayudar a minimizar la afectación neurológica posterior. Material y métodos Se establec...
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Evidence on the impact of MCS on pediatric heart transplant survival is still scarce related to congenital heart disease patients including univentricular physiology as well as the risk factors for complications. We performed a retrospective review of all urgent pediatric (aged ≤16 years) HT from 2004 to 2014 in the Spanish Pediatric Heart Transpla...
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Cardiac transplantation for children with end‐stage cardiac disease with no other medical or surgical options is now standard. The number of children in need of cardiac transplant continues to exceed the number of donors considered “acceptable.” Therefore, there is an urgent need to understand which recipients are in greatest need of transplant bef...
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Introduction and objectives Right ventricle (RV) measurements are crucial for certain congenital heart diseases and various cardiovascular conditions. Echocardiographic RV diameters are especially useful for its assessment. Paediatric echocardiographic data standardisation in normal subjects is complex, scarce, and heterogeneous. The aim of this st...
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The number of potential pediatric heart transplant recipients continues to exceed the number of donors, and consequently the waitlist mortality remains significant. Despite this, around 40% of all donated organs are not used and are discarded. This document (62 authors from 53 institutions in 17 countries) evaluates factors responsible for discardi...
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Importance Sudden cardiac death (SCD) is the most common mode of death in childhood hypertrophic cardiomyopathy (HCM), but there is no validated algorithm to identify those at highest risk. Objective To develop and validate an SCD risk prediction model that provides individualized risk estimates. Design, Setting, and Participants A prognostic mod...
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The evaluation of oncologic patients at risk of chemotherapy-induced cardiotoxicity usually focuses on left ventricular function. However, recent studies have demonstrated that right ventricle impairment often coexists (and in some cases precedes) left-side affectation. We present the case of a 19-year-old heart transplant recipient who developed s...
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Resumen Introducción y objetivos La cuantificación del tamaño del ventrículo derecho (VD) es crucial en determinadas cardiopatías congénitas. Para su evaluación se recomiendan distintas técnicas de imagen, siendo más accesible la medición de diámetros ventriculares mediante ecocardiografía. En pediatría la normalización de parámetros ecocardiográf...
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Resumen: Objetivos: El trasplante cardiaco es una terapia establecida para el paciente pediátrico con miocardiopatía o cardiopatía congénita terminales. El perfil de estos receptores ha ido cambiando. Presentamos nuestra experiencia de 24 años y analizamos los resultados. Métodos: Análisis retrospectivo: 73 trasplantes cardiacos realizados durante...
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A bilateral persistent ductus arteriosus with right proximal pulmonary artery agenesis is a very unusual anatomic variant. These malformations are assumed to occur during the transformation of the sixth aortic arch with the pulmonary trunk in the development of the aorta and its branches. A 2-months preterm baby was referred by severe bronchopulmon...
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Introduction and objectives: Danon disease (DD) is caused by mutations in the LAMP2 gene. It is considered a multisystemic disease characterized by hypertrophic cardiomyopathy with pre-excitation and extreme hypertrophy, intellectual disability, myopathy, childhood presentation, and worse prognosis in men. There are scarce data on the clinical cha...
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Resumen Introducción y objetivos La enfermedad de Danon (ED) es una enfermedad producida por mutaciones en el gen LAMP2. Se la considera una enfermedad multisistémica caracterizada por miocardiopatía hipertrófica con preexcitación e hipertrofia extrema, discapacidad intelectual, miopatía, presentación infantil y peor pronóstico en varones. Hay poc...
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Objectives: Mechanical circulatory support for pediatric heart failure patients with the Berlin Heart EXCOR ventricular assist system is the only approved and established bridging strategy for recovery or heart transplantation. In recent years, the burden of thromboembolic events has led to modifications of the recommended antithrombotic therapy....
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Rationale Infantile-onset Pompe disease, also known as glycogen storage disease type II, is a progressive and fatal disorder without treatment. Enzyme replacement therapy with recombinant human acid alpha-glucosidase (GAA) enhances survival; however, the best outcomes have been achieved with early treatment. Patient concerns We report a case of a...
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Introducción: En pacientes pediátricos puede ser necesario corregir la lesión valvular del tracto de salida del ventrículo derecho, secuela de la reparación primaria de su cardiopatía congénita. Objetivo: Comparar resultados de yugular bovina (YB)-Contegra® versus prótesis porcina (PPP), implantadas en pacientes menores de 18 años. Métodos: Todos l...
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The development of multidetector computed tomography has triggered a revolution in the study of the aorta and other large vessels and has replaced angiography in the diagnosis of congenital anomalies of the aortic arch, particularly vascular rings. The major advantage of multidetector computed tomography is that it permits clear 3-dimensional asses...
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Resumen El desarrollo de la tomografía computarizada con multidetectores ha supuesto una revolución en el estudio de la aorta y los grandes vasos y ha sustituido a la angiografía para diagnosticar las anomalías congénitas del arco aórtico, en particular los anillos vasculares. La tomografía computarizada con multidetectores ofrece la gran ventaja d...
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Clinical introduction A previously healthy 12-year-old boy presented with chest pain and dyspnoea. ECG (figure 1), echocardiogram (figure 2) and myocardial MRI (figure 3) were performed. Electromyography revealed mild proximal weakness. Blood tests showed creatine kinase 997 UI/L, aspartate transaminase 398 UI/L, alanine transaminase 293 UI/L and l...
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Introducción y objetivos: Los anillos vasculares son anomalías poco comunes, en los que el enfoque diagnóstico y quirúrgico puede ser controvertido. El objetivo es revisar nuestros resultados quirúrgicos hospitalarios y en seguimiento. Métodos: Estudio observacional descriptivo de pacientes con anillos vasculares intervenidos en nuestro hospital. R...
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Cortical hyperostosis is a very uncommon side-effect of prolonged prostaglandin therapy with distinctive radiological signs that may be accompanied by painful swelling of the limbs and responds rapidly to withdrawal of therapy.
Article
Resumen Desde el primer trasplante cardiaco pediátrico llevado a cabo en España en 1984 hasta el momento, se han realizado 379 trasplantes en menores de 16 años. Durante este tiempo, el Registro Español de Trasplante Cardiaco ha supuesto una herramienta esencial a través de la cual hoy podemos conocer las características clínicas, los resultados y...
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We report a male infant with a small thoracic strawberry hemangioma associated with other vascular anomalies: agenesis of the left vertebral artery and hypoplasia of the left carotid artery, and an intestinal hemangioma 45 cm in length removed at 1 1/2 months of age. He also had a severe aortic arch coarctation and ductus arteriosus. He died at the...
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Introduction and objectives: Different percutaneous interventional procedures are needed to reach and maintain adequate anatomical and physiological conditions for the Fontan circulation. We aim to describe the experience gained at a children's hospital in such interventions, and to analyze the clinical outcomes. Methods: Retrospective study of all...
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Introducción y objetivos: Los órganos cardíacos deben ser priorizados hacia pacientes en los que se vaya a obtener máxima supervivencia con menor morbilidad. El objetivo del estudio fue analizar la influencia del receptor, el donante y e tiempo de isquemia del órgano en la mortalidad. Métodos: Se consideraron todos los trasplantes cardíacos realiza...
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Congenital unilateral pulmonary artery agenesis or absense (UAPA) is a rare congenital anomaly, that is frequently associated with other cardiovascular abnormalities such as tetralogy of Fallot or septal defects. Symptomatology is varied, some patients are completely asympomatic, others have congestive heart failure, severe pulmonary hypertension,...
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Introduction Takayasu disease is a rare form of chronic non-specific large vessel vasculitis of unknown etiology. It usually affects young adults, and can be fatal in children. The first reported case is presented of ventricular assistance followed by heart transplant in a patient with Takayasu disease. Objectives The case is presented of 15 year...
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Introduction and objectives Iodinated contrast agents can block thyroid hormone synthesis. The aims of this study were: 1st) to study the incidence of thyroid function disturbances in children with congenital heart disease after cardiac catheterization, 2nd) to analyze the predisposing factors that may lead to the development of hypothyroidism afte...
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Infection is a leading cause of mortality in the first years following heart transplantation. We aimed to validate humoral immunity profiles to identify heart recipients at risk of severe infections.Methods and MaterialsWe prospectively analyzed 267 adult heart recipients from May 2009 to May 2011 performed at 9 centers in Spain. Study points: befo...
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Congenital heart disease management is extremely delicate. Most of the patients are diagnosed in fetal life, and although the majority will be treated and discharge, many of them will require continuous follow-up and several kinds of interventions along their life. Therefore, these patients should be managed in high qualified centers, with experien...
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We present the case of a two month-old infant with a torpid course lower airway infection associated with a common sign, such as stridor, which study let us diagnose a pathology which needs high clinical suspicion and whose course without treatment can lead to serious accidents.
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Congenital heart diseases (CHDs) have high infant mortality in their severe forms. When adulthood is reached, a heart transplant (HTx) may be required. Spanish adult population transplanted for CHD was analyzed and compared with the most frequent causes of HTx and between different subgroups of CHD. A total of 6048 patients (HTx 1984-2009) were inc...
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Introduction. Emery-Dreifuss muscular dystrophy (EDMD) is a genetic disease that can be inherited as autosomal dominant, autosomal recessive or X-linked form. The recessive X-linked form of EDMD is caused by mutations in the EMD gene. Methods. Immunohisto-chemistry of muscle biopsy of the patient with specific antibodies for dystrophin, sarcoglycan...
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Aortic arch abnormalities are a cause of respiratory disorders in children, including dyspnoea, stridor, recurrent respiratory tract infections, and asthma. On the other hand, adults develop more dysphagia (lusoria). We report a Caucasian 13-year-old girl complaining only of a 6-month history of cough, occasional dyspnoea and sibilances. She was o...
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Introduction and objectives: Tricuspid annular plane systolic excursion (TAPSE) is an echocardiographic measure that allows us to assess right ventricular systolic function. TAPSE measurement is common in adults but reference values for children are scarce. Our objective was to establish reference values for TAPSE in Spanish children and to determ...
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A new consensus document of the AHA has been recently published and it defines cardiomyopathies as a group of diseases of the myocardium that causes mechanic or electrical dysfunction. They are usually associated with hypertrophy or dilatation and are more often secondary to different causes, frequently of genetic origin. This new document addresse...
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En pacientes jóvenes y adultos con cardiopatías congénitas y fallo ventricular grave refractarios al tratamiento médico intenso con fármacos vasoactivos y en aquellos pacientes con fallo primario del injerto postrasplante cardíaco, la asistencia circulatoria, bien mediante extracorporeal membrane oxygenation (ECMO), asistencia centrífuga, o asisten...
Article
Tricuspid annular plane systolic excursion (TAPSE) is an echocardiographic measure that allows us to assess right ventricular systolic function. TAPSE measurement is common in adults but reference values for children are scarce. Our objective was to establish reference values for TAPSE in Spanish children and to determine the relationship of these...
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Full-text available
Purpose Nearly one-third of children diagnosed with dilated cardiomyopathy (DCM) receive a transplant or die within the first year after diagnosis. Limited long-term outcome of heart transplantation and scarcity of young donors justify every effort to improve medical therapy and to find alternative therapeutic approaches. There is increasing eviden...
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Introduction and objectivesSome paediatric publications have recently raised the value of intracoronary therapy with autologous bone marrow-derived progenitor cells (APCs) in children with dilated cardiomyopathy (DCM) and heart failure. We describe the usefulness of this treatment in two infants with severe DCM and heart failure, who had been trans...
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Some paediatric publications have recently raised the value of intracoronary therapy with autologous bone marrow-derived progenitor cells (APCs) in children with dilated cardiomyopathy (DCM) and heart failure. We describe the usefulness of this treatment in two infants with severe DCM and heart failure, who had been transferred to our hospital for...
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The association between respiratory viruses and myocarditis has hardly ever been described. We report a case of acute myocarditis in an immunocompetent child associated with the presence of parainfluenza virus type 3 infection, in a context of recent influenza illness, confirmed by molecular and serological studies.
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The field of pediatric cardiology is continually developing and now covers not only congenital and acquired heart disease in children but also congenital heart disease in adults and the prenatal diagnosis and prevention of heart disease. This review highlights new findings in the field of genetics, selected articles on the use of magnetic resonance...