Revista española de cardiología (English ed.)
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Rev Esp Cardiol (Engl Ed) · Apr 2017
ReviewThree-dimensional Printed Cardiac Models: Applications in the Field of Medical Education, Cardiovascular Surgery, and Structural Heart Interventions.
In recent years, three-dimensional (3D) printed models have been incorporated into cardiology because of their potential usefulness in enhancing understanding of congenital heart disease, surgical planning, and simulation of structural percutaneous interventions. This review provides an introduction to 3D printing technology and identifies the elements needed to construct a 3D model: the types of imaging modalities that can be used, their minimum quality requirements, and the kinds of 3D printers available. ⋯ We also review the most recent applications of 3D models in surgical planning and simulation of percutaneous structural heart interventions. Finally, the current limitations of 3D printing and its future directions are discussed to explore potential new applications in this exciting medical field.
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Rev Esp Cardiol (Engl Ed) · Aug 2016
Review Meta AnalysisBivalirudin Versus Unfractionated Heparin in Acute Coronary Syndromes: An Updated Meta-analysis of Randomized Trials.
Contrasting data have been reported on bivalirudin as an anticoagulation strategy during percutaneous coronary interventions, offering theoretical benefits on bleeding complications but raising concerns on a potential increase in the risk of stent thrombosis. We performed an updated meta-analysis to evaluate the efficacy and safety of bivalirudin compared with unfractionated heparin in patients undergoing percutaneous interventions for acute coronary syndromes. ⋯ In patients undergoing percutaneous coronary interventions, bivalirudin is not associated with a reduction in mortality compared with heparin but does increase stent thrombosis. The reduction in bleeding complications observed with bivalirudin does not translate into survival benefits but is rather influenced by a differential use of glycoprotein IIb/IIIa inhibitors.
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Rev Esp Cardiol (Engl Ed) · Feb 2016
ReviewUpdate on Myocarditis and Inflammatory Cardiomyopathy: Reemergence of Endomyocardial Biopsy.
Myocarditis is defined as an inflammatory disease of the heart muscle and is an important cause of acute heart failure, sudden death, and dilated cardiomyopathy. Viruses account for most cases of myocarditis or inflammatory cardiomyopathy, which could induce an immune response causing inflammation even when the pathogen has been cleared. Other etiologic agents responsible for myocarditis include drugs, toxic substances, or autoimmune conditions. ⋯ Furthermore, after the generalization of immunohistochemical and viral genome detection techniques, endomyocardial biopsy provides a definitive etiological diagnosis that can lead to specific treatments such as antiviral or immunosuppressive therapy. Endomyocardial biopsy is not commonly performed for the diagnosis of myocarditis due to safety reasons, but both right- and left endomyocardial biopsies have very low complication rates when performed by experienced operators. This document provides a state-of-the-art review of myocarditis and inflammatory cardiomyopathy, with special focus on the role of endomyocardial biopsy to establish specific treatments.
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Rev Esp Cardiol (Engl Ed) · Sep 2013
ReviewEpidemiology of infective endocarditis in Spain in the last 20 years.
Infective endocarditis is an uncommon disease, with an estimated incidence of 3.1 to 3.7 episodes per 100 000 inhabitants/year. The incidence is highest in elderly people. The microorganisms most frequently isolated in infective endocarditis are staphylococci and streptococci. ⋯ As a result of substantial epidemiological changes, few cases of infective endocarditis can be prevented by antibiotic prophylaxis. Despite advances in medical and surgical treatment, in-hospital mortality among infective endocarditis patients is high. Nevertheless, there is room for improvement in reducing the rate of nosocomial bacteremia, the prompt diagnosis of infective endocarditis in at-risk patients, and the early identification of patients with a highest risk of complications, as well as in the creation of multidisciplinary teams for the management of this disease.