Browsing by Author "Godoy I."
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- ItemEarly and late morbidity and mortality of aortic valve replacement with mechanical or biological prostheses during the last decade: The gold standardMorbimortalidad precoz y alejada del reemplazo valvular aórtico con prótesis mecánica y biológica durante la última década: El estándar de oro(2009) Becker P.; Ramírez A.; Cifuentes I.; Rebolledo R.; Zalaquett R.; Morán S.; Arretz C.; Godoy I.; Irarrázaval M.J.Background: There is a growing interest in alternative techniques for aortic valve replacement (AVR). Therefore it is important to have updated results of conventional AVR as a valid comparative standard. Aim: To evaluate both perioperative and late morbidity and mortality in patients undergoing conventional AVR, with either mechanical (RVAm) or biological (RVAb) prostheses. Patients and methods: Retrospective review of medical records and operative protocols of patients undergoing AVR between January 1995 and December 2005. Patients with previous cardiac surgery, aortic balloonplasty or simultaneous cardiovascular procedures were excluded. Results: During the study period, 788 patients underwent AVR and 317 met the inclusion criteria. Of the latter, 175 patients aged 13 to 83 years (63% males) were subjected to AVRm and 142 patients aged 49 to 87 years (64% males), were subjected to AVRb. Five (1.6%) patients died during the perioperative period (one AVRm and four AVRb). All were older than 65 years. Perioperative complications were recorded in 29 and 25% of patients in AVRm and AVRb groups, respectively (NS). During a median follow-up of six years, complications were recorded in 12 and 4% of patients in AVRm and AVRb groups, respectively (p <0.05). The actuarial survival for AVRm group at 1, 5 and 10 years, was 96, 92 and 87%, respectively. The figures for AVRb group were 95, 86 and 83%, respectively (NS). The 10 year reintervention free survival was 97% for the AVRm group and 84% for the AVRb (p <0.05). Conclusions: Perioperative mortality and rates of complications of AVR in this series of patients are low, which compares favorably with other series.
- ItemHeart energy metabolism and its role in the treatment of heart failureMetabolismo energético del corazón y sus proyecciones en el tratamiento de la insuficiencia cardíaca(2010) Castro P.; Gabrielli L.; Verdejo H.; Greig D.; Llevaneras S.; Hernández C.; Godoy I.; Jalil J.E.; Quintana J.C.; Orellana P.; Mellado R.; Concepción R.; Sepúlveda L.; Vukasovic J.L.; García L.; Pizarro M.; Pivet D.; Carrillo C.; Tapia F.; Navarro M.; Troncoso R.; Chiong M.; Lavandero S.; Lavandero S.; Baraona F.It is unknown why heart failure progresses even when patients are treated with the best therapy available. Evidences suggest that heart failure progression is due to loss of neurohumoral blockade in advanced stages of the disease and to alterations in myocardial metabolism induced, in part, by this neurohumoral activation. Alterations in cardiac energy metabolism, especially those related to substrate utilization and insulin resistance, reduce the efficiency of energy production, causing a heart energy reserve deficit. These events play a basic role in heart failure progression. Therefore, modulation of cardiac metabolism has arisen as a promissory therapy in the treatment of heart failure. This review describes myocardial energy metabolism, evaluates the role of impaired energy metabolism in heart failure progression and describes new therapies for heart failure involving metabolic intervention.