Browsing by Author "Valdebenito, M."

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    Angiographic and electrocardiographic parameters of myocardial reperfusion in angioplasty of patients with ST elevation acute myocardial infarction loaded with ticagrelor or clopidogrel (MICAMI-TICLO trial)
    (2014) Winter, J. L.; Lindefjeld, Dante; Veas, N.; Guarda, E.; Valdebenito, M.; Méndez, M; Pérez, Osvaldo; Zuanic, K.; Mestas, M.; Martínez, A.
    Introduction Ticagrelor has been shown to improve outcomes in patients with ACS. However, the effects of this drug on parameters of microvascular flow in patients presenting with ST-segment elevation myocardial infarction (STEMI) have not been completely evaluated. Methods Ninety-two patients presenting with STEMI where randomized to a loading dose of clopidogrel (600 mg) or ticagrelor (180 mg) before undergoing primary angioplasty. We assessed angiographic and electrocardiographic parameters of myocardial reperfusion. Blinded operators calculated angiographic corrected TIMI Frame count (cTFC) and myocardial blush grade (MBG) before and after stent implantation. ST segment resolution was also measured in all patients. Primary endpoint was cTFC after PCI. Secondary endpoints were cTFC prior to PCI, TIMI flow grade, MBG and the percentage of ST resolution. Results Of the 92 randomized patients, 70 patients were analyzed. Mean age of patients was 58.8 ± 10 years. Patients presented with a mean ischemic time of 4.4 ± 2.6 hours. There were no significant differences in the time between loading dose and stent deployment (35.2 ± 36.4 in ticagrelor and 42.7 ± 29.5 min in clopidogrel, p = 0.36). cTFC before angioplasty was significantly lower in ticagrelor than in clopidogrel (81.1 ± 29.4 vs. 95.1 ± 17.5 frames respectively, p = 0.01). After angioplasty there were no differences between ticagrelor and clopidogrel in cTFC (24.6 ± 9.3 vs. 27.0 ± 13.4 frames respectively, p = 0.62); MBG grade 3 was present in 76.4 vs. 69.4% of patients, respectively (p = 0.41). The percentage of ST resolution did not show any differences between groups (84.8 ± 23.4 in ticagrelor vs. 70.8 ± 33.7 in clopidogrel, p = 0.36). Conclusion Compared with clopidogrel, ticagrelor loading in patients presenting with STEMI is not associated with an improvement of angiographic and electrocardiographic parameters of myocardial reperfusion after angioplasty.
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    Síndrome carcinoide y compromiso valvular cardíaco
    (2014) Paredes, A.; Valdebenito, M.; Neira, V.; Castro Gálvez, Pablo Federico; Zalaquett Sepúlveda, Ricardo
    El carcinoide es un tumor neuroendocrino raro que se origina típicamente en el tracto gastrointestinal y que puede resultar en un amplio espectro de síntomas mediado por sustancias vasoactivas. La enfermedad carcinoide con compromiso cardíaco es caracterizada por el depósito de tejido fibroso en forma de placas, afectando más frecuentemente las válvulas cardíacas derechas y el endocardio. El compromiso valvular izquierdo ocurre en menos del 10% de los casos y es casi siempre asociado a un cortocircuito de derecha a izquierda o a un carcinoide bronquial primario. Los pacientes con falla cardíaca derecha sintomáticos tienen limitadas opciones terapéuticas diferentes a la cirugía cardíaca. El reemplazo valvular cardíaco es el único tratamiento efectivo para la enfermedad valvular carcinoide y debiese ser considerada en pacientes sintomáticos, en los cuales la enfermedad metastásica y los síntomas del síndrome carcinoide se encuentran bien controlados. Por estos motivos, se recomienda un enfoque multidisciplinario en un centro de experiencia para este tipo de pacientes. El presente artículo es una revisión actualizada de la literatura al respecto, tratando de clarificar las principales dudas con respecto al manejo de estos pacientes.
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    Successful percutaneous closure of a ruptured saphenous vein graft aneurysm
    (2018) Martínez, Gonzalo; Valdebenito, M.; Martínez Sepúlveda, José Alejandro; Patel, S.
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    Tratamiento endovascular de la coartación aórtica nativa y recurrente en pacientes mayores de 4 años : resultados y complicaciones
    (2013) Valdebenito, M.; Martínez Sepúlveda, José Alejandro; Martínez, Gonzalo; Veas, N.; Lindefjeld, Dante; Garay Greve, Francisco Javier; Heusser Risopatron, Felipe; Springmüller P., Daniel; Fajuri, Alejandro; Flores, A.; Vergara, F.
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    Uso de endoprótesis en el tratamiento de lesiones no oclusivas del territorio iliaco
    (2006) Mertens, R.; Krämer, A.; Valdés, F.; Bergoeing Reid, Michel Paul; Mariné, L.; Sagües, R.; Olguín, R.; Cruz, J.; Valdebenito, M.; Vergara, J.
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    Utilidad diagnóstica del Péptido Natriurético tipo B en pacientes con insuficiencia cardíaca y enfermedad renal crónica
    (2014) Valdebenito, M.; Paredes, A.; Baeza Vergara, Ricardo Gabriel; Castro Gálvez, Pablo Federico; Jalil Milad, Jorge
    There is a high prevalence of heart failure in patients with chronic renal disease and the latter has been considered an independent risk factor for cardiovascular events in this patient population. Type B natruretic peptide is useful for diagnosis and prognostic evaluation in patients with heart failure. However, the presence of renal dysfunction makes the interpretation of BNP levels more difficult. The appropriate considerations needed to evaluate BNP level as an indicator of heart failure in the presence of renal disease are discussed.