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Iván J Núñez-Gil¹, Daniel Bautista², Enrico Cerrato²

¹From Interventional Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain (I.J.N.-G. D.B., P.S., M.J.P.-V., J.E., C.M., A.F.O.); Cardiology Department, Ospedale degli Infermi, Rivoli TO, Italy (E.C., F.V.); Cardiogroup.org (E.C.); Division of Cardiology, Citta' della Salute e della Scienza di Torino, University of Turin, Italy (P.O.); Interventional Cardiology Department, San Giovanni Bosco Hospital, Turin, Italy (F.U.); Cardiology Division, "Bolognini" Hospital, Seriate BG, Italy (A.I.); Cardiology Department, Maria Vittoria Hospital, Turin, Italy (M.G.); Interventional Cardiology, Hospital Universitario La Paz, Madrid, Spain (R.M.); and Cardiovascular Imaging, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain (J.A.D.A., G.F.). ibnsky@yahoo.es.

|April 19, 2015

Resumen

La disección aórtica iatrogénica es una complicación rara de los procedimientos cardíacos. Un enfoque conservador, que a menudo implica la colocación de stents para la afectación de la arteria coronaria, conduce a excelentes resultados a corto y largo plazo para los pacientes.

Área de la Ciencia:

Cardiología Cardiología.
Cirugía vascular Cirugía vascular.
Cardiología Intervencionista Cardiología intervencionista.

Sus antecedentes:

La disección aórtica tipo A es una condición potencialmente mortal.
La disección aórtica iatrogénica después de procedimientos intervencionistas es poco común, con datos de pronóstico limitados.
Comprender la incidencia y los resultados de la disección aórtica iatrogénica es crucial.

Objetivo del estudio:

Para determinar la incidencia de disección aórtica iatrogénica después de procedimientos intervencionistas.
Para describir el perfil del paciente y los factores de riesgo asociados con esta complicación.
Para evaluar el pronóstico a largo plazo de los pacientes con disección aórtica iatrogénica.

Principales métodos:

Análisis retrospectivo de 74 pacientes con disección ascendente de la aorta entre 2000 y 2014.
Revisión de los datos clínicos y de los procedimientos.
Prospectivo seguimiento clínico a través de llamadas telefónicas o visitas al consultorio.

Principales resultados:

La incidencia de disección aórtica iatrogénica fue del 0,06%.
Los pacientes eran predominantemente hombres (67,6%), con una edad media de 66,9 años y múltiples factores de riesgo cardiovascular.
La mayoría de las disecciones se produjeron durante los intentos de involucrar las arterias coronarias, con un 60,8% que involucra una arteria coronaria; 36 pacientes fueron manejados de manera conservadora, y ninguno experimentó complicaciones relacionadas con la disección durante el seguimiento.

Conclusiones:

La disección por catéter iatrogénico de la aorta es rara, pero tiene un excelente pronóstico con un manejo conservador.
El stenting es efectivo para sellar disecciones que involucran arterias coronarias, asegurando buenos resultados a largo plazo.
Se recomienda una estrategia conservadora para las disecciones aórticas iatrogénicas.

Palabras clave:

Aneurisma de la aorta, torácico familiar 4 4 Enfermedades aórticas enfermedades de la aorta.cateterismo cardíaco por cateterismo cardíaco.Enfermedad iatrogénica enfermedad iatrogénica.pronóstico pronóstico pronóstico

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