Abordaje mínimamente invasivo para el recambio valvular aórtico: ¿está asociado a menor transfusión de hemoderivados?

Paredes, Federico; García-Fuster, Rafael; Sánchez, María Higinia; Villegas, Carolina; Hornero, Fernando; Gil, O.; Juez, Marina; Mena, Armando; Martínez-León, Juan

doi:10.1016/j.circv.2015.03.005

Cited by 5 publications

(4 citation statements)

References 35 publications

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“…There were no cases of mortality. The studies published about mortality with both techniques are so far similar, except in high-risk patients, in whom a mortality reduction has been demonstrated with MICS [10][11][12][13] ; similarly, lower early and late mortality has been documented in the literature, mainly in aortic valve replacement surgeries, as well as less postoperative bleeding and lower blood products' requirements [14][15][16][17][18][19] . A cohort study adjusted for risk propensity leveling showed that mitral valve repair and replacement techniques through right thoracotomy can be considered short-and long-term safe and efficacious procedures 20 .…”

Section: Discussionmentioning

confidence: 99%

Pediatric heart surgery minimally invasive: experience of a Colombian center

Hernández¹,

Fajardo²,

Díaz³

et al. 2022

ACME

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Objective: During the past decades, cardiac surgery has revolutionized; there is a growing interest in minimizing the physical aggression of surgical procedures, seeking a quick recovery, minimally invasive approaches have been a trend in recent years, with safety and efficacy equivalent to traditional techniques sternotomy. The objective of this study is to compare clinical results between pediatric patients with congenital heart disease undergoing minimally invasive surgery versus standard sternotomy. Methods: Case-control study, nested in a retrospective cohort. All pediatric patients over 10 kg in weight were included, between 2014 and 2019 who underwent surgical correction of simple congenital heart disease, in a cardiovascular center in Medellin. A case was defined as one that underwent a minimally invasive approach (minimally-invasive cardiac surgeries [MICS]) and control patients who were approached in a conventional manner (CONV). 122 patients were admitted, with a mean age (MICS: 6,(4)(5)(6)(7)(8)(9)(10)(11)(12)(2)(3)(4)(5)(6)(7)(8). No differences were found in the baseline characteristics of both groups. No statistically significant difference was documented in infusion times ; p = 0.54), nor differences in complications (MICS: 7.4 vs. CONV: 8.8%; p = 0.77). MICS patients had lactate on admission and a shorter intensive care unit stay than controls. Conclusion: The MICS approach turns out to be a novel, less invasive, safe and efficient technique compared to the conventional surgical approach for the repair of simple congenital heart disease in pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Pediatric heart surgery minimally invasive: experience of a Colombian center

Hernández¹,

Fajardo²,

Díaz³

et al. 2022

ACME

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“…No se presentó ningún caso de mortalidad. Los estudios publicados de mortalidad en ambas técnicas son similares hasta la fecha, excepto en los pacientes de alto riesgo, en quienes se ha demostrado una reducción en la mortalidad con MICS [10][11][12][13] ; igualmente se ha documentado en la literatura menor mortalidad precoz y tardía, principalmente en las cirugías de recambio valvular aórtico, así como un menor sangrado postoperatorio y menor requerimiento de hemoderivados [14][15][16][17][18][19] . En un estudio de cohortes ajustadas por nivelación del riesgo de propensión, demostró que las técnicas de reparo y sustitución de la válvula mitral a través de toracotomía derecha pueden considerarse un procedimiento seguro y eficaz corto y largo plazo 20 .…”

Section: Discussionunclassified

Cirugía cardiaca pediátrica mínimamente invasiva: experiencia de un centro colombiano cardiovascular

Hernández-Ruiz

Fajardo

Díaz

et al. 2021

ACM

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Durante las últimas décadas, la cirugía cardiaca ha evolucionado, existe un interés creciente en minimizar la agresión corporal de procedimientos quirúrgicos, buscando una rápida recuperación, los abordajes mínimamente invasivos han sido tendencia en los últimos años, con seguridad y eficacia equivalente a las técnicas tradicionales de esternotomía. El objetivo de este estudio es comparar resultados clínicos entre pacientes pediátricos con cardiopatías congénitas sometidos a cirugía mínimamente invasiva frente a esternotomía estándar. Métodos: Estudio de casos y controles, anidado en una cohorte retrospectiva. Se incluyeron todos los pacientes pediátricos mayores de 10 kg de peso, sometidos entre 2014 a 2019 a corrección quirúrgica de cardiopatías congénitas simples, en un centro cardiovascular en Medellín. Se definió caso aquel que fuera sometido a abordaje mínimamente invasivo (MICS) y control los pacientes que se abordaron de manera convencional (CONV). Un total de 122 pacientes fueron admitidos, con una media de edad ). No se encontraron diferencias en las características basales de ambos grupos. No se documentó diferencia estadísticamente significativa en los tiempos de perfusión ; p= 0,54), ni diferencias en las complicaciones (MICS: 7.4% vs. CONV: 8.8%; p = 0.77). Los pacientes MICS tuvieron un lactato al ingreso y una estadía en la UCI menor que los controles. Conclusión: El abordaje MICS resulta ser una técnica novedosa, menos invasiva, segura y eficiente, frente al abordaje quirúrgico CONV, para la reparación de cardiopatías congénitas simples en paciente pediátricos.

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“…Another important controversy relevant to the context of this thesis occurred in 2018 involving high-ranking judges who were recorded negotiating innocence or reduced sentences in return for bribes, including in one case of the rape of an under-aged girl (Paredes, 2018). These cases underline the difficulty in making addressing GBV through policies when machismo persists in powerful individuals and institutions at all levels of society.…”

Section: Gender-based Violence In Perumentioning

confidence: 99%

'Ni Una Menos': A women's social movement contesting gender-based violence in Arequipa, Peru

Infantes Abril

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<p>Ni Una Menos (NUM) is a social movement that since 2015 has spread through Latin America as a response to continuing problems of femicides and gender-based violence. NUM challenges gender power relations embedded in the machista culture, which top-down approaches within mainstream gender and development approaches (GAD) have overlooked. To date, most studies of NUM have focused on the movement in Argentina, and its major public actions. Few studies have sought a holistic understanding of how the movement contests Gender Based Violence (GBV) on a day-to-day basis. This research involved a case study of the NUM movement in Arequipa, Peru. I undertook a mixed methods approach, placing this in context of GAD and social movement theories. I worked with NUM Arequipa activists to understand the movement and its strategies in the local context; and with students to explore their knowledge about, and response to, NUM Arequipa’s strategies. NUM Arequipa practised two forms of activism. The first - ‘traditional’ activism’, raised awareness and challenged machista sociocultural structures through media, public campaigns and education. These strategies complemented international GAD practice by challenging unequal gender relationships and incorporating male participation. The second - ‘quiet’ or ‘everyday’ activism - focused on providing support and advocacy for victims of GBV, and a commitment to empathy, care and justice. For both types of strategies, social media and connections to local organisations were important. However, NUM Arequipa, with its non-feminist public identity and quiet activism, found challenges distinguishing itself from other ‘loud’ feminist NUM groups. This confusion meant that students had limited awareness of NUM Arequipa’s specific activities and achievements. The thesis concludes that grassroots movements like NUM Arequipa, alongside more explicitly feminist and confrontational forms of social movements, are essential to eradicating GBV because they can work through relationships to make short-term change in people’s lives while also challenging patriarchal and machista structures in ways that are sensitive to the sociocultural context.</p>

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Abordaje mínimamente invasivo para el recambio valvular aórtico: ¿está asociado a menor transfusión de hemoderivados?

Cited by 5 publications

References 35 publications

Pediatric heart surgery minimally invasive: experience of a Colombian center

Pediatric heart surgery minimally invasive: experience of a Colombian center

Cirugía cardiaca pediátrica mínimamente invasiva: experiencia de un centro colombiano cardiovascular

'Ni Una Menos': A women's social movement contesting gender-based violence in Arequipa, Peru

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