Publications by authors named "Gregorio Cuerpo Caballero"

7 Publications

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Retrospective cohort analysis of Spanish national trends of coronary artery bypass grafting and percutaneous coronary intervention from 1998 to 2017.

BMJ Open 2021 Apr 7;11(4):e046141. Epub 2021 Apr 7.

Cardiac Surgery, Hospital Clínico Universitario San Carlos Instituto Cardiovascular, Madrid, Comunidad de Madrid, Spain.

Introduction: Spain is one of the countries with the lowest rates of revascularisation and highest ratio of percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG).

Objectives: To investigate the changes and trends in the two revascularisation procedures between 1998 and 2017 in Spain.

Design: Retrospective cohort study. Analysis of in-hospital outcomes.

Setting: Minimum basic data set from the Spanish National Department of Health: mandatory database collecting information of patients who are attended in the Spanish public National Health System.

Participants: 603 976 patients who underwent isolated CABG or PCI in the Spanish National Health System. The study period was divided in four 5-year intervals. Patients with acute myocardial infarction on admission were excluded.

Primary And Secondary Outcomes: We investigated the volume of procedures nationwide, the changes of the risk profile of patients and in-hospital mortality of both techniques.

Results: We observed a 2.2-fold increase in the rate of any type of myocardial revascularisation per million inhabitants-year: 357 (1998) to 776 (2017). 93 682 (15.5%) had a coronary surgery. PCI to CABG ratio rose from 2.2 (1998-2002) to 8.1 (2013-2017). Charlson's index increased by 0.8 for CABG and 1 for PCI. The median annual volume of PCI/hospital augmented from 136 to 232, while the volume of CABG was reduced from 137 to 74. In the two decades, we detected a significant reduction of CABG in-hospital mortality (6.5% vs 2.6%, p<0.001) and a small increase in PCI (1.2% vs 1.5%, p<0.001). Risk adjusted mortality rate was reduced for both CABG (1.51 vs 0.48, p<0.001), and PCI (1.42 vs 1.05, p<0.001).

Conclusion: We detected a significant increase in the volume of revascularisations (particularly PCI) in Spain. Risk-adjusted in-hospital mortality was significantly reduced.
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http://dx.doi.org/10.1136/bmjopen-2020-046141DOI Listing
April 2021

Prognostic assessment of valvular surgery in active infective endocarditis: multicentric nationwide validation of a new score developed from a meta-analysis.

Eur J Cardiothorac Surg 2020 04;57(4):724-731

University of Alcalá de Henares, Madrid, Spain.

Objectives: Several risk prediction models have been developed to estimate the risk of mortality after valve surgery for active infective endocarditis (IE), but few external validations have been conducted to assess their accuracy. We previously developed a systematic review and meta-analysis of the impact of IE-specific factors for the in-hospital mortality rate after IE valve surgery, whose obtained pooled estimations were the basis for the development of a new score (APORTEI). The aim of the present study was to assess its prognostic accuracy in a nationwide cohort.

Methods: We analysed the prognostic utility of the APORTEI score using patient-level data from a multicentric national cohort. Patients who underwent surgery for active IE between 2008 and 2018 were included. Discrimination was evaluated using the area under the receiver operating characteristic curve, and the calibration was assessed using the calibration slope and the Hosmer-Lemeshow test. Agreement between the APORTEI and the EuroSCORE I was also analysed by Lin's concordance correlation coefficient (CCC), the Bland-Altman agreement analysis and a scatterplot graph.

Results: The 11 variables that comprised the APORTEI score were analysed in the sample. The APORTEI score was calculated in 1338 patients. The overall observed surgical mortality rate was 25.56%. The score demonstrated adequate discrimination (area under the receiver operating characteristic curve = 0.75; 95% confidence interval 0.72-0.77) and calibration (calibration slope = 1.03; Hosmer-Lemeshow test P = 0.389). We found a lack of agreement between the APORTEI and EuroSCORE I (concordance correlation coefficient = 0.55).

Conclusions: The APORTEI score, developed from a systematic review and meta-analysis, showed an adequate estimation of the risk of mortality after IE valve surgery in a nationwide cohort.
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http://dx.doi.org/10.1093/ejcts/ezz328DOI Listing
April 2020

Inflammatory myofibroblastic tumour in the right ventricle of a 66-year-old man.

Interact Cardiovasc Thorac Surg 2019 12;29(6):967-968

Cardiovascular Surgery Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Herein, we present the case of a 66-year-old man with an inflammatory myofibroblastic tumour. An inflammatory myofibroblastic tumour is an extremely rare entity, with only 60 cases having been reported to date in the literature. The origin of this type of tumour is unknown and the treatment of choice is surgical resection. We present the surgical technique of our case and a review of the literature regarding this tumour. This is the first case described in a man above 60 years of age with a tumour located in the right ventricle.
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http://dx.doi.org/10.1093/icvts/ivz189DOI Listing
December 2019

Role of age and comorbidities in mortality of patients with infective endocarditis.

Authors:
Carlos Armiñanzas Concepción Fariñas-Alvarez Jesús Zarauza Patricia Muñoz Víctor González Ramallo Manuel Martínez Sellés José Mª Miró Meda Juan Manuel Pericás Miguel Ángel Goenaga Guillermo Ojeda Burgos Regino Rodríguez Álvarez Laura Castelo Corral Juan Gálvez-Acebal Francisco Javier Martínez Marcos Maria Carmen Fariñas Fernando Fernández Sánchez Mariam Noureddine Gabriel Rosas Javier de la Torre Lima José Aramendi Elena Bereciartua María José Blanco Roberto Blanco María Victoria Boado Marta Campaña Lázaro Alejandro Crespo Josune Goikoetxea José Ramón Iruretagoyena Josu Irurzun Zuazabal Leire López-Soria Miguel Montejo Javier Nieto David Rodrigo David Rodríguez Regino Rodríguez Yolanda Vitoria Roberto Voces Mª Victoria García López Radka Ivanova Georgieva Guillermo Ojeda Isabel Rodríguez Bailón Josefa Ruiz Morales Ana María Cuende Tomás Echeverría Ana Fuerte Eduardo Gaminde Miguel Ángel Goenaga Pedro Idígoras José Antonio Iribarren Alberto Izaguirre Yarza Xabier Kortajarena Urkola Carlos Reviejo Rafael Carrasco Vicente Climent Patricio Llamas Esperanza Merino Joaquín Plazas Sergio Reus Nemesio Álvarez José María Bravo-Ferrer Laura Castelo José Cuenca Pedro Llinares Enrique Miguez Rey María Rodríguez Mayo Efrén Sánchez Dolores Sousa Regueiro Francisco Javier Martínez Mª Del Mar Alonso Beatriz Castro Dácil García Rosado Mª Del Carmen Durán Mª Antonia Miguel Gómez Juan Lacalzada Ibrahim Nassar Antonio Plata Ciezar José Mª Reguera Iglesias Víctor Asensi Álvarez Carlos Costas Jesús de la Hera Jonnathan Fernández Suárez Lisardo Iglesias Fraile Víctor León Arguero José López Menéndez Pilar Mencia Bajo Carlos Morales Alfonso Moreno Torrico Carmen Palomo Begoña Paya Martínez Ángeles Rodríguez Esteban Raquel Rodríguez García Mauricio Telenti Asensio Manuel Almela Juan Ambrosioni Manuel Azqueta Mercè Brunet Marta Bodro Ramón Cartañá Carlos Falces Guillermina Fita David Fuster Cristina García de la Mària Marta Hernández-Meneses Jaume Llopis Pérez Francesc Marco José M Miró Asunción Moreno David Nicolás Salvador Ninot Eduardo Quintana Carlos Paré Daniel Pereda Juan M Pericás José L Pomar José Ramírez Irene Rovira Elena Sandoval Marta Sitges Dolors Soy Adrián Téllez José M Tolosana Bárbara Vidal Jordi Vila Iván Adán Javier Bermejo Emilio Bouza Daniel Celemín Gregorio Cuerpo Caballero Antonia Delgado Montero Ana Fernández Cruz Ana García Mansilla Mª Eugenia García Leoni Víctor González Ramallo Martha Kestler Hernández Amaia Mari Hualde Mercedes Marín Manuel Martínez-Sellés Mª Cruz Menárguez Patricia Muñoz Cristina Rincón Hugo Rodríguez-Abella Marta Rodríguez-Créixems Blanca Pinilla Ángel Pinto Maricela Valerio Pilar Vázquez Eduardo Verde Moreno Isabel Antorrena Belén Loeches Alejandro Martín Quirós Mar Moreno Ulises Ramírez Verónica Rial Bastón María Romero Araceli Saldaña Jesús Agüero Balbín Cristina Amado Carlos Armiñanzas Castillo Ana Arnaiz García Manuel Cobo Belaustegui María Carmen Fariñas Concepción Fariñas-Álvarez Rubén Gómez Izquierdo Iván García Claudia González-Rico Manuel Gutiérrez-Cuadra José Gutiérrez Díez Marcos Pajarón José Antonio Parra Aurelio Sarralde Ramón Teira Jesús Zarauza Fernando Domínguez Pablo García Pavía Jesús González Beatriz Orden Antonio Ramos Tomasa Centella José Manuel Hermida José Luis Moya Pilar Martín-Dávila Enrique Navas Enrique Oliva Alejandro Del Río Soledad Ruiz Carmen Hidalgo Tenorio Manuel Almendro Delia Omar Araji José Miguel Barquero Román Calvo Jambrina Marina de Cueto Juan Gálvez Acebal Irene Méndez Isabel Morales Luis Eduardo López-Cortés Arístides de Alarcón Emilio García Juan Luis Haro José Antonio Lepe Francisco López Rafael Luque Luis Javier Alonso Pedro Azcárate José Manuel Azcona Gutiérrez José Ramón Blanco Lara García-Álvarez José Antonio Oteo Mercedes Sanz Natividad de Benito Mercé Gurguí Cristina Pacho Roser Pericas Guillem Pons M Álvarez A L Fernández Amparo Martínez A Prieto Benito Regueiro E Tijeira Marino Vega Andrés Canut Blasco José Cordo Mollar Juan Carlos Gainzarain Arana Oscar García Uriarte Alejandro Martín López Zuriñe Ortiz de Zárate José Antonio Urturi Matos Gloria García Domínguez Antonio Sánchez-Porto José Mª Arribas Leal Elisa García Vázquez Alicia Hernández Torres Ana Blázquez Gonzalo de la Morena Valenzuela Ángel Alonso Javier Aramburu Felicitas Elena Calvo Anai Moreno Rodríguez Paola Tarabini-Castellani Eva Heredero Gálvez Carolina Maicas Bellido José Largo Pau Mª Antonia Sepúlveda Pilar Toledano Sierra Sadaf Zafar Iqbal-Mirza Eva Cascales Alcolea Pilar Egea Serrano José Joaquín Hernández Roca Ivan Keituqwa Yañez Ana Peláez Ballesta Víctor Soriano Eduardo Moreno Escobar Alejandro Peña Monje Valme Sánchez Cabrera David Vinuesa García María Arrizabalaga Asenjo Carmen Cifuentes Luna Juana Núñez Morcillo Mª Cruz Pérez Seco Aroa Villoslada Gelabert Carmen Aured Guallar Nuria Fernández Abad Pilar García Mangas Marta Matamala Adell Mª Pilar Palacián Ruiz Juan Carlos Porres Begoña Alcaraz Vidal Nazaret Cobos Trigueros María Jesús Del Amor Espín José Antonio Giner Caro Roberto Jiménez Sánchez Amaya Jimeno Almazán Alejandro Ortín Freire Monserrat Viqueira González Pere Pericás Ramis Mª Ángels Ribas Blanco Enrique Ruiz de Gopegui Bordes Laura Vidal Bonet Mª Carmen Bellón Munera Elena Escribano Garaizabal Antonia Tercero Martínez Juan Carlos Segura Luque

Eur J Intern Med 2019 Jun 21;64:63-71. Epub 2019 Mar 21.

Complejo Hospitalario Universitario de Albacete Albacete, Spain.

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality.

Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk.

Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32-3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39-1.88),and non-performed surgery (HR:1.64;95% CI:11.16-1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality.

Conclusion: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group.
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http://dx.doi.org/10.1016/j.ejim.2019.03.006DOI Listing
June 2019

Perceval Less Invasive Aortic Replacement Register: multicentric Spanish experience with the Perceval S bioprosthesis in moderate-high-risk aortic surgery.

Interact Cardiovasc Thorac Surg 2018 04;26(4):596-601

Department of Cardiac Surgery, Hospital Germans Trias i Pujol, Badalona, Spain.

Objectives: The development of new percutaneous and surgical techniques has reduced the risk associated with aortic valve replacement procedures. We present the results of a Spanish register after initiating a programme for sutureless prostheses in moderate-high-risk patients.

Methods: This prospective multicentre study was carried out from November 2013 to November 2016. Data were obtained from 448 patients in whom a Perceval S prosthesis was implanted.

Results: The mean age was 79.24 (standard deviation [SD] 4.1) years, and 61.2% were women. The estimated EuroSCORE I log risk was 11.15% (SD 7.6), with an observed mortality of 4.4% (20 patients). Isolated aortic valve replacement was performed on 69.26% of patients, with 64% involving ministernotomy. The incidence of neurological events was 2%, with 2 permanent cerebrovascular accidents, and 41 (9.2%) patients were implanted with a permanent endocavitary pacemaker. At discharge, 12 (2.6%) patients presented minimal periprosthetic leakage, and 4 (0.89%) patients had moderate leakage. There were 3 reinterventions during follow-up (2 endocarditis and 1 dysfunction due to periprosthetic leak progression). The mean gradient at discharge, 6 months and 1 year was 12.94 (SD 5.3) mmHg, 12.19 (SD 4.7) mmHg and 11.77 (SD 4.7) mmHg, respectively; 59.4% of the patients were octogenarians, with a survival rate of 98% at both 6 months and 1 year at discharge. There was neither valve migration nor early structural degeneration. The mean follow-up was 12 ± 3 months. The 6-month and 1-year mortality was 1.4% and 2.1%, respectively.

Conclusions: This is a prospective multicentric study on the largest cohort of patients with sutureless valves conducted in Spain to date. It is a reproducible procedure that has enabled surgery on patients with a moderate-high risk with low morbidity and mortality, providing good haemodynamic results.
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http://dx.doi.org/10.1093/icvts/ivx384DOI Listing
April 2018

Recurrent Cardiac Fibroelastoma. Is It Really a Benign Tumor?

Rev Esp Cardiol (Engl Ed) 2018 Aug 11;71(8):685-687. Epub 2017 Jul 11.

Servicio de Cardiología, Hospital Universitario Madrid Montepríncipe, Boadilla del Monte, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2017.04.031DOI Listing
August 2018

Direct injury to right coronary artery in patients undergoing tricuspid annuloplasty.

Ann Thorac Surg 2014 Apr 14;97(4):1300-5. Epub 2014 Feb 14.

Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.

Background: Direct injury to the right coronary artery as a result of reparative operation on the tricuspid valve is a rare, probably underdiagnosed, but serious complication, which often involves dramatic clinical consequences. So far, only five cases have been described in the literature.

Methods: We describe our single-center experience of this complication, and review and analyze relevant clinical and anatomic considerations related to this entity. Cases previously reported in the literature were also reviewed.

Results: We describe four cases of direct injury to the right coronary artery in patients undergoing tricuspid annuloplasty (DeVega annuloplasty, 3; ring annuloplasty, 1) in our institution since 2005. All patients had right ventricular dilatation and severely dilated tricuspid annulus. Right coronary artery occlusion always occurred between the right marginal artery and the crux of the heart. Patients presented with hemodynamic or electrical instability. Coronary flow could be restored in 2 patients (percutaneously 1; surgically 1), both of whom finally survived, while it was not technically possible in the other 2 (1 died).

Conclusions: Occlusion of the right coronary artery in patients undergoing tricuspid annuloplasty is a rare complication that may occur if great annulus dilatation is present, thus altering both normal annular geometry and the relationship between the right coronary artery and the tricuspid annulus, particularly when DeVega annuloplasty is performed. Such an entity should be considered in the immediate postoperative period in an unstable patient, especially when complementary tests support this diagnosis. Prompt recognition and treatment can positively affect the patient's outcome, most often by means of an emergency revascularization strategy.
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http://dx.doi.org/10.1016/j.athoracsur.2013.12.021DOI Listing
April 2014