Publications by authors named "Miguel Rodríguez Del Río"

7 Publications

  • Page 1 of 1

Transradial Secondary Approach During Transfemoral TAVI: Usefulness of Placing a Wire Before Femoral Puncture for Management and Treatment of Vascular Complications.

Cardiovasc Revasc Med 2021 Feb 3;23:94-99. Epub 2020 Aug 3.

Clinical Cardiology, HM Hospitales-Centro Integral de enfermedades Cardiovasculares HM-CIEC, Madrid, Spain.

Vascular complications during transcatheter aortic valve implantation (TAVI) are relatively common, and some of them related to the transfemoral secondary access. The use of the transradial access (TRA) as an alternative vascular approach for transfemoral TAVI could reduce these complications, however, the treatment of potential vascular peripheral issues from this access has been scarcely described. The advance of a wire from the TRA to the primary transfemoral access at the beginning of the procedure could help the management of eventual vascular complications. A new TRA technique during transfemoral TAVI procedures is described, reporting the results in the first forty-two patients in one center.
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February 2021

Percutaneous Closure of Mitral Paravalvular Leaks Generating Refractory Heart Failure in the Immediate Postoperative Period.

J Invasive Cardiol 2019 Aug;31(8):E259-E260

Unidad de Hemodinámica y Cardiología Intervencionista, HM Hospitales-Hospital Universitario HM Montepríncipe, Avenida de Montepríncipe, 25, 28668 Boadilla del Monte, Madrid, Espaņa.

We present two patients with refractory heart failure due to mitral paravalvular leak (PVL) in whom percutaneous PVL closure was performed in the immediate postoperative period.
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August 2019

Left Bundle Branch Block after Transcatheter Aortic Valve Implantation with Edwards Sapien 3 Valve: Influence of the Valve Depth Implantation.

Cardiovasc Revasc Med 2019 Nov 9;20(11):949-955. Epub 2019 Jan 9.

Clinical Cardiology, Hospital Universitario HM Montepríncipe, Spain.

Objectives: The aim of this study is to determine the relation between the valve depth implantation and the new-onset left bundle branch block (LBBB) in patients treated with transcatheter aortic valve implantation (TAVI) using Edwards Sapien 3 (S3) prosthesis.

Background: LBBB is the most common conduction disturbance after TAVI. The S3 has been associated with a higher incidence of LBBB. A deep valve implant could be related to new-onset LBBB with S3.

Methods: Seventy-six consecutive patients treated with transfemoral TAVI with S3 were included. Electrocardiogram (ECG) registries were recorded at baseline, after the procedure, and before discharge. Valve depth implantation was determined in 40 patients by off-line analysis of the two/three-dimensional transeophageal echocardiogram (TEE) images, with measure of the valve stent percentage under the aortic annulus. Previous and new conduction anomalies were documented; and patient, anatomic and procedural characteristics were retrospectively analyzed.

Results: Complete atrioventricular block (AVB) incidence was 2.9%. LBBB after TAVI appeared in 39% of patients, being transient in almost half of the cases (permanent LBBB rate 20%). Patients with new-onset LBBB after TAVI were older, with a higher STS Score and a wider basal QRS. A deep valve position was associated with new-onset LBBB, with a ROC curve establishing a cut-off point of 34% of depth implant as risk factor for new-onset LBBB (sensitivity and specificity 0.8).

Conclusions: In transfemoral TAVI with S3 prosthesis, a higher valve implantation (<34% of valve stent introduced into the ventricle) may minimize the new-onset LBBB, especially in old and high-risk patients with a wide basal QRS.
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November 2019

Electrocardiographic changes and conduction disturbances after transfemoral aortic valve implantation with Edwards Sapien 3 prosthesis.

J Electrocardiol 2018 May - Jun;51(3):416-421. Epub 2018 Feb 20.

Clinical Cardiology Department, Hospital Universitario HM Montepríncipe, Madrid, Spain.

Objectives: The aim of this study is to describe electrocardiographic changes and conduction abnormalities in patients undergoing transcatheter aortic valve implantation (TAVI).

Methods: 76 patients who underwent TAVI using Edwards Sapien 3 prosthesis were included, comparing electrocardiographic registries at admission, post-procedure and before discharge.

Results: Patients after TAVI presented a longer PR interval, a wider QRS, and a longer corrected QT, with a left deviation of QRS axis and T waves; reversible changes that tended to correct in the following days after TAVI. Complete atrioventricular block incidence was 2.9%. New-onset left bundle branch block (LBBB) incidence was 39%, although solved in almost half of patients before discharge.

Conclusions: TAVI was associated with different reversible electrocardiographic changes that suggest a transient impact on the conduction system. One of every five patients presented permanent LBBB after valve implant.
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March 2019

Outcomes of patients at estimated low surgical risk undergoing transcatheter aortic valve implantation with balloon-expandable prostheses.

Cardiovasc Revasc Med 2018 04 30;19(3 Pt A):251-256. Epub 2017 Aug 30.

Cardiology, Hospital Universitario Madrid Montepríncipe.

Introduction And Objectives: Transcatheter aortic-valve implantation (TAVI) is an accepted treatment for patients with severe aortic stenosis and high surgical risk. However, there is lack in data about TAVI in low-risk patients that are already being treated with this therapy in some clinical contexts.

Methods: A retrospective analysis of patients treated with transfemoral TAVI using Edwards Sapien prosthesis in one center was performed, classifying the patients into three groups according to the surgical risk (high/intermediate/low risk for STS score>8/4-8/<4). Clinical characteristics, procedure and follow-up outcomes were collected, comparing the results between low and high surgical risk groups.

Results: 89 TAVIs using Edwards balloon expandable prosthesis were performed (9 Sapien XT and 80 Sapien 3 valves were implanted). 40 patients (45%) presented a STS score<4, while 33 (37%) had a STS>8. Low-risk patients were significantly younger and had lower rates of coronary artery disease, peripheral vascular disease, pulmonary lung disease and atrial fibrillation. There were no significant differences in most of the technical variables of the procedure, apart from vascular complications and complete left bundle branch block after valve implant, which were higher in the group with STS>8. Patients of low risk presented shorter hospital stay (2,91±1,6, vs 4,8±3,9 days), with lower rates of mortality at mid- and long follow-up (death from any cause 15,2% vs 0%, p 0,04).

Conclusions: TAVI in low-risk patients is safe and associated with better outcome at mid and long-term follow-up compared to high-risk patients.
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April 2018

Percutaneous closure of a giant coronary artery fistula after surgical pericardiectomy. Review of the literature.

Cardiovasc Revasc Med 2017 Jul - Aug;18(5):384-389. Epub 2017 Mar 9.

Anesthesiology, Hospital Universitario Madrid Montepríncipe, Madrid, Spain.

Coronary artery fistulae (CAF) are uncommon heart defects defined as a communication between a coronary artery and a cardiac chamber or vascular structure. They are frequently asymptomatic; nevertheless, they can produce angina, dyspnea or cardiac failure. CAF are believed to be congenital; however, isolated cases of CAF have been described as rare complications of cardiac surgery. We report the percutaneous closure of a giant CAF in an adult patient with angina and previous pericardiectomy.
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May 2018

Transcatheter Aortic Valve Implantation in Patients With Arterial Peripheral Vascular Disease.

Rev Esp Cardiol (Engl Ed) 2017 06 22;70(6):510-512. Epub 2016 Nov 22.

Servicio de Cardiología, Hospital Universitario Madrid Montepríncipe, Madrid, Spain.

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June 2017