Publications by authors named "Vicente J Cogollo"

4 Publications

  • Page 1 of 1

A rare case of large left internal maxillary artery pseudoaneurysm secondary to mandibular fracture: A case report and review of the literature.

Int J Surg Case Rep 2021 Jul 9;84:106072. Epub 2021 Jun 9.

Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA; University of South Florida, Tampa, FL, USA.

Introduction And Importance: Pseudoaneurysms secondary to traumatic vessel wall disruption are a rare but potentially fatal complication after traumatic injury. The majority of the cases are found incidentally.

Case Presentation: An 80-year-old woman was brought into our Level 1 Trauma Center after sustaining a ground-level fall with significant facial swelling. Her imaging revealed an acute traumatic comminuted fracture of the right mandibular condyle and left mandibular ramus. The patient underwent closed maxillomandibular fixation (MMF) to stabilize fractures, and allow the swelling to decrease for definitive fixation. During the definitive procedure, profuse bleeding was encountered. CT angiography evaluation was immediately performed and determined the presence of a left internal maxillary artery pseudoaneurysm which was successfully treated by coil and glue embolization.

Clinical Discussion: This case highlights an unusual presentation of a vascular injury following major traumatic mandibular fracture and its management. Mandibular fractures have been reported in a series of cases to be a risk factor for vascular injuries. When a vascular injury is suspected, or the evaluation is unclear, surgeons should carefully determine the necessity to perform additional studies like CT angiogram. Vascular injuries secondary to mandibular fractures can be fatal if left unrecognized and untreated. Hence adequate recognition and treatment are warranted to avoid prolonged length of stay with bad outcomes.

Conclusion: Optimal management of pseudoaneurysms is achieved by endovascular approach with prior resuscitation and adequate hemodynamic stabilization. Open surgical management is deferred only for those cases where endovascular treatment is not available, or disruption is found intraoperatively.
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http://dx.doi.org/10.1016/j.ijscr.2021.106072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196220PMC
July 2021

Short-term rapid weight loss induced by bariatric surgery improves ventricular ejection fraction in patients with severe obesity and heart failure.

Surg Obes Relat Dis 2021 May 15. Epub 2021 May 15.

Department of General Surgery, Cleveland Clinic, Weston, Florida; The Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida. Electronic address:

Background: Obesity is a major risk factor for the development of metabolic syndrome, coronary artery disease, and heart failure (HF). Rapid weight loss following bariatric surgery can significantly improve outcomes for patients with these diseases.

Objectives: To assess whether bariatric surgery improves ventricular ejection fraction in patients with obesity who have heart failure.

Setting: Private practice, United States.

Methods: We conducted a retrospective review of echocardiographic changes in systolic functions in patients with obesity that underwent bariatric surgery at our institution. Patients were divided into 2 groups, those (1) without known preoperative HF and (2) with preoperative HF. We compared the left ventricular ejection fraction (LVEF) before and after bariatric surgery in both groups. Common demographics and co-morbidities were also analyzed.

Results: A total of 68 patients were included in the analysis: 49 patients in group 1 and 19 in group 2. In group 1, 59.2% (n = 29) of patients were female, versus 57.9% (n = 11) in group 2. The excess body mass index lost at 12 months was 52.06 ± 23.18% for group 1 versus 67.12 ± 19.27% for group 2 (P = .0001). Patients with heart failure showed a significant improvement in LVEF, from 38.79 ± 13.26% before to 48.47 ± 14.57% after bariatric surgery (P = .039). Systolic function in patients from group 1 showed no significant changes (59.90 ± 6.37 mmHg) before and (59.88 ± 7.85 mmHg) after surgery (P = .98).

Conclusion: Rapid weight loss after bariatric surgery is associated with a considerable increase in LVEF and a significant improvement of systolic function.
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http://dx.doi.org/10.1016/j.soard.2021.05.004DOI Listing
May 2021

Left ventricular mass index and ventricular contractility improvement in patients with severe obesity following rapid weight loss after bariatric surgery.

Surg Obes Relat Dis 2021 Jun 6;17(6):1140-1145. Epub 2021 Feb 6.

Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida. Electronic address:

Background: Obesity is a well-known risk factor for heart disease, resulting in a broad spectrum of cardiovascular changes. Left ventricular mass (LVM) and contractility are recognized markers of cardiac function.

Objectives: To determine the changes of LVM and contractility after bariatric surgery (BaS).

Setting: University hospital, United States METHODS: To determine the cardiac changes in ventricular mass, ventricular contractility, and left ventricular shortening fraction (LVSF), we retrospectively reviewed the 2-dimensional echocardiographic parameters of patients with obesity who underwent BaS at our institution. We compared these results before and after BaS.

Results: A total of 40 patients met the inclusion criteria. The majority were females (57.5%; n = 23), with an average age of 63.5 ± 12.1. The excess body mass index (BMI) lost at 12 months was 48.9 ± 28.9%. The percent total weight loss after BaS was 16.46 ± 9.9%. The left ventricular mass was 234.9 ± 88.1 grams before and 181.5 ± 52.7 grams after BaS (P = .002). The LVM index was 101.3 ± 38.3 g/m before versus 86.7 ± 26.6 g/m after BaS (P = .005). The LVSF was 31% ± 8.8% before and 36.3% ± 8.2% after BaS (P = .007). We found a good correlation between the decrease in LVM index and the BMI after BaS (P = .03).

Conclusion: Rapid weight loss results in a decrease of the LVM index, as well as improvement in the left ventricular muscle contractility. Our results suggest that there is left ventricular remodeling and an improvement of heart dynamics following bariatric surgery. Further studies are needed to better assess these findings.
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http://dx.doi.org/10.1016/j.soard.2021.01.040DOI Listing
June 2021

Improvement of glucose metabolism following rapid weight loss after bariatric surgery and its impact on reduction of visceral abdominal fat versus free fat muscle.

Surg Obes Relat Dis 2021 May 2;17(5):933-938. Epub 2021 Feb 2.

Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida. Electronic address:

Background: Body fat distribution is highly associated with metabolic disturbances. Skeletal muscle plays an important role in glucose metabolism, as it serves as an important organ for glucose storage in the form of glycogen. In fact, low muscle mass has been associated with metabolic syndrome, type 2 diabetes (T2D), systemic inflammation, and decreased survival.

Objectives: To compare the relationship between visceral abdominal fat (VAF) and fat free mass (FFM) with the improved glucose metabolism after bariatric surgery.

Setting: University hospital, United States.

Methods: A retrospective review was performed of all patients who underwent bariatric surgery between 2011 and 2017 at a university hospital in the United States. In severely obese patients with T2D, we measured the VAF via abdominal computed tomography scan and we calculated the FFM preoperatively and at a 12-month follow-up. Data collected included baseline demographic characteristics and perioperative parameters, such as treatment for hypertension (HTN) and T2D, body mass index (BMI), glycated hemoglobin (HbA1C), glucose, and lipid profile.

Results: A total of 25 patients met the inclusion criteria. The average age was 52.5 ± 11.6 years. The initial BMI was 41.41 ± 5.7 kg/m and the postoperative BMI was 31.7 ± 6.9 kg/m (P < .0001). The preoperative VAF volume was 184.6 ± 90.2 cm and the postoperative VAF volume was 93.8 ± 46.8 cm at the 12-month follow-up (P < .0001). The preoperative FFM was 55.2 ± 11.4 kg and the postoperative FFM was 49.1 ± 12 kg (P < .072). The preoperative HbA1C was 5.8% ± .9%, which decreased postoperatively to 5.3% ± .4% at the 12-month follow-up (P < .013).

Conclusion: Bariatric surgery has been demonstrated to be an effective treatment modality for severe obesity and T2D. Our results suggest that at 12 months, there is a reduction in VAF and HbA1C without a significant loss of FFM. Further prospective studies are needed to better understand these findings.
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http://dx.doi.org/10.1016/j.soard.2021.01.031DOI Listing
May 2021
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