Papers by Guering Eid-lidt
Chest, 2008
Background: Massive angiographic pulmonary embolism (PE) with right ventricular dysfunction (RVD)... more Background: Massive angiographic pulmonary embolism (PE) with right ventricular dysfunction (RVD) is associated with a high early mortality rate. The therapeutic alternatives for this condition include thrombolysis, surgical embolectomy, or percutaneous mechanical thrombectomy (PMT). We describe our experience using PMT in patients with massive PE and RVD with unsuccessful thrombolysis, increased bleeding risk, or major contraindications for thrombolytic therapy. Methods: Clinical, hemodynamic, and angiographic parameters prior to and following PMT were evaluated. Our primary objective was to describe the incidence of in-hospital cardiovascular death, and of major and minor complications. Mid-term outcomes included analysis of occurrence of cardiovascular death, recurrent pulmonary embolism, change of New York Heart Association functional class, and hospital readmission. Results: From July 2004 to May 2007, 69 patients were referred to the cardiac catheterization laboratory with a diagnosis of acute PE, 18 of whom met the criteria for massive PE and are the subject of this study. All patients underwent thrombus fragmentation using a pigtail catheter that was complemented in 13 patients with thrombus aspiration. A percutaneous thrombectomy device (Aspirex; Straub Medical; Wangs, Switzerland) was used in 11 patients. Hemodynamic, angiographic, and blood oxygenation parameters improved after the procedure. A significant increase was observed for systolic systemic BP (74.3 ؎ 7.5 mm Hg vs 89.4 ؎ 11.3 mm Hg, p ؍ 0.001) [mean ؎ SD], as was a decrease in mean pulmonary artery pressure (37.1 ؎ 8.5 mm Hg vs 32.3 ؎ 10.5 mm Hg , p ؍ 0.0001). The in-hospital major complications rate was 11.1%; one patient died from refractory shock, and one patient had intracerebral hemorrhage with minor neurologic sequelae. No cardiovascular deaths or recurrent pulmonary thromboembolism were documented during clinical follow-up (12.3 ؎ 9.4 months). Conclusions: In patients with massive PE, RVD and major contraindications to thrombolytic therapy, increased bleeding risk, failed thrombolysis, or unavailable surgical thrombectomy, PMT appears to be a useful therapeutic alternative.
Revista Española de Cardiologia, 2004
Acta Cardiologica
BACKGROUND The comparative mid and long-term durability, including the rates of bioprosthetic val... more BACKGROUND The comparative mid and long-term durability, including the rates of bioprosthetic valve failure (BVF) of the Sapien XT® and Sapien 3® transcatheter heart valve (THV) in patients with intermediate surgical risk has not been reported. METHODS Consecutive intermediate-risk patients with severe aortic stenosis from the Mexican registry of transcatheter aortic valve replacement (TAVR) with Sapien® THVs were included. The primary endpoint was to compare the BVF rate between THVs at 2 years of follow-up. Secondary endpoints were comparisons of the composite of global mortality, cardiovascular mortality, and neurological events at 30 d and 24 months of follow-up. RESULTS During 2014-2019, 115 (60 Sapien XT® and 55 Sapien 3®) patients met the inclusion criteria in five medical centres. The mean age was 77.3 ± 8.4 years. The average Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) was 5.6 ± 2.9. There was no statistically significant difference between the groups in BVF rate. At 30 d, overall, cardiovascular and non-cardiovascular mortality was 4.3%, 2.6%, and 1.7%, respectively. Neurological events rate was 1.73%. The mean long-term follow-up was 25.3 ± 14.2 months with an overall mortality of 9.56% but lower for the Sapien 3® group (15% vs. 3.6%, p=.037). The only independent predictor of composite mortality and neurological events that occurred in the long term was using a Sapien XT® [OR 1.6, CI 95%, 1.0-24.9; p=.049]. CONCLUSIONS The BVF rate at 25 months of follow-up was similar with the XT and S3 systems. During this follow-up period, the major composite events of death from any cause and neurological events were significantly lower with the S3 system.
Archivos de cardiologia de Mexico, 2003
Peripheral arterial disease comprises those entities that result in obstruction to blood flow in ... more Peripheral arterial disease comprises those entities that result in obstruction to blood flow in the supra-aortic, mesenteric, renal and infrainguinal vessels. This review focuses on the endovascular treatment of extracranial internal carotid obstructive lesions, descending thoracic aorta aneurysms, and reconstruction of the aortoiliac bifurcation. The utilization of carotid artery stenting as a less invasive alternative to the surgical treatment for the extracranial internal carotid artery stenosis has progressively increased. Preliminary reports of carotid stenting with distal protection have shown a favorable reduction in the adverse event rates; but, the advantage of the endovascular approach has to be established in comparative and randomized trials. Transluminal endovascular stent grafting is rapidly emerging as a modality to repair descending thoracic aorta aneurysms. Preliminary experience has demonstrated the feasibility and safety of endovascular stent-graft treatment. How...
Archivos de cardiologia de Mexico, 2010
OBJECTIVE Our main objective was to compare the in-hospital and long-term outcomes of saphenous v... more OBJECTIVE Our main objective was to compare the in-hospital and long-term outcomes of saphenous vein graft stenting and native coronary artery stenting in patients with previous coronary artery bypass grafting. METHODS We studied 127 patients who had prior coronary artery bypass; they were divided in two groups, according to the kind of percutaneous coronary intervention performed. The first group included 49 patients with saphenous vein graft stenting and the second group included 78 patients who underwent native coronary artery stenting. RESULTS There was no significant difference in age, incidence of diabetes, smoking, arterial hypertension, dyslipidemia, left ventricular ejection fraction or in the New York Heart Association functional class between both groups. The incidence of no reflow phenomenon was higher in group 1 (10.2% vs. 1.2%, p = 0.0001). The cumulative incidence of major adverse cardiac events was different between groups at 1 month (10.2% vs. 2.5%, p = 0.041). Ther...
Salud publica de Mexico, 2021
Archivos de cardiologia de Mexico, 2006
When aneurysm of the root of aorta, bicuspid aorta valve and coarctation coexist, surgical repair... more When aneurysm of the root of aorta, bicuspid aorta valve and coarctation coexist, surgical repair involves technical problems. We present the case of a patient in whom initial correction of the coarctation was made by means of interventional treatment, with an impressive and practically immediate resolution of heart failure. In a second intervartional, the aortic root pathology was corrected through the Bentall and de Bono's surgical technique. We present the short- and mid-term results. In addition this case demostrates the little well-know fact, that the patients with bicuspid aorta also have cystic media degeneration of the wall of the aorta.
Revista Portuguesa De Pneumologia, 2005
The use of a synthetic membrane-covered stent has been suggested to overcome some specific lesion... more The use of a synthetic membrane-covered stent has been suggested to overcome some specific lesions in coronary arteries and to solve some potential complications that could arise in any procedure of coronary intervention. A synthetic membrane coronary stent graft (JOSTENT-JOMED) is constituted by a membrane of polytetrafluoroethylene (PTFE), fixed between two thin metallic stents. In this clinical review of our laboratory's experience, the Jostent graft was used in several angiographic circumstances in coronary arteries or in vein grafts. Our clinical experience consists of 17 patients that were treated with placement of PTFE stents for different indications: coronary rupture in two patients; thrombus and degenerative vein grafts in eight patients, coronary aneurysms in four patients, and thrombus in coronary arteries in three more. Our clinical results with this device suggest that its implant is feasible and safe with a clinical success of 100% without complications during in-hospital stay; during the clinical 11 +/- 3 months follow-up, only three patients exhibited major cardiac events. The indication for PTFE stent in vein grafts with degenerative and thrombus lesions has not been determined yet; however, recently, some randomized trials have shown little benefit in this circumstance. On the other side, coronary vessel rupture and coronary aneurysms are currently the most definitive indications.
de endoprótesis en el tratamiento de enfermedad aneurismática fue reportado por primera vez por B... more de endoprótesis en el tratamiento de enfermedad aneurismática fue reportado por primera vez por Balko y cols. En 1991 JC Parodi publicó la primer serie clínica (n=5) de exclusión vía trans
Resumen El stent cubierto con membrana se ha reportadocomo un dispositivo util para corregir lesi... more Resumen El stent cubierto con membrana se ha reportadocomo un dispositivo util para corregir lesionesangiograficas especificas, asi como complicacio-nes potenciales secundarias a procedimientosde intervencionismo coronario. El stent cubiertocon membrana de (Jostent-Jomed) esta com-puesto por una fina capa de politetrafluoroetile-no (PTFE) que se localiza entre dos stents me-talicos. En esta revision retrospectiva el stent dePTFE se utilizo en varias lesiones y situacionesangiograficas tanto en arterias coronarias comoen injertos venosos. Nuestra experiencia consis-tio de 17 pacientes que fueron tratados por dife-rentes indicaciones clinicas y angiograficas: per-foracion coronaria en dos pacientes (pts), injertosvenosos con trombo y cambios degenerativos enocho (pts), aneurismas coronarios en 4 (pts) ytrombo grande refractario a tratamiento habitualen otros 3 casos. Nuestros resultados con el stentde PTFE mostraron una tasa de exito clinico del100% sin complicaciones durante la fase ...
Resumen Cuando coexisten coartacion y aorta bivalvacon aneurisma en la raiz de la aorta, la corre... more Resumen Cuando coexisten coartacion y aorta bivalvacon aneurisma en la raiz de la aorta, la correc-cion quirurgica representa problemas tecnicosimportantes. Presentamos el caso de un pacien-te, al cual se le realizo correccion inicial de lacoartacion por medio de intervencionismo conuna impresionante y practicamente inmediatamejoria de la insuficiencia cardiaca y en un se-gundo tiempo se corrigio la patologia de la raizde aorta por medio de cirugia de Bentall y deBono, los resultados a corto y mediano plazoson presentados. Este caso demuestra ademas,el hecho poco conocido de que los pacientescon Aorta bicuspide tienen tambien degenera-cion quistica de la pared de la aorta. SummaryE XTREME AORTIC COARCTACTION , SEVERE AORTICREGURGITATION AND HEART FAILURE RELIEVEDIMMEDIATELY AFTER STENT AORTOPLASTY , AND COMPLETERESOLUTION THROUGH B ENTAL / DE ONO SURGICAL REPAIR When aneurysm of the root of aorta, bicuspid aortavalve and coarctation coexist, surgical repair in-volves technical probl...
JACC: Cardiovascular Interventions
JACC: Cardiovascular Interventions
Journal of the American College of Cardiology
Catheterization and Cardiovascular Interventions
The COVID‐19 was first described in late 2019 that quickly became a pandemic affecting every heal... more The COVID‐19 was first described in late 2019 that quickly became a pandemic affecting every health system as we know it. The high transmissibility among humans represents a well‐known high burden of morbidity and mortality not only for cardiovascular patients but also for a higher risk between health care professionals that must deliver high‐quality care to them in any scenario, and cardiac catheterization rooms are no exception. This creates a new dilemma, minimize exposure to patients and health care professionals to COVID‐19 while maintaining high quality in cardiovascular therapeutics. In order to achieve this, several international recommendations on treatment algorithms modifications and in safety measures in the catheterization room have been published, always aiming to solve this dilemma in the best possible way. Hereby, we present a summary of the most recent treatment algorithms in the most important cardiovascular interventions (acute coronary syndromes, structural and congenital heart diseases) as well as specific safety measures with a step‐by‐step preparedness before and after any interventional procedure during COVID‐19 outbreak. The objective of this document is to inform and to train health care professionals that works in cardiac catheterization rooms on the risks as well on the plan for containment, mitigation, and response to the global situation of COVID‐19 infection in order to apply this in their own local work environments.
Cardiovascular and Metabolic Science
Journal of the American College of Cardiology
The main complication of transradial access (TRA) is radial artery occlusion (RAO). RAO is clinic... more The main complication of transradial access (TRA) is radial artery occlusion (RAO). RAO is clinically relevant because it limits the radial approach for future coronary interventions and disables this conduit for coronary bypass grafting and arteriovenous fistulas. Strategies to prevent RAO are
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Papers by Guering Eid-lidt