La sustitución valvular aórtica a través de cirugía de mínimo acceso, una técnica segura en nuestro medio: experiencia de un centro.

The aim of this study was to analyze the results of minimum access surgery in comparison with conventional surgery, especially in relation to post-operative (PO) mortality. This study was retrospective observational study, employing regressions, and bivariate correlations in the statistical analysis. A total of 114 patients over 65 years of age referred to cardiac surgery: 57 subjects in the minimum access group and 57 subjects in the sternotomy group. The main variables of interest were: demographic variables, PO course, mainly mortality, as well as duration of admission to critical care and total admission time. The mean age was 73.11 years, with 52.6% of women and 47.4% of men, and no significant differences between the pre-operative characteristics of either group. Regarding mortality, this was lower in the minimum access group, statistically significant in the analysis using bivariate correlations. Aortic valve replacement using a minimally invasive approach is a safe technique in our environment, despite its necessary learning curve

Unraveling the Etiology of Dilated Cardiomyopathy through Differential miRNA–mRNA Interactome

Dilated cardiomyopathy (DCM) encompasses various acquired or genetic diseases sharing a common phenotype. The understanding of pathogenetic mechanisms and the determination of the functional effects of each etiology may allow for tailoring different therapeutic strategies. MicroRNAs (miRNAs) have emerged as key regulators in cardiovascular diseases, including DCM. However, their specific roles in different DCM etiologies remain elusive. Here, we applied mRNA-seq and miRNA-seq to identify the gene and miRNA signature from myocardial biopsies from four patients with DCM caused by volume overload (VCM) and four with ischemic DCM (ICM). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were used for differentially expressed genes (DEGs). The miRNA–mRNA interactions were identified by Pearson correlation analysis and miRNA target-prediction programs. mRNA-seq and miRNA-seq were validated by qRT-PCR and miRNA–mRNA interactions were validated by luciferase assays. We found 112 mRNAs and five miRNAs dysregulated in VCM vs. ICM. DEGs were positively enriched for pathways related to the extracellular matrix (ECM), mitochondrial respiration, cardiac muscle contraction, and fatty acid metabolism in VCM vs. ICM and negatively enriched for immune-response-related pathways, JAK-STAT, and NF-kappa B signaling. We identified four pairs of negatively correlated miRNA–mRNA: miR-218-5p-DDX6, miR-218-5p-TTC39C, miR-218-5p-SEMA4A, and miR-494-3p-SGMS2. Our study revealed novel miRNA–mRNA interaction networks and signaling pathways for VCM and ICM, providing novel insights into the development of these DCM etiologies

Implantación de válvula tricúspide transcatéter en paciente con disfunción de bioprótesis

Resumen: Se presenta el caso de un paciente al que se le implanta una prótesis transcatéter en posición tricúspide vía vena yugular interna sobre una bioprótesis disfuncionante demostrando que es una alternativa terapéutica válida a la reintervención en esos enfermos de alto riesgo quirúrgico. Abstract: The case is presented of a patient who received an implant with a transcatheter prosthesis in tricuspid position through the internal jugular vein on a dysfunctional bioprosthesis, demonstrating that it is a valid therapeutic alternative to re-operation in these patients with high surgical risk. Palabras clave: Implantación de prótesis transcatéter, Posición tricúspide, Disfunción de bioprótesis, Keywords: Transcatheter prosthesis implantation, Tricuspid position, Bioprosthesis dysfunctio

Efectos de la hemodiluciónnormovolémicacon autodonaciónde bajo volumen sobre algunos parámetros hematológicos en la cirugía cardiovascular con circulación extracorpórea

Introduction and Objectives: Cardiac surgery with extracorporeal circulation is characterized by large perioperative blood loss and multifactorial disorders of coagulation parameters. For these reasons, there is frequent use of allogeneic transfusions. The purpose of this study was to determine the effects of intentional normovolemic hemodilution, with low volume autologous donation, on some hematological parameters in patients undergoing cardiopulmonary bypass. Method: A longitudinal, comparative, prospective study was performed in 27 patients who underwent cardiovascular surgery with cardiopulmonary bypass, subjected to intentional low volume normovolemic hemodilution. The following parameters were studied: the patient's blood volume, bleeding count, hematocrit figures, platelet count, thromboplastin time and INR before and after hemodilution and autotransfusion. Results: A blood volume average extraction of 10.5% for men and 13,12 % for women was found, with a highly significant reduction in hematocrit, and a significant reduction in platelet, although both variables were within normal values, without involvement of the coagulation parameters with hemodilution. After autotransfusion, a highly significant increase in hematocrit and platelet count was found, with significant reduction of thromboplastin time and INR. Conclusions: The low volume normovolemic hemodilution does not produce clinically important changes in the studied hematological parameters, and autotransfusion after cardiopulmonary bypass improves these parameters.Antecedentes y objetivos: La cirugía cardíaca con circulación extracorpórea se caracteriza por grandes pérdidas hemáticas perioperatorias y alteraciones mul Por estas razones es frecuente el empleo de transfusiones alogénicas. El propósito de este trabajo fue determinar los efectos de la hemodilución normovolémica intencional, con autodonación de bajo volumen, sobre algunos parámetros hematológicos en el paciente intervenido con circulación extracorpórea. Método: Estudio longitudinal, comparativo, prospectivo, en 27 pacientes a los que se les realizó cirugía cardiovascular con circulación extracorpórea, sujetos a hemodilución normovolémica intencional de bajo volumen. Se estudiaron parámetros, como: volemia del enfermo, cuantía de la sangría, cifras de hematócrito, conteo de plaquetas, tiempo de tromboplastina e INR, antes y después de la hemodilución y de la autotransfusión. Resultados: Se encontró una extracción promedio de 10,5 % de la volemia para los hombres y 13,12 % para las mujeres, con reducción altamente significativa del hematócrito, y significativa de las plaquetas, aunque ambas variables se mantuvieron dentro de valores normales, sin existir afectación de los parámetros de la coagulación con la hemodilución; luego de la autotransfusión se encontró un incremento altamente significativo del hematócrito y del conteo de plaquetas, con reducción significativa de los tiempos de tromboplastina e INR. Conclusiones: La hemodilución normovolémica de bajo volumen no produce alteraciones clínicas importantes de los parámetros hematológicos estudiados, y la autotransfusión posterior a la derivación cardiopulmonar mejora estos parámetros. Palabras clave: Transfusión de sangre antóloga, hemodilución, cirugía torácic

EFECTOS DE LA HEMODILUCIÓN NORMOVOLÉMICA CON AUTODONACIÓN DE BAJO VOLUMEN SOBRE ALGUNOS PARÁMETROS HEMATOLÓGICOS EN LA CIRUGÍA CARDIOVASCULAR CON CIRCULACIÓN EXTRACORPÓREA / Effects of normovolemic hemodilution with low volume autologous donations on various hematological parameters in cardiovascular surgery with cardiopulmonary bypass

Introduction and Objectives: Cardiac surgery with extracorporeal circulation is characterized by large perioperative blood loss and multifactorial disorders of coagulation parameters. For these reasons, there is frequent use of allogeneic transfusions. The purpose of this study was to determine the effects of intentional normovolemic hemodilution, with low volume autologous donation, on some hematological parameters in patients undergoing cardiopulmonary bypass. Method: A longitudinal, comparative, prospective study was performed in 27 patients who underwent cardiovascular surgery with cardiopulmonary bypass, subjected to intentional low volume normovolemic hemodilution. The following parameters were studied: the patient's blood volume, bleeding count, hematocrit figures, platelet count, thromboplastin time and INR before and after hemodilution and autotransfusion. Results: A blood volume average extraction of 10.5% for men and 13,12 % for women was found, with a highly significant reduction in hematocrit, and a significant reduction in platelet, although both variables were within normal values, without involvement of the coagulation parameters with hemodilution. After autotransfusion, a highly significant increase in hematocrit and platelet count was found, with significant reduction of thromboplastin time and INR. Conclusions: The low volume normovolemic hemodilution does not produce clinically important changes in the studied hematological parameters, and autotransfusion after cardiopulmonary bypass improves these parameters

Monitoring changes in the cellular content of biomolecules during ageing with FTIR spectroscopy

Dietary regimens have proven to promote longevity in several eukaryotic model organisms including the budding yeast Saccharomyces cerevisiae. These interventions are effective strategies for preventing ageing and diseases and many of them are linked to amino acid and protein levels. The aim of this work was to better understand how the age-related TOR1 and SCH9 genes and the presence of amino acids affect cell metabolomes and to establish their impact on the ageing process. Cellular metabolic profiles were determined by FTIR spectroscopy. We demonstrated that metabolic signatures of cells deficient in SCH9, the major TORC1 effector, were very different to those of wild type and TOR1 deficient cells. In cells lacking Sch9 we also observed changes in other processes related to ageing such as endoplasmic reticulum stress and autophagy. We identified several anti-ageing biomarkers being the most relevant the intracellular content of pyruvate, glucose, ribose/deoxyribose associated compounds, and the presence of special protein conformational structures. The very sensitive FTIR technique allowed us to highlight important changes that occur along ageing in the metabolomes of the cells deficient in the key nutrient-sensitive Tor1-Sch9 pathway, even though slight differences on chronological lifespan were detected in our conditions