Browsing by Author "González Urquijo, Mauricio"

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Coronary-subclavian steal syndrome: A case series and review of the literature
    (2024) González Urquijo, Mauricio; Valdés Echenique, José Francisco; Bulnes Muzard, Juan Francisco; Torres Álvarez, Josemaría; Vargas Serrano, José Francisco; Bergoeing Reid, Michel Paul; Mertens Martin, Renato Alfonso; Marine Massa, Leopoldo Ario Fernando
    Objective: To report a case series of three patients with symptomatic coronary-subclavian steal syndrome (CSSS) and to review the literature on published case series. Methods: We retrospectively reviewed three cases of CSSS patients treated with open and endovascular surgery at a single center over a period of three decades (1996–2024). A comprehensive review of case series involving more than three patients was also performed. Results: The first patient was a 65-year-old male with a 12-year history of coronary artery bypass grafting (CABG), presenting with unstable angina. Coronary angiography revealed a patent left internal mammary artery (LIMA) graft with retrograde flow through the left subclavian artery (LSA) and occlusion at the LSA ostium. He underwent a successful carotid-subclavian bypass, which significantly improved his symptoms. He died 6 years later from heart failure. The second patient was a 73-year-old woman with a 15-year history of CABG and balloon angioplasty of the grafts. She presented with dyspnea, stable angina, and progressive functional decline. Critical stenosis in the LSA was identified, and her symptoms resolved after successful stent placement. She died 6 years later from progressive heart failure. The third patient was a 75-year-old woman with diabetes, hypertension, and heart failure, who also had a history of CABG. She presented with worsening dyspnea, orthopnea, and edema. Imaging revealed occlusion of the circumflex artery graft and severe LSA stenosis. Successful stenting of the LSA alleviated her symptoms and restored normal blood flow from the LIMA graft. She was discharged after 2 days and remains well at the six-month follow-up. Conclusion: CSSS should be considered in the differential diagnosis of patients with a history of CABG who present with angina or heart failure. Prompt treatment can lead to significant symptom improvement.
  • Thumbnail Image
    Item
    Three Cases of Intracardiac Leiomyomatosis with Very Long-term Follow-up
    (Korean Society for Vascular Surgery, 2024) González Urquijo, Mauricio; Valdés E., Francisco; Mertens Martin, Renato; Mariné M., Leopoldo; Vargas Serrano, José Francisco; Bergoeing Reid, Michel Paul
    Uterine intravascular leiomyomatosis (IVL) with extension into the right heart is uncommon, with no more than 400 cases reported in the literature since 1907. The present study aims to report three patients with intracardiac IVL surgically treated in our institution, with long-term follow-up. Three female patients in their third to fifth decades of life, with a history of difficult hysterectomy due to extensive myomatosis, presented with symptoms of right-sided heart failure. Echocardiography and computed tomography were performed, where IVL extending from the pelvis into the right heart was observed. All three patients underwent a one-stage operation under extracorporeal circulation through a right auriculotomy and inferior vena cavotomy, accessed via a sterno-laparotomy. The tumors were extirpated without complications, with ligation of the vena cava or iliac vein. The patients at 10-, 13-, and 37-year follow-up were well and alive with mild lower extremities symptoms.