Browsing by Author "Vargas Serrano, José Francisco"
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- ItemAngioplastía renal por hipertensión severa durante el embarazo, reporte de un caso(2018) Drazic Beni, O.; Zárate Bertoglio, C.; Leiva Madariaga, J.; Vargas Serrano, José Francisco; Mertens Martín, Renato
- ItemConcentración de la cirugía de aneurisma de aorta abdominal roto en centros especializados calificados(2022) Mariné Massa, Leopoldo Ario Fernando; Mertens Martin, Renato Alfonso; Valdés Echenique, José Francisco; Torrealba Fonck, José Ignacio; Bergoeing Reid, Michel Paul; Vargas Serrano, José Francisco; Villarroel, RicardoRuptured abdominal aortic aneurysm (RAAA) is an arterial emergency with an overall mortality of 80%-90% secondary to massive hemorrhage. If a patient with RAAA presents in a primary hospital without resolution capacity, survival will depend on early transfer to a center with adequately trained specialists. This article reviews the evidence supporting the centralization of AAAR treatment in qualified centers, specifying the criteria used for the selection of referral centers and the role of a coordinating unit. Our current referral system, which is based primarily on costs, is also described. Patients with AAAR who consult in non-resolving centers should be rapidly transferred to a qualified referral center, following a transfer protocol, and guided by a coordinating unit acting according to technical and established criteria based on results, quality, and costs. Qualified referral centers should have an accredited vascular surgeon and a high institutional aortic surgery volume, adequate infrastructure, endovascular resolution capacity, support services (intensive care, hemodialysis, etc.) and specialized personnel permanently available.
- ItemCoronary-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 FernandoObjective: 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.
- ItemCorrelación de Valores de TTPa con Anti Factor Xa para establecer rango terapéutico en tratamiento anticoagulante con Heparina Sódica(2014) Mariné M., Leopoldo; Gonzalo, Sánchez; Vargas Serrano, José Francisco; Zúñiga Contreras, Pamela; Aizman, Andrés; Mertens Martín, Renato; Bergoeing Reid, Michel Paul; Muñoz, Blanca
- ItemDolor pélvico crónico secundario a síndrome de congestión pélvica. Resultados del tratamiento endovascular de la insuficiencia venosa pelviana y várices genitales(SOC MEDICA SANTIAGO, 2019) Drazic Beni, Obren Danilo; Zarate Bertoglio, Cristian Fernando; Valdés Echenique, José Francisco; Mertens Martin, Renato Alfonso; Bergoeing Reid, Michel Paul; Kramer Schumacher, Albrecht Helmuth; Marine Massa, Leopoldo Ario Fernando; Vargas Serrano, José FranciscoBackground: Pelvic venous insufficiency may cause pelvic congestion syndrome that is characterized by chronic pelvic pain exacerbated by prolonged standing, sexual activity or menstrual cycle. It may be treated by embolizing the dysfunctional pelvic venous drainage and sometimes resecting vulvar, perineal and thigh varices. Aim: To assess the results of embolization of insufficient pelvic or ovarian veins on pelvic congestion syndrome. Material and Methods: Analysis of 17 female patients aged 32 to 53 years, who underwent subjected to a selective coil embolization of insufficient pelvic and/or ovarian veins through the jugular, basilic or cephalic veins. In the preoperative period, all patients had a lower extremity venous duplex pelvic ultrasound examination and some had an abdominal and pelvic CT angiogram. Results: The technical success of the procedure was 100% and no complications were registered. During a 32 month follow up, no patient had symptoms of pelvic venous insufficiency or relapse of vulvar or thigh varices. Conclusions: Embolization of insufficient pelvic and ovarian veins is a safe and successful procedure for the treatment of pelvic venous insufficiency or vulvar varices.
- ItemEndovascular management of a ruptured Iliac aneurysm with an inferior vena cava fistula(2020) Torrealba Fonck, José Ignacio; Vargas Serrano, José Francisco; Mertens Martín, Renato; Valdés, F. J.; Mariné M., Leopoldo; Bergoeing Reid, Michel Paul
- ItemInsuficiencia mesentérica crónica luego de radioterapia para aórtica(2015) Vargas Serrano, José Francisco; Mertens Martín, Renato; Bergoeing Reid, Michel Paul; Kramer, Albrecht; Mariné M., Leopoldo; Valdés Echeñique, José Francisco
- ItemSurgical Outcomes of Infective Native Aortoiliac Aneurysms in a Chilean Academic Center(ELSEVIER SCIENCE INC, 2024) Gonzalez Urquijo, Mauricio; Mertens Martin, Renato Alfonso; Vargas Serrano, José Francisco; Marine Massa, Leopoldo Ario Fernando; Bergoeing Reid, Michel Paul; Valdes, Francisco; Torrealba Fonck, José IgnacioBackground: Infective native aortic aneurysms (INAAs), formerly called mycotic aneurysms, remain an uncommon disease with significant heterogeneity among cases; hence, there is lack of solid evidence to opt for the best treatment strategy. The present study aims to describe a 20-year experience at a single institution treating this uncommon condition. Methods: Retrospective study of all patients treated for INAA at a single academic hospital in Santiago, Chile, between 2002 and 2022. Clinical characteristics are described, as well as operative outcomes per type of treatment. Nonparametric Mann-Whitney U-test or Kruskal-Wallis tests were performed when appropriate, and results were reported as median and ranges. Survival at given timeframes was determined by a Kaplan-Meier curve, with analysis performed through a Cox regression model. Results: During the study period, 1,798 patients underwent aortic procedures at our center, of which 35 (1.9%) were treated for INAA. Of them, 25 (71.4%) were male. One patient had 2 INAAs. Median age was 69.5 years (range: 34-89 years). Of the 36 INAAs, the most frequent location was the abdominal and thoracic aorta in 20 (55.5%) and 11 (30.5%) cases, respectively, followed by the iliac arteries in 4 (11.1%) cases. One (2.7%) patient presented a thoracoabdominal INAA. Overall, endovascular treatment associated with long-term antibiotics was used in 20 (57.1%) patients: 4 of them underwent hybrid treatment. Fifteen (42.8%) patients underwent direct aortic debridement followed by in situ or extra anatomic revascularization. There was a significant difference in age between both treatment strategies (a median of 76.5 years for endovascular versus a median of 57 years for open, P = 0.011). The median hospital stay was 15 days (range: 2-70 days). The early complications rate (<30 postoperative days) was 20% (n = 7). Early mortality rate (inhospital or before postoperative 30 days) was 14.2% (n = 5). Median follow-up was 33 months (range: 6-216 months). The overall survival rates at 1, 3, and 5 years were 69.9% (standard error [SE] 8.0), 61.7% (SE 9.8), and 50.9% (SE 11.8), respectively. Five-year survival rate of patients undergoing endovascular treatment compared with open approach was 45.9% (SE 15.1) versus 80.0% (SE 17.8), respectively (P = 0.431). There were no significant differences in survival between open and endovascular treatment, hazard ratio 3.58 (confidence interval 95%: 0.185-1.968, SE +/- 0.45 P = 0.454). Conclusions: Patients treated by endovascular approach were older than patients treated by open approach. Even though, the open group had a higher 5-year survival rate than the endovascular group, not statically significance differences were found between treatments.
- ItemTécnica de ligadura subfascial mini-invasiva de venas perforantes de las piernas(2014) Mariné M., Leopoldo; Tapia, R.; Bergoeing Reid, Michel Paul; Mertens Martín, Renato; Vargas Serrano, José Francisco; Valdés Echeñique, José Francisco; Kramer, Albrecht
- ItemTelemedicina en cirugía vascular y endovascular: experiencia en un centro universitario(2022) Morales Palma, Álvaro José; Torrealba Fonck, José Ignacio; Bergoeing Reid, Michel Paul; Mariné M., Leopoldo; Mertens Martin, Renato; Valdés Echeñique, José Francisco; Vargas Serrano, José FranciscoBackground: Telemedicine became a relevant means to provide healthcare without face-to-face medical evaluation during the COVID-19 pandemic. Aim: To describe the effectiveness of telemedicine in vascular surgery. Materials and Methods: Review of medical records of all vascular surgery consultations carried out in a clinical hospital between April and October 2020. The main outcome measured was the resolution of the reason for consultation. Secondary outcomes were the need to request laboratory tests or imaging, the need to evaluate the patient in person, and the need for referral to hospitalization or emergency service. Results: One hundred-six new consultations and their follow-up (remotely or in person) were analyzed. A definitive diagnosis could be reached in 74% of consultations, treatment could be instituted or modified in 69% of them, and the reason for consultation could be resolved in 74% of cases. Laboratory and imaging tests were requested in 36 and 63% of consultations, respectively. Four percent of patients were referred to the emergency department or hospitalization. Conclusions: In the vast majority of consultations, it was possible to achieve a definitive diagnosis, prescribe a treatment and resolve the reason for consultation without the need for a face-to-face medical evaluation.
- ItemThree 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 PaulUterine 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.
- ItemTratamiento híbrido de arteria subclavia derecha aberrante(2013) Vargas Serrano, José Francisco; Mertens Martín, Renato; Sánchez C., Gonzalo; Bergoeing Reid, Michel Paul; Kramer, Albrecht; Mariné M., Leopoldo; Valdés, Francisco E.