Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 22
Filtrar
1.
J Card Surg ; 34(7): 591-597, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31111565

RESUMEN

BACKGROUND AND AIM OF STUDY: The treatment of inoperable patients with concomitant complex coronary artery disease and severe aortic stenosis unsuitable for conventional transcatheter aortic valve replacement (TAVR) poses a significant challenge. Effective treatment is even more difficult in those patients with complex coronary anatomy unamenable to percutaneous revascularization. Our manuscript aims to enlighten clinicians on the management of this complex patient. METHODS: We conducted a contemporary review of the literature of combined off-pump coronary artery bypass grafting and transaortic TAVR in this patient population and describe our own successful experience in an inoperable patient with a porcelain aorta. RESULTS: Including our report, 17 cases have been described in the literature. All patients had multiple comorbidities with elevated STS (range, 2.6-25; 6%) and EuroScore I (range, 13.7-83; 7%) and were not considered candidates for conventional CABG and SAVR. Most had severe, complex, multivessel CAD deemed unsuitable for PCI and structural findings precluding them from other standard percutaneous or alternative TAVR approaches (transfemoral/subclavian/transcaval/transapical). Out of the 17 cases, 5 (29%) had porcelain aortas. Most reports specify the decision-making process is driven by a multidisciplinary team. CONCLUSION: This report demonstrates that hybrid off-pump CABG surgery and transaortic TAVR can be successfully performed in high-risk patients with porcelain aortas who are not candidates for percutaneous methods, on-pump revascularization, transfemoral, subclavian, or transcaval valve implantations. It also highlights that careful study of the CTA scan could predict adequate access for a transaortic approach even in the presence of porcelain aorta in selected patients.


Asunto(s)
Variación Anatómica , Estenosis de la Válvula Aórtica/cirugía , Puente de Arteria Coronaria Off-Pump/métodos , Enfermedad de la Arteria Coronaria/cirugía , Vasos Coronarios/anatomía & histología , Arteria Femoral/patología , Reemplazo de la Válvula Aórtica Transcatéter/métodos , Anciano de 80 o más Años , Aorta Abdominal/patología , Calcinosis , Humanos , Masculino , Intervención Coronaria Percutánea/métodos , Riesgo , Índice de Severidad de la Enfermedad
2.
Heart ; 104(10): 828-834, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29352008

RESUMEN

OBJECTIVE: We aimed to analyse the incidence of prosthesis-patient mismatch (PPM) and elevated gradients after aortic valve in valve (ViV), and to evaluate predictors and associations with clinical outcomes of this adverse event. METHODS: A total of 910 aortic ViV patients were investigated. Elevated residual gradients were defined as ≥20 mm Hg. PPM was identified based on the indexed effective orifice area (EOA), measured by echocardiography, and patient body mass index (BMI). Moderate and severe PPM (cases) were defined by European Association of Cardiovascular Imaging (EACVI) criteria and compared with patients without PPM (controls). RESULTS: Moderate or greater PPM was found in 61% of the patients, and severe in 24.6%. Elevated residual gradients were found in 27.9%. Independent risk factors for the occurrence of lower indexed EOA and therefore severe PPM were higher gradients of the failed bioprosthesis at baseline (unstandardised beta -0.023; 95% CI -0.032 to -0.014; P<0.001), a stented (vs a stentless) surgical bioprosthesis (unstandardised beta -0.11; 95% CI -0.161 to -0.071; P<0.001), higher BMI (unstandardised beta -0.01; 95% CI -0.013 to -0.007; P<0.001) and implantation of a SAPIEN/SAPIEN XT/SAPIEN 3 transcatheter device (unstandardised beta -0.064; 95% CI -0.095 to -0.032; P<0.001). Neither severe PPM nor elevated gradients had an association with VARC II-defined outcomes or 1-year survival (90.9% severe vs 91.5% moderate vs 89.3% none, P=0.44). CONCLUSIONS: Severe PPM and elevated gradients after aortic ViV are very common but were not associated with short-term survival and clinical outcomes. The long-term effect of poor post-ViV haemodynamics on clinical outcomes requires further evaluation.


Asunto(s)
Estenosis de la Válvula Aórtica , Válvula Aórtica , Bioprótesis/efectos adversos , Prótesis Valvulares Cardíacas/efectos adversos , Hemodinámica , Complicaciones Posoperatorias , Reoperación , Reemplazo de la Válvula Aórtica Transcatéter , Anciano , Anciano de 80 o más Años , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/fisiopatología , Estenosis de la Válvula Aórtica/fisiopatología , Estenosis de la Válvula Aórtica/cirugía , Índice de Masa Corporal , Ecocardiografía/métodos , Femenino , Humanos , Incidencia , Masculino , Evaluación de Resultado en la Atención de Salud , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/cirugía , Valor Predictivo de las Pruebas , Diseño de Prótesis , Falla de Prótesis , Reoperación/instrumentación , Reoperación/métodos , Medición de Riesgo , Factores de Riesgo , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Reemplazo de la Válvula Aórtica Transcatéter/métodos
3.
J Geriatr Cardiol ; 12(5): 465-9, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26512235
6.
J Electrocardiol ; 48(1): 1-7, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25283739

RESUMEN

IMPORTANCE: AliveCor ECG is an FDA approved ambulatory cardiac rhythm monitor that records a single channel (lead I) ECG rhythm strip using an iPhone. In the past few years, the use of smartphones and tablets with health related applications has significantly proliferated. OBJECTIVE: In this initial feasibility trial, we attempted to reproduce the 12 lead ECG using the bipolar arrangement of the AliveCor monitor coupled to smart phone technology. METHODS: We used the AliveCor heart monitor coupled with an iPhone cellular phone and the AliveECG application (APP) in 5 individuals. RESULTS: In our 5 individuals, recordings from both a standard 12 lead ECG and the AliveCor generated 12 lead ECG had the same interpretation. CONCLUSIONS: This study demonstrates the feasibility of creating a 12 lead ECG with a smart phone. The validity of the recordings would seem to suggest that this technology could become an important useful tool for clinical use. This new hand held smart phone 12 lead ECG recorder needs further development and validation.


Asunto(s)
Arritmias Cardíacas/diagnóstico , Diagnóstico por Computador/métodos , Electroencefalografía/métodos , Aplicaciones Móviles , Teléfono Inteligente , Adulto , Anciano , Algoritmos , Estudios de Factibilidad , Femenino , Humanos , Persona de Mediana Edad , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Interfaz Usuario-Computador , Adulto Joven
7.
Curr Heart Fail Rep ; 12(2): 150-7, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25488281

RESUMEN

Most cardiovascular implantable electronic devices (CIEDs) require a ventricular lead to be placed across the tricuspid valve. Tricuspid regurgitation (TR) is an understudied clinical complication of right ventricular lead implantation and its clinical significance is unknown. We review the incidence, predictors, and current management of TR as a complication of ventricular lead implantation. Emerging technologies, including leadless pacing devices and subcutaneous systems, offer the benefit of little or none tricuspid valve disruption.


Asunto(s)
Terapia de Resincronización Cardíaca/efectos adversos , Desfibriladores Implantables/efectos adversos , Marcapaso Artificial/efectos adversos , Insuficiencia de la Válvula Tricúspide/etiología , Humanos
10.
Crit Pathw Cardiol ; 13(2): 49-54, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24827880

RESUMEN

We identified all patients with age 21 years and older, without a history of obstructive coronary artery disease, who presented to the emergency department with chest pain, and were admitted for cardiac observation followed by stress echocardiography during a 1-year period. The positive predictive value of stress echocardiography and cardiovascular outcomes were compared based on patients' Diamond chest pain classification. In patients with typical chest pain, who accounted for 8.7% (44/503) of the total cohort, the positive predictive value of stress echocardiography was 75% compared with 0% for all other subgroups (P = 0.007). Six patients (14%) with typical chest pain went on to have coronary revascularization compared with 0% for all other subgroups (P < 0.001). No patient in any subgroup died or was readmitted with a myocardial infarction in 30 days. Applying the Diamond criteria could improve utilization of stress echocardiography for patients with low-risk chest pain in the emergency department.


Asunto(s)
Dolor en el Pecho/diagnóstico por imagen , Ecocardiografía de Estrés/estadística & datos numéricos , Ecocardiografía de Estrés/normas , Servicio de Urgencia en Hospital/normas , Isquemia Miocárdica/diagnóstico , Adulto , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Adulto Joven
12.
Congenit Heart Dis ; 9(3): 221-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-23947935

RESUMEN

BACKGROUND: Atrial tachyarrhythmias (AT) including atrial fibrillation (AF), atrial flutter (AFL), and atrial tachycardia represent a clinical challenge in the adult with congenital heart disease (CHD). Dofetilide (D) is a rapidly activating delayed rectifier potassium channel (IKr) blocker effective in pharmacological conversion and maintenance of normal sinus rhythm in patients with AF and AFL. There is limited knowledge regarding the role of D in adults with CHD. METHODS: Safety and efficacy of D was evaluated in a consecutive group of thirteen adult patients (age 40 ± 11; six women) with CHD and refractory AT. RESULTS: Ten patients had persistent (four AFL, one AF, and five atrial tachycardia) and three paroxysmal (one AF and two atrial tachycardia) AT. All patients were symptomatic during tachycardia, 12 patients had previously failed 2 ± 1 antiarrhythmic drugs. Mean systemic ventricular ejection fraction was 55 ± 9%; baseline QRS complex duration was 129 ± 45 ms (>120 ms in six patients). Patients were followed on D for 33 ± 39 months (median 16). Among 10 patients with persistent AT, seven patients (70%) pharmacologically converted to sinus rhythm on D and three patients (30%) required direct current cardioversion. Two patients (15.4%) experienced complete arrhythmia suppression, and seven (53.8%) experienced significant clinical improvement with sporadic recurrences; average time to recurrence was 5.5 ± 3.5 months. One patient developed torsade de pointes during loading, and the drug was discontinued. D was discontinued in five (38.5%) other patients due to recurrence of AT (n = 4) and renal failure (n = 1). Corrected QT interval (QTc) increased from 452 ± 61 to 480 ± 49 ms (P = .04) and corrected JT interval (JTc) from 323 ± 39 to 341 ± 33 ms (P = .09). CONCLUSIONS: D should be considered a pharmacologic alternative when adult patients with CHD develop AT. D does not depress conduction, sinus node, or ventricular function but needs close monitoring for potential ventricular pro-arrhythmia.


Asunto(s)
Antiarrítmicos/uso terapéutico , Fibrilación Atrial/tratamiento farmacológico , Aleteo Atrial/tratamiento farmacológico , Cardiopatías Congénitas/complicaciones , Fenetilaminas/uso terapéutico , Bloqueadores de los Canales de Potasio/uso terapéutico , Sulfonamidas/uso terapéutico , Taquicardia Supraventricular/tratamiento farmacológico , Adulto , Factores de Edad , Antiarrítmicos/efectos adversos , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/etiología , Fibrilación Atrial/fisiopatología , Aleteo Atrial/diagnóstico , Aleteo Atrial/etiología , Aleteo Atrial/fisiopatología , Femenino , Cardiopatías Congénitas/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Fenetilaminas/efectos adversos , Bloqueadores de los Canales de Potasio/efectos adversos , Recurrencia , Sulfonamidas/efectos adversos , Taquicardia Supraventricular/diagnóstico , Taquicardia Supraventricular/etiología , Taquicardia Supraventricular/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
13.
Rare Tumors ; 5(3): e46, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24179658

RESUMEN

Epithelioid angiomyolipomas (EAMLs) are rare mesenchymal tumors whose malignant variant is extremely uncommon and highly aggressive. Treatment strategies include chemo radiation, transcatheter arterial embolization and surgical resection, which has remained the mainstay treatment. Targeted therapies including mammalian target of rapamycin (mTOR) inhibitors such as Temsirolimus may offer some hope for progressive malignant EAMLs that are not amenable to other treatment modalities. We report a fatal case in a young female who presented with rapidly progressive metastatic EAML that did not respond to mTOR therapy. The literature has shown reduction in tumor burden with the use of mTOR inhibitors, but unfortunately due to the rarity of malignant EAML, a meaningful approach to treatment remains challenging.

15.
J Interv Card Electrophysiol ; 38(3): 197-202, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24022757

RESUMEN

PURPOSE: Cardiac rhythm management devices (CRMD) require a ventricular lead to be placed across the tricuspid valve. Tricuspid regurgitation (TR) is an under-recognized clinical complication of lead implantation and its clinical significance is unknown. We studied the incidence of hospitalizations for congestive heart failure (CHF) exacerbation among patients with worsening TR after ventricular lead implantation. METHODS: We reviewed 148 patients (age 68 ± 15) that received a CRMD. TR and pulmonary artery systolic pressure (PASP) measured by Doppler echocardiography before and after CRMD implantation were analyzed. Hospitalizations for CHF exacerbation post-implantation were counted. RESULTS: Follow-up was 32 ± 14 months. Ninety-nine (67%) patients had no change, 24 (16%) slight, and 9 (6%) significant increase in TR after CRMD implantation, while 13 (9%) patients had slight and 3 (2%) significant improvement. Patients with a significant increase in TR had higher incidence of hospitalizations (1.7 ± 0.5) compared to patients with slight (0.8 ± 1; p = 0.006) or no increase (0.5 ± 1; p = 0.0002) in TR. Patients with significant increase in TR had a greater change in PASP (25 mmHg; p = 0.002) after device implantation compared to those with a slight (10 mmHg; p = 0.002) or no increase (0.7 mmHg; p = 0.17). CONCLUSION: Increased TR following CRMD implantation is relatively common (33%) and correlated with subsequent risk of hospitalization for heart failure. A preventive strategy and close monitoring for development or worsening of CHF after CRMD implantation may help prevent hospital admissions.


Asunto(s)
Estimulación Cardíaca Artificial/estadística & datos numéricos , Electrodos Implantados/estadística & datos numéricos , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/prevención & control , Complicaciones Posoperatorias/epidemiología , Insuficiencia de la Válvula Tricúspide/epidemiología , Anciano , Estimulación Cardíaca Artificial/efectos adversos , Comorbilidad , Electrodos Implantados/efectos adversos , Femenino , Insuficiencia Cardíaca/diagnóstico , Ventrículos Cardíacos/cirugía , Hospitalización , Humanos , Masculino , Pennsylvania/epidemiología , Prevalencia , Pronóstico , Reproducibilidad de los Resultados , Estudios Retrospectivos , Factores de Riesgo , Sensibilidad y Especificidad , Insuficiencia de la Válvula Tricúspide/diagnóstico , Insuficiencia de la Válvula Tricúspide/etiología
16.
Tex Heart Inst J ; 40(3): 331-8, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23914034

RESUMEN

Isolated left ventricular noncompaction is a rare form of cardiomyopathy characterized by prominent left ventricular trabeculations and intertrabecular recesses. The typical clinical manifestations are severe systolic and diastolic dysfunction, conduction abnormalities, and cardiac embolic events theorized to result from thrombus formation within the intertrabecular recesses. Evidence-based recommendations for preventing thromboembolic events in isolated left ventricular noncompaction have not been established. We report the case of a woman who, at 10 years of age, had been diagnosed with hypertrophic cardiomyopathy without systolic dysfunction. At age 30, she presented with left hemiparesis consequent to a large right-hemispheric ischemic stroke, and she was diagnosed with isolated left ventricular noncompaction. In addition to discussing the patient's case, we review the medical literature that pertains to isolated left ventricular noncompaction.


Asunto(s)
Embolia Intracraneal/etiología , No Compactación Aislada del Miocardio Ventricular/complicaciones , Accidente Cerebrovascular/etiología , Adulto , Anticoagulantes/uso terapéutico , Angiografía Cerebral/métodos , Ecocardiografía Doppler en Color , Femenino , Humanos , Embolia Intracraneal/diagnóstico , Embolia Intracraneal/tratamiento farmacológico , No Compactación Aislada del Miocardio Ventricular/diagnóstico , No Compactación Aislada del Miocardio Ventricular/tratamiento farmacológico , Paresia/etiología , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Warfarina/uso terapéutico
17.
J Invasive Cardiol ; 25(7): E159-62, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23813076

RESUMEN

Spontaneous coronary artery dissection (SCAD) is an uncommon condition with a variety of clinical presentations. Our knowledge base for SCAD is limited and derives from case reports and retrospective reviews. Several aspects of this disorder, including its rarity, heterogeneity of its presentation, and lack of identification during initial assessment, propose obstacles to reliably secure an accurate diagnosis and consequently we believe that the incidence of this disorder is likely underestimated in the literature. We present a case series of 5 patients with SCAD who exhibit features of this disorder that pose diagnostic challenges and outline the aspects of their history, presentation, and work-up. We propose that this condition is more than rare and may be underestimated; improved awareness of this disorder and associated trends might improve a clinician's index of suspicion and lead to a better diagnostic approach. Case reports and reviews remain vital to our understanding of this disorder and its true prevalence.


Asunto(s)
Anomalías de los Vasos Coronarios/diagnóstico , Anomalías de los Vasos Coronarios/epidemiología , Enfermedades Vasculares/congénito , Adulto , Angiografía Coronaria , Errores Diagnósticos/prevención & control , Electrocardiografía , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Ultrasonografía Intervencional , Enfermedades Vasculares/diagnóstico , Enfermedades Vasculares/epidemiología
19.
J Cardiovasc Electrophysiol ; 23(3): 296-301, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21955243

RESUMEN

BACKGROUND: Patients with an implanted cardioverter defibrillator (ICD) and ventricular arrhythmias leading to ICD therapies have poor clinical outcomes and quality of life. Antiarrhythmic agents and catheter ablation are needed to control these arrhythmias. Dofetilide has only been approved for the treatment of atrial fibrillation. The role of dofetilide in the control of ventricular arrhythmias in patients with an ICD has not been established. OBJECTIVE: Evaluate the safety and efficacy of dofetilide in a consecutive group of patients with an ICD and recurrent ventricular tachycardia (VT) and/ or ventricular fibrillation (VF) after other antiarrhythmic drugs have failed to suppress these arrhythmias. METHODS: We studied 30 patients (age 59 ± 11; 5 women) with symptomatic VT or VF and ICDs for secondary prevention of sudden cardiac death. These patients had an average of 1.8 ± 4.5 episodes of VT/VF per month despite antiarrhymic therapy. Twenty-one patients (70%) had recurrent appropriate ICD therapies prior to initiation of dofetilide, and 9 (30%) VTs below the programmed detection rate of the ICD. Twenty-three patients (77%) had coronary artery disease. Mean ejection fraction was 30 ± 14% and 26/30 (87%) had congestive heart failure. All patients had previously failed 2 ± 1 antiarrhythmic drugs including amiodarone (n = 19) and sotalol (n = 10). RESULTS: During the first month of treatment, 25 patients (83%) had complete suppression of VT/VF and of the 21 patients with ICD therapies 16 (76%) had no therapies during the first month of treatment. During a follow-up period of 32 ± 32 months, dofetilide reduced the monthly episodes of VT/VF from 1.8 ± 4.5 to 1.0 ± 3.5 (P = 0.006). Monthly ICD therapies decreased from 0.9 ± 1.4 to 0.4 ± 1.7 (P = 0.037). In 9 patients that presented with slow VTs under the ICD detection zone, dofetilide reduced monthly VT/VF episodes from 0.7 ± 0.6 to 0.1 ± 0.1 (P = 0.01) and 6 (67%) had no further ICD therapies. Dofetilide was discontinued in 13 patients (43%) after 24 ± 30 months due to failure to control VT/VF (n = 7), placement of a left ventricular assist device (n = 3), catheter ablation (n = 1), heart transplantation (n = 1), and left ventricular restoration surgery (n = 1). There were 7 documented deaths (2 patients died suddenly; 3 patients of progressive heart failure; and 2 of non-cardiac causes). CONCLUSIONS: In patients with an ICD and ventricular arrhythmias, dofetilide decreases the frequency of VT/VF and ICD therapies even when other antiarrhythmic agents, including amiodarone, have previously been ineffective. Recurrences still occur in some patients requiring catheter ablation, mechanical support, or heart transplantation.


Asunto(s)
Antiarrítmicos/uso terapéutico , Desfibriladores Implantables , Fenetilaminas/uso terapéutico , Sulfonamidas/uso terapéutico , Taquicardia Ventricular/tratamiento farmacológico , Fibrilación Ventricular/tratamiento farmacológico , Anciano , Antiarrítmicos/administración & dosificación , Antiarrítmicos/efectos adversos , Cardiomiopatía Dilatada/complicaciones , Enfermedad de la Arteria Coronaria/complicaciones , Muerte Súbita Cardíaca/prevención & control , Relación Dosis-Respuesta a Droga , Cardioversión Eléctrica , Femenino , Estudios de Seguimiento , Insuficiencia Cardíaca/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Fenetilaminas/administración & dosificación , Fenetilaminas/efectos adversos , Recurrencia , Volumen Sistólico/efectos de los fármacos , Volumen Sistólico/fisiología , Sulfonamidas/administración & dosificación , Sulfonamidas/efectos adversos , Taquicardia Ventricular/fisiopatología , Taquicardia Ventricular/terapia , Resultado del Tratamiento , Fibrilación Ventricular/fisiopatología , Fibrilación Ventricular/terapia , Función Ventricular Izquierda/efectos de los fármacos , Función Ventricular Izquierda/fisiología
20.
Arch Cardiol Mex ; 80(4): 289-300, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-21169094

RESUMEN

Cardiac resynchronization therapy (CRT) is an established treatment modality for systolic heart failure. Aimed to produce simultaneous biventricular stimulation and correct the lack of ventricular synchrony in selected patients with congestive heart failure, CRT has shown to improve mortality and reduce hospital admissions when compared to medical treatment. At present, the indication criteria for the implantation of a CRT device include an ejection fraction of less than 35%, heart failure symptoms consistent with NYHA functional class III-IV and a QRS complex duration equal or longer than 120 milliseconds. It has been reported that 30% of patients who meet those criteria still may not derive clinical benefit from CRT. Due to the existing diversity of imagin modalities and resources for their process and analysis, a great expectation in terms of more accurate diagnosis of ventricular dyssynchrony has been raised. Reilable identification of dyssynchrony could allow us to better predict the favorable response of an individual patient to CRT and therefore offer this procedure to those individuals most likely to benefit. We review the available techniques for the study of ventricular dyssynchrony for CRT patient selection and the results of its application in clinical trials. Despite tremendous progress in the imaging technology available for the assessment and diagnosis of ventricular dyssynchrony, an ideal method has not been identified and the duration of QRS complex in the surface ECG remains the accepted criteria of dyssynchrony in the selection of patients for CRT.


Asunto(s)
Terapia de Resincronización Cardíaca , Selección de Paciente , Disfunción Ventricular/terapia , Insuficiencia Cardíaca/complicaciones , Humanos , Ultrasonografía , Disfunción Ventricular/diagnóstico por imagen , Disfunción Ventricular/etiología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA