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Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2016;35:627-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1938 "formatos" => array:3 [ "EPUB" => 181 "HTML" => 1343 "PDF" => 414 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Leadless pacemaker: A paradigm change" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "627" "paginaFinal" => "628" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "<span class="elsevierStyleItalic">Pacemaker</span> sem elétrodos: uma mudança no paradigma" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 709 "Ancho" => 710 "Tamanyo" => 59579 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Placing the system against the right ventricular septum and assessing its position with dye.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Nicodemus Lopes, Diogo Cavaco, Pedro Adragão, Pedro Carmo, Francisco Costa, Francisco Morgado" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Nicodemus" "apellidos" => "Lopes" ] 1 => array:2 [ "nombre" => "Diogo" "apellidos" => "Cavaco" ] 2 => array:2 [ "nombre" => "Pedro" "apellidos" => "Adragão" ] 3 => array:2 [ "nombre" => "Pedro" "apellidos" => "Carmo" ] 4 => array:2 [ "nombre" => "Francisco" "apellidos" => "Costa" ] 5 => array:2 [ "nombre" => "Francisco" 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array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 576 "Ancho" => 1614 "Tamanyo" => 136921 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiogram (3-chamber view). (A) Ruptured aneurysm of the anterior mitral valve leaflet. 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after angioplasty of the first septal branch with a drug-eluting balloon and LAD predilation (C), a bioresorbable scaffold was implanted in the mid LAD using the Szabo technique (D and E).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The Szabo technique provides a unique way to accurately position a stent in ostial lesions, avoiding geographic miss and shifting of plaque to non-affected adjacent vessels.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 64-year-old woman with dyslipidemia presented to the emergency department with unstable angina. Coronary angiography showed single-vessel disease, with severe proximal left anterior descending (LAD) artery stenosis and a critical bifurcation lesion of the mid LAD and the first major septal branch (Medina score 1,1,1) (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A and B). The left coronary ostium was cannulated with a 3.5F Extra Back-up<span class="elsevierStyleSup">®</span> guide catheter, two BMW<span class="elsevierStyleSup">®</span> wires were advanced to the LAD and the first septal branch, and the latter was treated with a 2.0 mm×15 mm drug-eluting balloon. After proximal and mid LAD predilation (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C), a 3.5 mm×28 mm Absorb GT1<span class="elsevierStyleSup">®</span> bioresorbable scaffold (BRS) was advanced to the LAD, but deployment was not performed, due to device movement and unstable scaffold position (Video 1). An anchor wire crossed through the proximal BRS trailing strut was advanced to the circumflex (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D, arrow), and the BRS was implanted in the ostial LAD, with a good angiographic result (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>E). Intracoronary optical coherence tomography (OCT) showed optimal strut apposition (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>A) and the small anchoring strut floating in the circumflex ostium, as depicted by the arrow in <a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>B (OCT view from the LAD) and <a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>C (three-dimensional OCT reconstruction view from the LAD).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">To our knowledge, this case reports for the first time the feasibility and safety of the Szabo technique in an ostial lesion with BRS implantation. The use of intracoronary OCT imaging enabled us to ensure and document an excellent result with this technique.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-10-13" "fechaAceptado" => "2015-12-20" "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0060" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary material" "identificador" => "sec0035" ] ] ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1320 "Ancho" => 1501 "Tamanyo" => 312662 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Coronary angiography showing severe disease of the mid left anterior descending (LAD) artery, involving the bifurcation with the first major septal branch (Medina 1,1,1) (A and B); after angioplasty of the first septal branch with a drug-eluting balloon and LAD predilation (C), a bioresorbable scaffold was implanted in the mid LAD using the Szabo technique (D and E).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 849 "Ancho" => 1601 "Tamanyo" => 167280 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Intracoronary optical coherence tomography revealing optimal strut apposition (A) and the small anchoring strut (white arrow) floating in the circumflex ostium; (B) two-dimensional view from the left anterior descending (LAD); (C) three-dimensional reconstruction, view from LAD.</p>" ] ] 2 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 1132355 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003500000011/v1_201611160155/S2174204916302112/v1_201611160155/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003500000011/v1_201611160155/S2174204916302112/v1_201611160155/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302112?idApp=UINPBA00004E" ]
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2019 August | 18 | 5 | 23 |
2019 July | 30 | 8 | 38 |
2019 June | 23 | 13 | 36 |
2019 May | 11 | 10 | 21 |
2019 April | 21 | 21 | 42 |
2019 March | 18 | 10 | 28 |
2019 February | 35 | 11 | 46 |
2019 January | 17 | 6 | 23 |
2018 December | 63 | 11 | 74 |
2018 November | 46 | 5 | 51 |
2018 October | 128 | 13 | 141 |
2018 September | 35 | 9 | 44 |
2018 August | 33 | 7 | 40 |
2018 July | 49 | 9 | 58 |
2018 June | 57 | 12 | 69 |
2018 May | 54 | 8 | 62 |
2018 April | 67 | 10 | 77 |
2018 March | 101 | 16 | 117 |
2018 February | 48 | 5 | 53 |
2018 January | 55 | 4 | 59 |
2017 December | 86 | 2 | 88 |
2017 November | 30 | 7 | 37 |
2017 October | 30 | 7 | 37 |
2017 September | 32 | 14 | 46 |
2017 August | 31 | 19 | 50 |
2017 July | 29 | 14 | 43 |
2017 June | 29 | 5 | 34 |
2017 May | 39 | 4 | 43 |
2017 April | 22 | 5 | 27 |
2017 March | 30 | 16 | 46 |
2017 February | 25 | 16 | 41 |
2017 January | 32 | 6 | 38 |
2016 December | 55 | 19 | 74 |
2016 November | 30 | 13 | 43 |