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"subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2017;36:319-20" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1609 "formatos" => array:3 [ "EPUB" => 127 "HTML" => 1188 "PDF" => 294 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Left-sided endocarditis extending to the right chambers: Usefulness of three-dimensional echocardiography in preoperative assessment" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "319" "paginaFinal" => "320" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Endocardite esquerda com extensão direita: utilidade da ecocardiografia tridimensional na avaliação pré-operatória" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1417 "Ancho" => 1883 "Tamanyo" => 261091 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography in mid-esophageal view: (A) two-dimensional transesophageal echocardiography (2D-TEE) showing a cavity between the aortic prosthesis and the right atrium RA corresponding to a PA, which communicates with the RA (blue arrow) and with the RV through the base of the TSL (yellow arrow); (B) three-dimensional transesophageal echocardiography (3D-TEE), showing the PA from the RA in the middle of the image, the aortic prosthesis on the left, the superior vena cava on the right, the interatrial septum at the top and the TSL at the bottom; (C) 2D-TEE showing turbulent flow from the PA to the RA 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PA: pseudoaneurysm; RA: right atrium; RV: right ventricle; TSL: tricuspid septal leaflet.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Zorba Blázquez Bermejo, Teresa López Fernández, Ulises Ramírez Valdiris, Juan Caro Codón, Inés Ponz de Antonio, Sandra Rosillo Rodríguez, José María Mesa García, Mar Moreno Yangüela" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Zorba" "apellidos" => "Blázquez Bermejo" ] 1 => array:2 [ "nombre" => "Teresa" "apellidos" => "López Fernández" ] 2 => array:2 [ "nombre" => "Ulises" "apellidos" => "Ramírez Valdiris" ] 3 => array:2 [ "nombre" => "Juan" "apellidos" => "Caro Codón" ] 4 => array:2 [ "nombre" => "Inés" "apellidos" => "Ponz de Antonio" ] 5 => array:2 [ "nombre" => "Sandra" "apellidos" => "Rosillo Rodríguez" ] 6 => array:2 [ "nombre" => "José María" "apellidos" => "Mesa García" ] 7 => array:2 [ "nombre" => "Mar" "apellidos" => "Moreno Yangüela" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917300995?idApp=UINPBA00004E" "url" => "/21742049/0000003600000004/v1_201704230025/S2174204917300995/v1_201704230025/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Warm hands but cold feet" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "321" "paginaFinal" => "322" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carina Arantes, Jorge Marques, Sílvia Ribeiro, Catarina Quina-Rodrigues, Glória Abreu, Sérgia Rocha" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Carina" "apellidos" => "Arantes" "email" => array:1 [ 0 => "arantescarina@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Jorge" "apellidos" => "Marques" ] 2 => array:2 [ "nombre" => "Sílvia" "apellidos" => "Ribeiro" ] 3 => array:2 [ "nombre" => "Catarina" "apellidos" => "Quina-Rodrigues" ] 4 => array:2 [ "nombre" => "Glória" "apellidos" => "Abreu" ] 5 => array:2 [ "nombre" => "Sérgia" "apellidos" => "Rocha" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Hospital de Braga, Braga, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Mãos quentes… pés frios…" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 793 "Ancho" => 2333 "Tamanyo" => 132942 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Left heart catheterization: (A) radial access made impossible due to the tortuosity of the subclavian artery, which prevented passage of the guidewire; (B) contrast-guided puncture of the left femoral artery; (C) catheterization by femoral access revealing a mobile thread-like structure (arrow), consistent with a thrombus.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0145" class="elsevierStylePara elsevierViewall">A 77-year-old woman with a history of hypertension, angioplasty of the anterior descending coronary artery, ischemic stroke, rheumatic mitral stenosis and atrial fibrillation, underwent gynecological surgery. Her warfarin therapy had been changed to enoxaparin, but at hospital discharge her international normalized ratio was below therapeutic levels, and so warfarin was restarted in addition to enoxaparin at prophylactic doses.</p><p id="par0150" class="elsevierStylePara elsevierViewall">Two weeks after the procedure, she was admitted to the emergency department with chest discomfort. She was hypotensive and showed signs of peripheral hypoperfusion. The electrocardiogram revealed atrial fibrillation with complete atrioventricular block and ST-segment elevation in the inferior leads.</p><p id="par0155" class="elsevierStylePara elsevierViewall">She was scheduled for primary angioplasty, which could not be performed by a radial approach due to the tortuosity of the subclavian artery (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A) and femoral access was hampered by absence of a pulse, and so a contrast-guided puncture was performed (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B and C). The external iliac artery was found to be occluded, but was passed using a hydrophilic guidewire. The mid segment of the right coronary artery was occluded by a thrombus (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>A), which was removed by thrombectomy (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall">After reperfusion, signs of hypoperfusion persisted in the patient's lower limbs. In view of this finding, together with difficulty in femoral access, aortography was performed, which revealed thrombotic occlusion of the infrarenal abdominal aorta, extending to the iliac arteries (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>). The echocardiogram showed a mass in the left atrium, consistent with a thrombus (<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>). Thromboembolectomy of the left iliac axis and femoro-femoral bypass were performed, but the patient developed multiple organ failure and died.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0165" class="elsevierStylePara elsevierViewall">This case illustrates a cardioembolic catastrophe with both coronary and systemic embolization and highlights the importance of appropriate perioperative anticoagulation.</p><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation.</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0135" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0140" 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" => "sec0065" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0070" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0075" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0080" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-04-10" "fechaAceptado" => "2016-04-19" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Arantes C, Marques J, Ribeiro S, Quina-Rodrigues C, Abreu G, Rocha S. Mãos quentes… pés frios…. Rev Port Cardiol. 2017;36:321–322.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 793 "Ancho" => 2333 "Tamanyo" => 132942 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Left heart catheterization: (A) radial access made impossible due to the tortuosity of the subclavian artery, which prevented passage of the guidewire; (B) contrast-guided puncture of the left femoral artery; (C) catheterization by femoral access revealing a mobile thread-like structure (arrow), consistent with a thrombus.</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" => 1038 "Ancho" => 2085 "Tamanyo" => 132308 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Right coronary angiography: (A) occlusion of the mid segment of the right coronary artery; (B) reperfusion following aspiration of the thrombus.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1228 "Ancho" => 1250 "Tamanyo" => 91197 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Aortography: occlusion of the abdominal aorta by a large thrombus (arrow).</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1168 "Ancho" => 1500 "Tamanyo" => 80908 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiography, apical 4-chamber view, showing a hyperechoic and extremely mobile image (arrow) in the left atrium, consistent with a thrombus.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003600000004/v1_201704230025/S2174204917300533/v1_201704230025/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/21742049/0000003600000004/v1_201704230025/S2174204917300533/v1_201704230025/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917300533?idApp=UINPBA00004E" ]
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