Estatísticas

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            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; <span class="elsevierStyleItalic">Trichosporon inkin</span>&#58; Sabouraud glucose agar&#44; 30<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; 7 days&#59; &#40;B&#41; <span class="elsevierStyleItalic">T&#46; inkin</span> arthroconidia and blastoconidia &#40;lactophenol cotton blue 40&#215;&#41;&#59; &#40;C&#41; transesophageal echocardiogram showing a hypermobile mass causing severe obstruction &#40;D and E&#41; at the aortic valve&#59; &#40;E&#41; positron emission tomography fused with computed tomography with a maximum standardized uptake value of 13 showing a vegetation located in the left anterolateral aortic wall&#46;</p>"
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            "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Suggested therapeutic regimen for the management of hypertension&#46;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">31</span></a><span class="elsevierStyleSup">a</span>CKD is defined as eGFR&#60;60 ml&#47;min&#47;1&#46;72 m<span class="elsevierStyleSup">2</span> with or without proteinuria&#59; <span class="elsevierStyleSup">b</span>preferential use of loop diuretics if eGFR&#60;30 ml&#47;min&#47;1&#46;72 m<span class="elsevierStyleSup">2</span>&#44; due to thiazide diuretics or similar being much less effective when eGFR is reduced to these levels&#59; <span class="elsevierStyleSup">c</span>caution&#58; risk of hyperkalemia with spironolactone&#44; especially when eGFR is less than 45 ml&#47;min&#47;1&#46;72 m<span class="elsevierStyleSup">2</span> or when basal kalemia &#8805;4&#46;5 mmol&#47;L&#46; ACEi&#58; angiotensin converting enzyme inhibitor&#59; AMI&#58; acute myocardial infarction&#59; ARB&#58; angiotensin receptor blocker&#59; BP&#58; blood pressure&#59; CCB&#58; calcium channel blocker&#59; CKD&#58; chronic kidney disease&#59; eGFR&#58; estimated glomerular filtration rate&#59; HF&#58; heart failure&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 50-year-old patient with a history of complex congenital heart disease with multiple reoperations including mechanical aortic valve replacement and bioprosthetic pulmonary valve replacement complicated by endocarditis&#44; underwent percutaneous mitral valve &#40;MV&#41; repair &#40;MVR&#41; due to severe symptomatic mitral regurgitation &#40;MR&#41; caused by anterior leaflet prolapse in a dysplastic valve &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#44; panels A and B&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The main difficulty of the procedure was to find adequate echocardiographic views to perform the transeptal puncture and valve grasping&#44; since the usual ones were not feasible given the complexity of the patient&#39;s heart disease&#46; The use of three-dimensional tools in real-time enabled an adequate orientation to guide the transseptal puncture and evaluate the distance from the foramen ovale to the valve plane &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#44; panels C and D&#41;&#46; The catheter guide and mitral grasping were performed from transgastric views &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#44; panels E and F&#41;&#44; which enabled the successful implantation of an NTr MitraClip system &#40;Abbott Laboratories&#44; AbbottPark&#44; IL&#44; USA&#41; with functional and echocardiographic improvement of the MR&#44; leading to a reduction to grade 2 MVR &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#44; panels G and H&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Percutaneous MVR with Mitraclip&#8482; is an alternative to high-risk traditional MV surgery even in patients with congenital MV disease&#46; Mitraclip&#8482; implantation in patients with complex congenital heart disease is unusual and the technique is not clearly standardized&#46; Echocardiographic guidance of transcatheter MVR is especially complex because these patients have undergone multiple cardiac surgeries&#44; have an abnormal cardiac position&#44; anatomical variants and intracardiac devices&#44; leading to a suboptimal echocardiographic window in many cases&#46; This case shows the benefits of alternative echocardiographic views that could be helpful and should be considered in this scenario&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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