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Papers by Fernando Riesgo Gil

International Journal of Cardiology

Heart Failure in Congenital Heart Disease:, 2010

Page 1. 59 RE Shaddy (ed.), Heart Failure in Congenital Heart Disease, DOI: 10.1007/978-1-84996-4... more Page 1. 59 RE Shaddy (ed.), Heart Failure in Congenital Heart Disease, DOI: 10.1007/978-1-84996-480-7_4, © Springer-Verlag London Limited 2011 Heart Failure in Adults with Congenital Heart Disease Konstantinos Dimopoulos ...

ESC Heart Failure

AimsWe present a single‐centre retrospective experience using oral milrinone in patients with a l... more AimsWe present a single‐centre retrospective experience using oral milrinone in patients with a left ventricular assist device (LVAD) and concurrent refractory right ventricular failure.Methods and resultsAll patients implanted with LVAD between January 2013 and July 2021 from a high‐volume advanced heart failure service were reviewed. Eight patients were initiated on oral milrinone during this period. Oral milrinone was started 1.5 [inter‐quartile range (IQR) 1–2.3] years after LVAD implantation and continued for 1.2 (IQR 0.5–2.8) years. Therapeutic milrinone levels were achieved (232.2 ± 153.4 ng/mL) with 62.4 ± 18% of time within the therapeutic range. Two patients had adverse events (non‐sustained ventricular tachycardia and ventricular fibrillation effectively treated by internal cardioverter defibrillator) but did not require milrinone discontinuation. Four deaths occurred, one after transplant and three from disease progression determined to be unrelated to oral milrinone use...

Interactive CardioVascular and Thoracic Surgery, 2020

OBJECTIVES Left ventricular assist device (LVAD) implantation for end-stage heart failure patient... more OBJECTIVES Left ventricular assist device (LVAD) implantation for end-stage heart failure patients has been on the rise, providing a reliable long-term option. For some LVAD patients, longer term LV unloading leads to recovery; hence, the need for evaluating potential myocardial recovery and weaning eligibility has emerged. METHODS All patients who underwent contemporary LVAD explantation at our institution between 2009 and 2020 were included in the study. Patients in New York Heart Association I, left ventricular ejection fraction >40%, a cardiac index >2.4 l/min and a peak oxygen intake >50% predicted underwent a 4-phase weaning assessment. A minimally invasive approach using a titanium plug was the surgery of choice in the most recent explants. Kaplan–Meier curves were used to estimate the survival at 1 and 5 years. RESULTS Twenty-six patients (17 HeartMate II, 9 HeartWare) underwent LVAD explantation after a median 317 days of support [IQ (212–518)], range 131–1437. Mea...

JACC: Case Reports, 2020

A young man presented with syncope. He was diagnosed with triglyceride deposit cardiomyovasculopa... more A young man presented with syncope. He was diagnosed with triglyceride deposit cardiomyovasculopathy and skeletal myopathy secondary to adipose triglyceride lipase (ATGL) deficiency. Despite optimal medical therapy, he required heart transplantation to treat his heart failure. Five years post-transplant, the graft function was normal with no

Cardiovascular Revascularization Medicine, 2019

Introduction: The Impella family of devices are short-term mechanical circulatory support (MCS) p... more Introduction: The Impella family of devices are short-term mechanical circulatory support (MCS) pumps that hold promise in treating patients with acute cardiogenic shock, acting as bridge to recovery, transplant or durable left ventricular assist device. We assessed the clinical utility, indications and outcomes of the Impella family of devices in a tertiary centre. Methods: In the current study we present our initial 2-year experience with different Impella types. We explored the indications for device implantation, initial hemodynamic and biochemical response and mid-term survival. Results: A total of 57 patients underwent Impella implantation; 36 Impella CP, 14 Impella 5.0 and 7 Impella RP. Mean age was 54.2 ± 15.2 whereas 78.9% were males. The main indications for left sided MCS included cardiogenic shock secondary to ACS, decompensated dilated or ischemic end stage cardiomyopathy and myocarditis. Mean LVEF pre-Impella implantation was 23 ± 13.7%. PCI was performed in 24 (54.5%) patients. Main indication for Impella RP was RV failure following LVAD implantation. The median duration of support was 5 days (IQR 1 to 10.5 days). 24 h following Impella implantation, there was significant improvement in all hemodynamic parameters as well as renal and liver function. Patients presenting with INTERMACS I had a 30-day survival of 40% whereas patients with INTEMACS 2 or above had a 30-day survival of 82.4%. Conclusions: The Impella short-term mechanical assist device provides immediate improvement in hemodynamic parameters and end organ function recovery. Patient outcomes are heavily influenced by the stage of shock and the timely insertion of MCS.

International Journal of Cardiology

Heart Failure in Congenital Heart Disease:, 2010

Page 1. 59 RE Shaddy (ed.), Heart Failure in Congenital Heart Disease, DOI: 10.1007/978-1-84996-4... more Page 1. 59 RE Shaddy (ed.), Heart Failure in Congenital Heart Disease, DOI: 10.1007/978-1-84996-480-7_4, © Springer-Verlag London Limited 2011 Heart Failure in Adults with Congenital Heart Disease Konstantinos Dimopoulos ...

ESC Heart Failure

AimsWe present a single‐centre retrospective experience using oral milrinone in patients with a l... more AimsWe present a single‐centre retrospective experience using oral milrinone in patients with a left ventricular assist device (LVAD) and concurrent refractory right ventricular failure.Methods and resultsAll patients implanted with LVAD between January 2013 and July 2021 from a high‐volume advanced heart failure service were reviewed. Eight patients were initiated on oral milrinone during this period. Oral milrinone was started 1.5 [inter‐quartile range (IQR) 1–2.3] years after LVAD implantation and continued for 1.2 (IQR 0.5–2.8) years. Therapeutic milrinone levels were achieved (232.2 ± 153.4 ng/mL) with 62.4 ± 18% of time within the therapeutic range. Two patients had adverse events (non‐sustained ventricular tachycardia and ventricular fibrillation effectively treated by internal cardioverter defibrillator) but did not require milrinone discontinuation. Four deaths occurred, one after transplant and three from disease progression determined to be unrelated to oral milrinone use...

Interactive CardioVascular and Thoracic Surgery, 2020

OBJECTIVES Left ventricular assist device (LVAD) implantation for end-stage heart failure patient... more OBJECTIVES Left ventricular assist device (LVAD) implantation for end-stage heart failure patients has been on the rise, providing a reliable long-term option. For some LVAD patients, longer term LV unloading leads to recovery; hence, the need for evaluating potential myocardial recovery and weaning eligibility has emerged. METHODS All patients who underwent contemporary LVAD explantation at our institution between 2009 and 2020 were included in the study. Patients in New York Heart Association I, left ventricular ejection fraction >40%, a cardiac index >2.4 l/min and a peak oxygen intake >50% predicted underwent a 4-phase weaning assessment. A minimally invasive approach using a titanium plug was the surgery of choice in the most recent explants. Kaplan–Meier curves were used to estimate the survival at 1 and 5 years. RESULTS Twenty-six patients (17 HeartMate II, 9 HeartWare) underwent LVAD explantation after a median 317 days of support [IQ (212–518)], range 131–1437. Mea...

JACC: Case Reports, 2020

A young man presented with syncope. He was diagnosed with triglyceride deposit cardiomyovasculopa... more A young man presented with syncope. He was diagnosed with triglyceride deposit cardiomyovasculopathy and skeletal myopathy secondary to adipose triglyceride lipase (ATGL) deficiency. Despite optimal medical therapy, he required heart transplantation to treat his heart failure. Five years post-transplant, the graft function was normal with no

Cardiovascular Revascularization Medicine, 2019

Introduction: The Impella family of devices are short-term mechanical circulatory support (MCS) p... more Introduction: The Impella family of devices are short-term mechanical circulatory support (MCS) pumps that hold promise in treating patients with acute cardiogenic shock, acting as bridge to recovery, transplant or durable left ventricular assist device. We assessed the clinical utility, indications and outcomes of the Impella family of devices in a tertiary centre. Methods: In the current study we present our initial 2-year experience with different Impella types. We explored the indications for device implantation, initial hemodynamic and biochemical response and mid-term survival. Results: A total of 57 patients underwent Impella implantation; 36 Impella CP, 14 Impella 5.0 and 7 Impella RP. Mean age was 54.2 ± 15.2 whereas 78.9% were males. The main indications for left sided MCS included cardiogenic shock secondary to ACS, decompensated dilated or ischemic end stage cardiomyopathy and myocarditis. Mean LVEF pre-Impella implantation was 23 ± 13.7%. PCI was performed in 24 (54.5%) patients. Main indication for Impella RP was RV failure following LVAD implantation. The median duration of support was 5 days (IQR 1 to 10.5 days). 24 h following Impella implantation, there was significant improvement in all hemodynamic parameters as well as renal and liver function. Patients presenting with INTERMACS I had a 30-day survival of 40% whereas patients with INTEMACS 2 or above had a 30-day survival of 82.4%. Conclusions: The Impella short-term mechanical assist device provides immediate improvement in hemodynamic parameters and end organ function recovery. Patient outcomes are heavily influenced by the stage of shock and the timely insertion of MCS.