metricas
covid
Buscar en
Cirugía Cardiovascular
Toda la web
Inicio Cirugía Cardiovascular Sustitución valvular aórtica con bioprótesis convencionales o sin sutura: res...
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Original
Sustitución valvular aórtica con bioprótesis convencionales o sin sutura: resultados clínicos y comportamiento hemodinámico a 3 años
3-year outcomes and hemodynamic performance of sutureless or conventional aortic valve bioprostheses
María A. Giraldo-Molano, Daniel Pérez-Camargo
Autor para correspondencia
Daniel.perezc@gmail.com

Autor para correspondencia.
, Manuel Carnero-Alcázar, Lourdes Montero-Cruces, Paula Campelos-Fernández, Fernando Reguillo-Lacruz, Javier Cobiella-Carnicer, Luis C. Maroto Castellanos
Departamento de Cirugía Cardiaca, Hospital Universitario Clínico San Carlos, Madrid, España
Leído
1063
Veces
se ha leído el artículo
304
Total PDF
759
Total HTML
Compartir estadísticas
 array:23 [
  "pii" => "S113400962200184X"
  "issn" => "11340096"
  "doi" => "10.1016/j.circv.2022.07.007"
  "estado" => "S300"
  "fechaPublicacion" => "2023-05-01"
  "aid" => "714"
  "copyright" => "Sociedad Española de Cirugía Cardiovascular y Endovascular"
  "copyrightAnyo" => "2022"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Cir Cardiov. 2023;30:123-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1134009622002431"
    "issn" => "11340096"
    "doi" => "10.1016/j.circv.2022.11.004"
    "estado" => "S300"
    "fechaPublicacion" => "2023-05-01"
    "aid" => "740"
    "copyright" => "Sociedad Española de Cirugía Cardiovascular y Endovascular"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Cir Cardiov. 2023;30:130-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Mediastinitis en cirug&#237;a card&#237;aca&#46; Tasa cero en diez a&#241;os en centro de referencia para cirug&#237;a card&#237;aca&#46; M&#233;xico"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "130"
          "paginaFinal" => "135"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Mediastinitis in cardiac surgery&#46; Zero rate in ten years in reference center for cardiac surgery&#46; Mexico"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1298
              "Ancho" => 2510
              "Tamanyo" => 124235
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">N&#250;mero de d&#237;as en espera de cirug&#237;a&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Juan M&#46; Tarelo-Saucedo, Edgar Hern&#225;ndez-Rendon, Erik E&#46; Ortega-Romo, Mario Pe&#241;aloza-Guadarrama, Jorge Villela-Caleti, Daniel Molina-Ramirez, Guadalupe D&#46; Rodr&#237;guez-Aquino, Jorge Meza-Carmona, Mariana Aguirre-Varas de Valdez, Jes&#250;s A&#46; Morales-Hern&#225;ndez"
          "autores" => array:10 [
            0 => array:2 [
              "nombre" => "Juan M&#46;"
              "apellidos" => "Tarelo-Saucedo"
            ]
            1 => array:2 [
              "nombre" => "Edgar"
              "apellidos" => "Hern&#225;ndez-Rendon"
            ]
            2 => array:2 [
              "nombre" => "Erik E&#46;"
              "apellidos" => "Ortega-Romo"
            ]
            3 => array:2 [
              "nombre" => "Mario"
              "apellidos" => "Pe&#241;aloza-Guadarrama"
            ]
            4 => array:2 [
              "nombre" => "Jorge"
              "apellidos" => "Villela-Caleti"
            ]
            5 => array:2 [
              "nombre" => "Daniel"
              "apellidos" => "Molina-Ramirez"
            ]
            6 => array:2 [
              "nombre" => "Guadalupe D&#46;"
              "apellidos" => "Rodr&#237;guez-Aquino"
            ]
            7 => array:2 [
              "nombre" => "Jorge"
              "apellidos" => "Meza-Carmona"
            ]
            8 => array:2 [
              "nombre" => "Mariana"
              "apellidos" => "Aguirre-Varas de Valdez"
            ]
            9 => array:2 [
              "nombre" => "Jes&#250;s A&#46;"
              "apellidos" => "Morales-Hern&#225;ndez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134009622002431?idApp=UINPBA00004N"
    "url" => "/11340096/0000003000000003/v1_202306121237/S1134009622002431/v1_202306121237/es/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1134009623000529"
    "issn" => "11340096"
    "doi" => "10.1016/j.circv.2023.04.006"
    "estado" => "S300"
    "fechaPublicacion" => "2023-05-01"
    "aid" => "774"
    "copyright" => "Sociedad Espa&#241;ola de Cirug&#237;a Cardiovascular y Endovascular"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Cir Cardiov. 2023;30:121-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Valvulopat&#237;a mitral cong&#233;nita&#58; &#191;qu&#233; aporta la cirug&#237;a en 2023&#63;"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "121"
          "paginaFinal" => "122"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Mitral congenital valvulopathy&#58; What surgery offers in 2023&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Luz Polo"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Luz"
              "apellidos" => "Polo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134009623000529?idApp=UINPBA00004N"
    "url" => "/11340096/0000003000000003/v1_202306121237/S1134009623000529/v1_202306121237/es/main.assets"
  ]
  "es" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
    "titulo" => "Sustituci&#243;n valvular a&#243;rtica con biopr&#243;tesis convencionales o sin sutura&#58; resultados cl&#237;nicos y comportamiento hemodin&#225;mico a 3 a&#241;os"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "123"
        "paginaFinal" => "129"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Mar&#237;a A&#46; Giraldo-Molano, Daniel P&#233;rez-Camargo, Manuel Carnero-Alc&#225;zar, Lourdes Montero-Cruces, Paula Campelos-Fern&#225;ndez, Fernando Reguillo-Lacruz, Javier Cobiella-Carnicer, Luis C&#46; Maroto Castellanos"
        "autores" => array:8 [
          0 => array:2 [
            "nombre" => "Mar&#237;a A&#46;"
            "apellidos" => "Giraldo-Molano"
          ]
          1 => array:4 [
            "nombre" => "Daniel"
            "apellidos" => "P&#233;rez-Camargo"
            "email" => array:1 [
              0 => "Daniel.perezc@gmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:2 [
            "nombre" => "Manuel"
            "apellidos" => "Carnero-Alc&#225;zar"
          ]
          3 => array:2 [
            "nombre" => "Lourdes"
            "apellidos" => "Montero-Cruces"
          ]
          4 => array:2 [
            "nombre" => "Paula"
            "apellidos" => "Campelos-Fern&#225;ndez"
          ]
          5 => array:2 [
            "nombre" => "Fernando"
            "apellidos" => "Reguillo-Lacruz"
          ]
          6 => array:2 [
            "nombre" => "Javier"
            "apellidos" => "Cobiella-Carnicer"
          ]
          7 => array:2 [
            "nombre" => "Luis C&#46;"
            "apellidos" => "Maroto Castellanos"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Departamento de Cirug&#237;a Cardiaca&#44; Hospital Universitario Cl&#237;nico San Carlos&#44; Madrid&#44; Espa&#241;a"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "3-year outcomes and hemodynamic performance of sutureless or conventional aortic valve bioprostheses"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0035"
        "etiqueta" => "Figura 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1640
            "Ancho" => 2504
            "Tamanyo" => 133771
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Fuga periprot&#233;sica al alta y en el seguimiento&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">Actualmente&#44; la estenosis a&#243;rtica es la patolog&#237;a valvular que con mayor frecuencia requiere una intervenci&#243;n quir&#250;rgica o transcat&#233;ter como parte de su tratamiento&#46; Con el incremento en la esperanza de vida&#44; los pacientes referidos para una intervenci&#243;n valvular a&#243;rtica suelen tener una edad m&#225;s avanzada y m&#250;ltiples comorbilidades asociadas&#46; En consecuencia&#44; en las &#250;ltimas dos d&#233;cadas se ha observado una tendencia al mayor uso de biopr&#243;tesis&#44; abordajes m&#237;nimamente invasivos y t&#233;cnicas transcat&#233;ter<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">1-3</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La cirug&#237;a de sustituci&#243;n valvular a&#243;rtica &#40;SVAo&#41; empleando la biopr&#243;tesis sin sutura &#40;BSS&#41; autoexpandible Perceval S &#40;LivaNova Group&#44; Mil&#225;n&#44; Italia&#41; combina las ventajas de una cirug&#237;a abierta convencional&#44; una resecci&#243;n valvular y decalcificaci&#243;n anular completa&#44; con una disminuci&#243;n significativa de los tiempos quir&#250;rgicos tanto de circulaci&#243;n extracorp&#243;rea como de isquemia&#44; al no requerir sutura&#44; lo cual podr&#237;a ser particularmente beneficioso para el subgrupo poblacional mencionado previamente&#44; al aligerar la carga fisiol&#243;gica de una cirug&#237;a abierta&#46; Hasta el momento&#44; este tipo de pr&#243;tesis han demostrado resultados comparables a las biopr&#243;tesis convencionales &#40;BC&#41;&#46; No obstante&#44; la mayor&#237;a de estudios publicados se limitan a los resultados perioperatorios y al seguimiento a corto plazo&#44; con evidencia escasa a mediano plazo<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">4-7</span></a>&#46; Dadas estas circunstancias&#44; realizamos un estudio con el objetivo de analizar y comparar eventos adversos cardiovasculares mayores y el comportamiento hemodin&#225;mico entre pacientes portadores de BSS y BC a medio plazo&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Dise&#241;o</span><p id="par0015" class="elsevierStylePara elsevierViewall">El presente trabajo es un estudio retrospectivo de pacientes con SVAo por biopr&#243;tesis&#44; con o sin revascularizaci&#243;n concomitante&#46; Los pacientes fueron incluidos seg&#250;n los siguientes criterios&#58; SVAo aislada o SVAo con cirug&#237;a de revascularizaci&#243;n concomitante&#46; Fueron excluidos pacientes con pr&#243;tesis transcat&#233;ter&#44; pacientes con cirug&#237;a cardiaca previa&#44; intervenidos de manera urgente o emergente&#44; y los intervenidos con anterioridad al a&#241;o en que se implant&#243; la primera pr&#243;tesis sin sutura en nuestra instituci&#243;n&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Definiciones</span><p id="par0020" class="elsevierStylePara elsevierViewall">La mortalidad perioperatoria fue definida como muerte por cualquier causa a 30<span class="elsevierStyleHsp" style=""></span>d&#237;as tras la intervenci&#243;n&#44; o durante el ingreso hospitalario&#44; independientemente del tiempo de estancia&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">El infarto de miocardio postoperatorio fue definido como un incremento en troponina<span class="elsevierStyleHsp" style=""></span>T o CK-MB&#44; superior a 5 veces el rango superior de referencia durante las primeras 72<span class="elsevierStyleHsp" style=""></span>horas tras la intervenci&#243;n&#44; esto asociado a cambios electrocardiogr&#225;ficos o ecocardiogr&#225;ficos sugerentes de isquemia&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El ictus postoperatorio fue definido como un d&#233;ficit neurol&#243;gico global o focal&#44; con duraci&#243;n mayor de 24<span class="elsevierStyleHsp" style=""></span>horas o menor de 24<span class="elsevierStyleHsp" style=""></span>horas&#44; en caso de existir evidencia mediante imagen de hemorragia o infarto reciente&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">La estimaci&#243;n del riesgo preoperatorio fue realizada empleando el EuroScore<span class="elsevierStyleHsp" style=""></span>II <span class="elsevierStyleItalic">&#40;European System for Cardiac Operative Risk Evaluation&#41;</span><a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">8</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Recogida de datos</span><p id="par0040" class="elsevierStylePara elsevierViewall">La recogida de las variables perioperatorias se realiz&#243; de manera prospectiva al momento del ingreso y de la intervenci&#243;n&#46; Los datos referentes a la supervivencia fueron obtenidos del registro del Instituto Nacional de Defunciones&#46; Los datos referentes a los eventos adversos&#44; a la clase funcional y al comportamiento hemodin&#225;mico de las pr&#243;tesis en el seguimiento fueron extra&#237;dos de informes cl&#237;nicos de los centros hospitalarios del Servicio Madrile&#241;o de Salud&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Intervenci&#243;n quir&#250;rgica</span><p id="par0045" class="elsevierStylePara elsevierViewall">Todas las intervenciones se realizaron bajo anestesia general y circulaci&#243;n extracorp&#243;rea&#46; El acceso quir&#250;rgico mediante esternotom&#237;a completa o parcial dependi&#243; del tipo de intervenci&#243;n &#40;SVAo aislada o con revascularizaci&#243;n concomitante&#41; y de la preferencia del cirujano&#46; El tipo de pr&#243;tesis implantada fue decidido de manera conjunta entre el paciente&#44; el cirujano y el cardi&#243;logo&#44; tras valorar los riesgos y los beneficios de cada tipo de pr&#243;tesis&#46; La t&#233;cnica de implante ya se ha descrito previamente<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">9&#44;10</span></a>&#46; En los pacientes con cirug&#237;a coronaria concomitante la elecci&#243;n de los injertos &#40;arteria mamaria interna&#44; arteria radial&#44; vena safena&#41; fue realizada seg&#250;n el vaso afectado&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Objetivos</span><p id="par0050" class="elsevierStylePara elsevierViewall">El objetivo primario fue la supervivencia a 3<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; Los objetivos secundarios incluyeron&#58; supervivencia libre de ictus&#44; infarto agudo de miocardio y reintervenci&#243;n valvular a 3<span class="elsevierStyleHsp" style=""></span>a&#241;os&#59; comportamiento hemodin&#225;mico valvular a&#243;rtico basal&#44; al alta y en el seguimiento&#44; y la evoluci&#243;n de la clase funcional basal y en el seguimiento&#46; Los objetivos para determinar la seguridad incluyeron la incidencia en el periodo perioperatorio de muerte&#44; ictus&#44; infarto agudo de miocardio&#44; reintervenci&#243;n por hemorragia o taponamiento cardiaco&#44; fracaso renal con necesidad de terapia de sustituci&#243;n e implante de marcapasos&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">An&#225;lisis estad&#237;stico</span><p id="par0055" class="elsevierStylePara elsevierViewall">Se aplic&#243; un test de normalidad a todas las variables perioperatorias&#46; Las variables continuas fueron expresadas como mediana y rango intercuart&#237;lico&#44; y las categ&#243;ricas&#44; como frecuencia absoluta y relativa&#46; Las comparaciones entre grupos se realizaron utilizando el test de &#967;<span class="elsevierStyleSup">2</span>&#44; test de Fisher y t de Student o Wilcoxon&#44; seg&#250;n el tipo de variable y su distribuci&#243;n&#46; La supervivencia fue estimada mediante el m&#233;todo de Kaplan-Meier&#44; y la comparaci&#243;n entre grupos&#44; con el test de Log-Rank&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Con la finalidad de limitar sesgos&#44; el an&#225;lisis de los eventos se realiz&#243; en una muestra ajustada mediante puntuaci&#243;n de propensi&#243;n<span class="elsevierStyleItalic">&#46;</span> Para dicho ajuste se identificaron variables con distribuci&#243;n desigual entre grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;20&#41;&#44; que posteriormente fueron incluidas en un modelo no saturado para estimar una puntaci&#243;n de propensi&#243;n&#46; Los pacientes fueron apareados en una proporci&#243;n 1&#58;1 con el m&#233;todo de <span class="elsevierStyleItalic">nearest neighbor</span>&#59; el caliper fue seleccionado tras estimar el 0&#44;25 de la desviaci&#243;n est&#225;ndar del logit de la puntaci&#243;n de propensi&#243;n&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Todas las pruebas de contraste de hip&#243;tesis fueron de dos colas&#44; con un nivel de significaci&#243;n estad&#237;stica de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; El an&#225;lisis estad&#237;stico fue realizado con Stata 14 &#40;StataCorp&#44; 2015&#46; College Station&#44; TX&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Consideraciones &#233;ticas</span><p id="par0070" class="elsevierStylePara elsevierViewall">El presente estudio sigue las recomendaciones de la Declaraci&#243;n de Helsinki de la Asociaci&#243;n M&#233;dica Mundial sobre los principios &#233;ticos para las investigaciones m&#233;dicas en seres humanos&#46; Dado el dise&#241;o y la fuente de informaci&#243;n&#44; el estudio se consider&#243; exento de la recogida del consentimiento informado&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Resultados</span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Caracter&#237;sticas de la cohorte</span><p id="par0075" class="elsevierStylePara elsevierViewall">De 2015 a 2021&#44; 624 pacientes fueron intervenidos&#46; Tras el ajuste mediante puntuaci&#243;n de propensi&#243;n&#44; 104 pacientes fueron incluidos en el an&#225;lisis &#40;52<span class="elsevierStyleHsp" style=""></span>BC y 52<span class="elsevierStyleHsp" style=""></span>BSS&#41;&#46; La eficacia del apareamiento mediante puntuaci&#243;n de propensi&#243;n fue analizada con histogramas de la puntuaci&#243;n de propensi&#243;n seg&#250;n el tipo de pr&#243;tesis &#40;BC&#47;BSS&#41;&#44; mediante an&#225;lisis de diferencia estandarizada y comparaci&#243;n de medias&#44; sin observar diferencias significativas en las caracter&#237;sticas preoperatorias de ambos grupos&#46; La mediana de edad fue de 73&#44;65<span class="elsevierStyleHsp" style=""></span>a&#241;os &#40;IQR&#58; 68&#44;58-77&#44;19&#41; y el riesgo de mortalidad perioperatoria estimado mediante EuroScore<span class="elsevierStyleHsp" style=""></span>II fue del 2&#44;11&#37; &#40;IQR&#58; 1&#44;39-3&#44;66&#41;&#46; Las caracter&#237;sticas preoperatorias se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Procedimiento</span><p id="par0080" class="elsevierStylePara elsevierViewall">El acceso por miniesternotom&#237;a se emple&#243; de manera m&#225;s frecuente en pacientes con BSS &#40;25&#37; vs 63&#44;46&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los tiempos de circulaci&#243;n extracorp&#243;rea y de isquemia mioc&#225;rdica fueron significativamente menores en el grupo BSS &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los tama&#241;os de pr&#243;tesis m&#225;s frecuentemente implantados en el grupo BC fueron el 21 y el 23&#44; mientras que en el grupo BSS fue el L&#46; No existieron diferencias respecto a la revascularizaci&#243;n concomitante &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;00&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Evento primario y secundarios</span><p id="par0085" class="elsevierStylePara elsevierViewall">La mediana de seguimiento fue de 2&#44;34<span class="elsevierStyleHsp" style=""></span>a&#241;os &#40;IQR&#58; 1&#44;36-3&#44;41&#41;&#46; A 3<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; no se identificaron diferencias significativas en la supervivencia &#40;92&#44;31&#37; vs 92&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;957&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#44; la supervivencia libre de ictus &#40;100&#37; vs 94&#44;23&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;080&#41;&#44; de infarto agudo de miocardio &#40;100&#37; en ambos grupos&#41; ni de reintervenci&#243;n valvular &#40;100&#37; vs 94&#44;81&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;200&#41; entre BC y BSS&#44; respectivamente &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Respecto al comportamiento hemodin&#225;mico&#44; se observ&#243; un gradiente m&#225;ximo y medio en el momento del alta hospitalaria significativamente mayor para las BSS &#40;Gmax&#58; 19&#44;86<span class="elsevierStyleHsp" style=""></span>mmHg vs 26&#44;02<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#59; Gmed&#58; 10&#44;46<span class="elsevierStyleHsp" style=""></span>mmHg vs 12&#44;95<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;049&#41;&#46; En el seguimiento se observ&#243; una disminuci&#243;n significativa en el gradiente m&#225;ximo a&#243;rtico respecto al medido al alta en el grupo de BSS &#40;26&#44;02<span class="elsevierStyleHsp" style=""></span>mmHg vs 21&#44;55<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;027&#41;&#44; sin diferencias significativas en el gradiente medio&#46; No se observaron diferencias significativas entre grupos &#40;Gmed BSS&#58; 10&#44;7<span class="elsevierStyleHsp" style=""></span>mmHg&#59; Gmed BC&#58; 10&#44;6<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;875&#59; Gmax BSS&#58; 21&#44;0<span class="elsevierStyleHsp" style=""></span>mmHg&#59; Gmax BC&#58; 20&#44;7<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;856&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0025">fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Al alta&#44; ning&#250;n paciente present&#243; fuga periprot&#233;sica moderada o severa y en el seguimiento&#44; y no se observaron diferencias significativas en este evento &#40;0 vs 1&#44;92&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;136&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0035">fig&#46; 4</a>&#41;&#46; Finalmente&#44; se observ&#243; una mejor&#237;a no significativa en la clase funcional en ambos grupos&#44; sin existir diferencias significativas entre portadores de BC y BSS &#40;NYHA<span class="elsevierStyleHsp" style=""></span>I-II&#58; 92&#44;83&#37; vs 100&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;117&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0040">fig&#46; 5</a>&#41;&#46;</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia><elsevierMultimedia ident="fig0040"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Eventos de seguridad</span><p id="par0100" class="elsevierStylePara elsevierViewall">De manera perioperatoria&#44; la incidencia de los eventos de seguridad fue baja y no se identificaron diferencias significativas en la incidencia de muerte&#44; ictus&#44; infarto agudo de miocardio y reintervenci&#243;n por hemorragia o taponamiento&#46; No obstante&#44; la incidencia de implante de marcapasos tras la intervenci&#243;n fue significativamente mayor en pacientes con BSS &#40;1&#44;92&#37; vs 13&#44;46&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;027&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Discusi&#243;n</span><p id="par0105" class="elsevierStylePara elsevierViewall">La evidencia comparativa a medio plazo entre BSS y BC es escasa&#46; A nuestro conocimiento&#44; nuestro estudio es el primero en realizar una comparaci&#243;n a 3<span class="elsevierStyleHsp" style=""></span>a&#241;os de eventos adversos cardiovasculares mayores y comportamiento hemodin&#225;mico entre BSS y BC&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A medio plazo&#44; la supervivencia reportada para portadores de BSS var&#237;a entre el 88&#37; al 70&#37;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">11-13</span></a>&#46; Ensayos cl&#237;nicos aleatorizados y registros prospectivos no han identificado diferencias significativas respecto a las BC&#46; No obstante&#44; Muneretto et al&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">6</span></a> han reportado un beneficio significativo al comparar las BSS con pr&#243;tesis a&#243;rticas transcat&#233;ter en pacientes con riesgo quir&#250;rgico intermedio &#40;STS score 6&#37;&#59; HR&#58; 1&#44;86&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;09-3&#44;16&#41;&#46; En nuestro estudio observamos una supervivencia a 3<span class="elsevierStyleHsp" style=""></span>a&#241;os del 92&#44;1&#37; para BSS&#44; sin diferencias significativas con las BC&#46; Estos resultados se deben principalmente al perfil de pacientes incluidos en el estudio de riesgo quir&#250;rgico bajo &#40;EuroScore<span class="elsevierStyleHsp" style=""></span>II<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>3&#37;&#41; y una mediana de edad de 73<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; De manera similar&#44; en los ensayos cl&#237;nicos PARTNER<span class="elsevierStyleHsp" style=""></span>3 y Evolut Low Risk Trial&#44; que compararon SVAo quir&#250;rgica con pr&#243;tesis a&#243;rticas transcat&#233;ter en pacientes de bajo riesgo&#44; la supervivencia a 2<span class="elsevierStyleHsp" style=""></span>a&#241;os fue superior al 90&#37;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">14&#44;15</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">No se presentaron ictus en el seguimiento en ambos grupos&#46; No obstante&#44; el 5&#44;8&#37; de BSS presentaron un evento en periodo perioperatorio&#46; Como ha sido estudiado previamente&#44; las principales causas de estos eventos se encuentran en relaci&#243;n con la edad y el proceso degenerativo de aterosclerosis&#44; con mayor riesgo de desprendimiento y embolizaci&#243;n de placas ateromatosas durante la intervenci&#243;n<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">16</span></a>&#46; Respecto a la tasa de reintervenci&#243;n valvular&#44; no identificamos diferencias significativas entre BSS y BC &#40;100&#37; vs 94&#44;81&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;200&#41;&#46; En registros publicados previamente&#44; la incidencia de este evento en el seguimiento var&#237;a entre el 1&#44;5&#37; y el 4&#37;&#44; siendo la endocarditis infecciosa y la fuga paravalvular las principales causas de reintervenci&#243;n valvular en dichas series<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">11&#44;13</span></a>&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">En cuanto al comportamiento hemodin&#225;mico a mediano plazo&#44; estudios previos reportan un gradiente medio en BSS entre 9&#44;3 y 11&#44;3<span class="elsevierStyleHsp" style=""></span>mmHg<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">11-13</span></a>&#46; Nuestro estudio report&#243; resultados satisfactorios para ambos grupos &#40;Gmed BSS&#58; 10&#44;7<span class="elsevierStyleHsp" style=""></span>mmHg&#59; Gmed BC&#58; 10&#44;6<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;875&#41;&#44; adem&#225;s de una incidencia baja de fuga paravalvular&#46; Como hallazgo relevante&#44; identificamos una disminuci&#243;n significativa en el gradiente m&#225;ximo en el seguimiento respecto al alta para las BSS&#46; Posibles causas de esta observaci&#243;n podr&#237;an ser el estado hiperdin&#225;mico postoperatorio o la anemia&#44; que&#44; una vez resueltas&#44; provocar&#237;an un descenso en dicho gradiente&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">La incidencia de los eventos de seguridad fue en general baja y en l&#237;nea con lo publicado&#46; No obstante&#44; observamos una incidencia alta de implante de marcapasos postoperatorio para las BSS&#46; Este hallazgo ya ha sido reportado previamente y se ha asociado a una inadecuada selecci&#243;n del tama&#241;o de la pr&#243;tesis&#44; as&#237; como a la t&#233;cnica de implante<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">17-21</span></a>&#46; El presente estudio&#44; al tener un tama&#241;o de muestra limitado&#44; no permite realizar un an&#225;lisis <span class="elsevierStyleItalic">a posteriori</span> con la finalidad de evaluar con m&#225;s detalle esta complicaci&#243;n y su impacto en la supervivencia&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">En resumen&#44; el presente estudio pone en evidencia la similitud que hay entre los resultados a corto y a medio plazo entre la SVAo con BC y BSS en cuanto a supervivencia&#44; eventos cardiovasculares mayores&#44; par&#225;metros hemodin&#225;micos y perfil de seguridad&#46; A su vez&#44; nuestro estudio apoya la evidencia cient&#237;fica respecto al uso y al comportamiento de la BSS disponible hoy en d&#237;a&#46; No obstante&#44; se necesita evidencia de mayor calidad a medio y largo plazo&#46; El ensayo cl&#237;nico PERSIST-AVR &#40;NCT02673697&#41;&#44; que compara BSS versus BC y que ya ha reportado resultados a 1<span class="elsevierStyleHsp" style=""></span>a&#241;o&#44; esclarecer&#225; cuestiones importantes en este tema&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Limitaciones</span><p id="par0135" class="elsevierStylePara elsevierViewall">Se trata de un estudio retrospectivo&#44; unic&#233;ntrico y con una muestra de pacientes limitada&#46; A pesar del uso de t&#233;cnicas estad&#237;sticas para obtener muestras similares&#44; pueden existir sesgos no controlados que influyan nuestros resultados&#44; por lo que estos deben interpretarse con cautela y &#250;nicamente como generadores de hip&#243;tesis&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Conclusi&#243;n</span><p id="par0140" class="elsevierStylePara elsevierViewall">A 3 a&#241;os&#44; la BSS Perceval S se asocia a una supervivencia libre de eventos adversos cardiovasculares mayores similar a la de las BC&#46; El comportamiento hemodin&#225;mico de la BSS es comparable al de las BC a medio plazo&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Conflicto de intereses</span><p id="par0145" class="elsevierStylePara elsevierViewall">Ninguno que declarar&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres1911753"
          "titulo" => "Resumen"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Objetivos"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "M&#233;todos"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Resultados"
            ]
            4 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1651039"
          "titulo" => "Palabras clave"
        ]
        2 => array:3 [
          "identificador" => "xres1911752"
          "titulo" => "Abstract"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Objectives"
            ]
            2 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Methods"
            ]
            3 => array:2 [
              "identificador" => "abst0045"
              "titulo" => "Results"
            ]
            4 => array:2 [
              "identificador" => "abst0050"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1651038"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introducci&#243;n"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "M&#233;todos"
          "secciones" => array:7 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Dise&#241;o"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Definiciones"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Recogida de datos"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Intervenci&#243;n quir&#250;rgica"
            ]
            4 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Objetivos"
            ]
            5 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "An&#225;lisis estad&#237;stico"
            ]
            6 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Consideraciones &#233;ticas"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0050"
          "titulo" => "Resultados"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Caracter&#237;sticas de la cohorte"
            ]
            1 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Procedimiento"
            ]
            2 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Evento primario y secundarios"
            ]
            3 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "Eventos de seguridad"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Discusi&#243;n"
        ]
        8 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Limitaciones"
        ]
        9 => array:2 [
          "identificador" => "sec0085"
          "titulo" => "Conclusi&#243;n"
        ]
        10 => array:2 [
          "identificador" => "sec0090"
          "titulo" => "Conflicto de intereses"
        ]
        11 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2022-06-02"
    "fechaAceptado" => "2022-07-26"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1651039"
          "palabras" => array:4 [
            0 => "Sustituci&#243;n valvular a&#243;rtica"
            1 => "Perceval"
            2 => "Sin sutura"
            3 => "Biopr&#243;tesis"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1651038"
          "palabras" => array:4 [
            0 => "Aortic valve replacement"
            1 => "Perceval"
            2 => "Sutureless"
            3 => "Bioprosthesis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La biopr&#243;tesis autoexpandible sin sutura Perceval S ofrece resultados a un a&#241;o similares a las biopr&#243;tesis convencionales&#46; No obstante&#44; la evidencia a medio plazo a&#250;n es escasa&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Analizar eventos cardiovasculares mayores &#40;muerte&#44; ictus&#44; reintervenci&#243;n valvular&#41; y el comportamiento hemodin&#225;mico a mediano plazo&#44; en una cohorte ajustada de pacientes portadores de una pr&#243;tesis Perceval S y biopr&#243;tesis convencionales&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Revisi&#243;n retrospectiva de una cohorte ajustada 1&#58;1 mediante <span class="elsevierStyleItalic">propensity score</span> de pacientes con sustituci&#243;n valvular a&#243;rtica&#44; con o sin revascularizaci&#243;n mioc&#225;rdica concomitante&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 52 pacientes en cada grupo&#44; sin diferencias significativas en caracter&#237;sticas preoperatorias&#46; A 3<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; no identificamos diferencias significativas en la supervivencia libre de eventos adversos cardiovasculares mayores&#44; ni en el comportamiento hemodin&#225;mico entre biopr&#243;tesis convencionales y sin sutura&#46; Supervivencia&#58; 92&#44;31&#37; vs 92&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;957&#46; Ictus&#58; 100&#37; vs 94&#44;23&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;080&#46; Reintervenci&#243;n valvular&#58; 100&#37; vs 94&#44;81&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;200&#46; Gradiente medio&#58; 10&#44;6<span class="elsevierStyleHsp" style=""></span>mmHg vs 10&#44;7<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;875&#46; Gradiente m&#225;ximo&#58; 20&#44;7<span class="elsevierStyleHsp" style=""></span>mmHg vs 21&#44;0<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;856&#46; Fuga periprot&#233;sica moderada o severa&#58; 0 vs 1&#44;92&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;136&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A 3 a&#241;os&#44; la biopr&#243;tesis Perceval S se asocia a una supervivencia libre de eventos adversos cardiovasculares mayores&#44; similar al de las biopr&#243;tesis convencionales&#46; El comportamiento hemodin&#225;mico de la pr&#243;tesis es similar entre ambos grupos a medio plazo&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objetivos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "M&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">1-year outcomes of the sutureless bioprosthesis Perceval S are similar to conventional bioprostheses&#46; Nevertheless&#44; the mid-term evidence is scarce&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objectives</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Mid-term follow up analysis of major adverse cardiovascular events analysis and hemodynamic performance&#44; after aortic valve replacement with conventional bioprostheses or the Perceval S bioprosthesis in an adjusted cohort&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Retrospective analysis of a 1&#58;1 propensity score matched cohort of patients who underwent aortic valve replacement&#44; with or without concomitant coronary artery bypass grafting&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">52 patients were included in each group&#44; with similar preoperative characteristics&#46; At 3-year follow up&#44; we observed no statistically significant differences in major adverse cardiovascular events nor hemodynamic performance between conventional or sutureless bioprostheses&#46; Survival&#58; 92&#44;31&#37; vs 92&#44;1&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;957&#46; Stroke&#58; 100&#37; vs 94&#44;23&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;080&#46; Valve reintervention&#58; 100&#37; vs 94&#44;81&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;200&#46; Mean gradient&#58; 10&#44;6<span class="elsevierStyleHsp" style=""></span>mmHg vs 10&#44;7<span class="elsevierStyleHsp" style=""></span>mmHg&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;875&#46; Peak gradient&#58; 20&#44;7<span class="elsevierStyleHsp" style=""></span>mmHg vs 21&#44;0<span class="elsevierStyleHsp" style=""></span>mmHg&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;856&#46; Moderate or severe periprosthetic leak&#58; 0 vs 1&#44;92&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;136&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">At 3 years&#44; the Perceval S bioprosthesis presented similar outcomes in major adverse cardiovascular events and hemodynamic performance as conventional bioprosthesis&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objectives"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "multimedia" => array:7 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 880
            "Ancho" => 1258
            "Tamanyo" => 56049
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Supervivencia a 3 a&#241;os estimada mediante el m&#233;todo de Kaplan Meier&#46; L&#237;nea continua&#58; biopr&#243;tesis sin sutura&#59; l&#237;nea punteada&#58; biopr&#243;tesis convencional&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1442
            "Ancho" => 2091
            "Tamanyo" => 113690
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Supervivencia libre de ictus y supervivencia libre de reintervenci&#243;n&#46; L&#237;nea continua&#58; biopr&#243;tesis sin sutura&#59; l&#237;nea punteada&#58; biopr&#243;tesis convencional&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0025"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1664
            "Ancho" => 2504
            "Tamanyo" => 178316
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Comportamiento hemodin&#225;mico basal&#44; al alta y en el seguimiento&#46;Gmax&#58; gradiente m&#225;ximo &#40;mmHg&#41;&#59; Gmed&#58; gradiente medio &#40;mmHg&#41;&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0035"
        "etiqueta" => "Figura 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1640
            "Ancho" => 2504
            "Tamanyo" => 133771
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Fuga periprot&#233;sica al alta y en el seguimiento&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "fig0040"
        "etiqueta" => "Figura 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 1581
            "Ancho" => 2504
            "Tamanyo" => 132874
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Clase funcional previa a la intervenci&#243;n y en el seguimiento&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; ERC&#58; enfermedad renal cr&#243;nica&#59; FEVI&#58; fracci&#243;n de eyecci&#243;n de ventr&#237;culo izquierdo&#59; IAM&#58; infarto agudo de miocardio&#59; NYHA&#58; clase funcional seg&#250;n la <span class="elsevierStyleItalic">New York Heart Association</span>&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biopr&#243;tesis convencional &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biopr&#243;tesis sin sutura &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexo M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;46&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;51&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;556&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad &#40;mediana&#59; IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#44;75 &#40;68&#44;9-77&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#44;42 &#40;68&#44;4-77&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;983&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;28&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;44&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipertensi&#243;n arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;78&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;642&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Obesidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;42&#44;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;34&#44;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;420&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tabaquismo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;190&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ERC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;28&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;23&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;502&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Arteriopat&#237;a perif&#233;rica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;21&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;21&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;11&#44;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;13&#44;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;767&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ictus previo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fibrilaci&#243;n auricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;15&#44;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;17&#44;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;791&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Marcapasos previo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NYHA III-IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;38&#44;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;44&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;550&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IAM previo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;647&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intervenci&#243;n coronaria percut&#225;nea previa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;308&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad coronaria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;26&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;823&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FEVI &#40;mediana&#59; IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#40;60-65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#40;60-65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;975&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Euroscore II &#40;mediana&#59; IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;57 &#40;1&#44;6-3&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;68 &#40;1&#44;2-3&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;696&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas preoperatorias</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">CEC&#58; circulaci&#243;n extracorp&#243;rea&#59; IAM&#58; infarto agudo de miocardio&#59; IOT&#58; intubaci&#243;n orotraqueal&#59; UCI&#58; unidad de cuidados intensivos&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biopr&#243;tesis convencional &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biopr&#243;tesis sin sutura &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Acceso por miniesternotom&#237;a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;63&#44;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">V&#225;lvula a&#243;rtica bic&#250;spide</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;15&#44;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;13&#44;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;780&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tama&#241;o de la pr&#243;tesis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;17&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;19&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;40&#44;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>XL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;23&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;17&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;36&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;36&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tiempo de CEC&#44; min &#40;mediana&#59; IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84 &#40;67-111&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67 &#40;54&#44;3-85&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tiempo de isquemia&#44; min &#40;mediana&#59; IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67 &#40;55-82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&#44;5 &#40;41-60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Revascularizaci&#243;n concomitante</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;19&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#40;19&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tiempo de IOT&#44; horas &#40;mediana&#59; IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;3-13&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;3-7&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;757&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Estancia en UCI&#44; d&#237;as &#40;mediana&#59; IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1-2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1-3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;328&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Estancia hospitalaria&#44; d&#237;as &#40;mediana&#59; IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;5-11&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;3-7&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;140&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Reintervenci&#243;n por hemorragia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;11&#44;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;141&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Taponamiento cardiaco</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;558&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Fibrilaci&#243;n auricular</span> de novo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;26&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;823&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Fracaso renal con necesidad&#58; terapia de sustituci&#243;n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;308&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Implante de marcapasos</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;13&#44;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;027&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Mediastinitis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;315&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">IAM</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Ictus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;079&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Muerte</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;647&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas perioperatorias</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:21 [
            0 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular surgery in Spain in 2019&#46; Interventions registry from the Spanish Society of Cardiovascular Surgery &#40;SECCE&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Cuerpo Caballero"
                            1 => "J&#46; L&#243;pez Men&#233;ndez"
                            2 => "L&#46; Polo L&#243;pez"
                            3 => "T&#46; Centella Hern&#225;ndez"
                            4 => "M&#46; Carnero Alc&#225;zar"
                            5 => "R&#46; Garc&#237;a Fuster"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cir Cardiovasc&#46;"
                        "fecha" => "2021"
                        "volumen" => "28"
                        "paginaInicial" => "162"
                        "paginaFinal" => "176"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Variablity of mechanical or tissue valve implantation in patients undergoing surgical aortic valve replacement in spain&#58; National retrospective analysis from 2007 to 2018"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Carnero-Alc&#225;zar"
                            1 => "E&#46; Rodr&#237;guez-Caulo"
                            2 => "D&#46; Hern&#225;ndez-Vaquero"
                            3 => "L&#46; Montero-Cruces"
                            4 => "D&#46; P&#233;rez-Camargo"
                            5 => "D&#46; Fern&#225;ndez-de Velasco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/jcm10153209"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Med&#46;"
                        "fecha" => "2021"
                        "volumen" => "10"
                        "paginaInicial" => "3209"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34361993"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2021 ESC&#47;EACTS guidelines for the management of valvular heart disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Vahanian"
                            1 => "F&#46; Beyersdorf"
                            2 => "F&#46; Praz"
                            3 => "M&#46; Milojevic"
                            4 => "S&#46; Baldus"
                            5 => "J&#46; Bauersachs"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehab395"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J&#46;"
                        "fecha" => "2022"
                        "volumen" => "43"
                        "paginaInicial" => "561"
                        "paginaFinal" => "632"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34453165"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perceval or trifecta to prevent patient-prosthesis mismatch"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Hernandez-Vaquero"
                            1 => "C&#46; Vigil-Escalera"
                            2 => "Y&#46; Persia"
                            3 => "C&#46; Morales"
                            4 => "I&#46; Pascual"
                            5 => "A&#46; Dom&#237;nguez-Rodr&#237;guez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/jcm9010001"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Med&#46;"
                        "fecha" => "2020"
                        "volumen" => "9"
                        "paginaInicial" => "1"
                        "paginaFinal" => "11"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31861257"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of conventional surgery&#44; transcatheter aortic valve replacement&#44; and sutureless valves in &#171;real-world&#187; patients with aortic stenosis and intermediate- to high-risk profile"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Muneretto"
                            1 => "O&#46; Alfieri"
                            2 => "B&#46;M&#46; Cesana"
                            3 => "G&#46; Bisleri"
                            4 => "M&#46; de Bonis"
                            5 => "R&#46; di Bartolomeo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jtcvs.2015.08.052"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thorac Cardiovasc Surg&#46;"
                        "fecha" => "2015"
                        "volumen" => "150"
                        "paginaInicial" => "1570"
                        "paginaFinal" => "1579"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26384753"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sutureless versus transcatheter aortic valves in elderly patients with aortic stenosis at intermediate risk&#58; A multi-institutional study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Muneretto"
                            1 => "M&#46; Solinas"
                            2 => "T&#46; Folliguet"
                            3 => "R&#46; di Bartolomeo"
                            4 => "A&#46; Repossini"
                            5 => "F&#46; Laborde"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jtcvs.2020.04.179"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thorac Cardiovasc Surg&#46;"
                        "fecha" => "2022"
                        "volumen" => "163"
                        "paginaInicial" => "925"
                        "paginaFinal" => "935&#46;e5"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32727681"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sutureless versus conventional bioprostheses for aortic valve replacement in severe symptomatic aortic valve stenosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Fischlein"
                            1 => "T&#46; Folliguet"
                            2 => "B&#46; Meuris"
                            3 => "M&#46;L&#46; Shrestha"
                            4 => "E&#46;E&#46; Roselli"
                            5 => "A&#46; McGlothlin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jtcvs.2020.11.162"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thorac Cardiovasc Surg&#46;"
                        "fecha" => "2021"
                        "volumen" => "161"
                        "paginaInicial" => "920"
                        "paginaFinal" => "932"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33478837"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Euroscore II"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;A&#46;M&#46; Nashef"
                            1 => "F&#46; Roques"
                            2 => "L&#46;D&#46; Sharples"
                            3 => "J&#46; Nilsson"
                            4 => "C&#46; Smith"
                            5 => "A&#46;R&#46; Goldstone"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ejcts/ezs043"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg&#46;"
                        "fecha" => "2012"
                        "volumen" => "41"
                        "paginaInicial" => "734"
                        "paginaFinal" => "745"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22378855"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A simple modification to lower incidence of heart block with sutureless valve implantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46; Yanagawa"
                            1 => "J&#46; Cruz"
                            2 => "L&#46; Boisvert"
                            3 => "D&#46; Bonneau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Thorac Cardiovasc Surg&#46;"
                        "fecha" => "2016"
                        "volumen" => "152"
                        "paginaInicial" => "630"
                        "paginaFinal" => "632"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Snugger method &#8212; The Oldenburg modification of perceval implantation technique"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Mashhour"
                            1 => "K&#46; Zhigalov"
                            2 => "M&#46; Szczechowicz"
                            3 => "S&#46; Mkalaluh"
                            4 => "J&#46; Easo"
                            5 => "H&#46; Eichstaedt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4330/wjc.v10.i9.119"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Cardiol&#46;"
                        "fecha" => "2018"
                        "volumen" => "10"
                        "paginaInicial" => "119"
                        "paginaFinal" => "122"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30344959"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "European multicentre experience with the sutureless Perceval valve&#58; Clinical and haemodynamic outcomes up to 5 years in over 700 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Shrestha"
                            1 => "T&#46; Fischlein"
                            2 => "B&#46; Meuris"
                            3 => "W&#46; Flameng"
                            4 => "T&#46; Carrel"
                            5 => "F&#46; Madonna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ejcts/ezv040"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg&#46;"
                        "fecha" => "2016"
                        "volumen" => "49"
                        "paginaInicial" => "234"
                        "paginaFinal" => "241"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25750010"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perceval sutureless aortic valve implantation&#58; Midterm outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46; Szecel"
                            1 => "R&#46; Eurlings"
                            2 => "F&#46; Rega"
                            3 => "P&#46; Verbrugghe"
                            4 => "B&#46; Meuris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Thorac Surg&#46;"
                        "fecha" => "2021"
                        "volumen" => "111"
                        "paginaInicial" => "1331"
                        "paginaFinal" => "1337"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mid-term assessment of structural valve deterioration of Perceval S sutureless prosthesis using the last European consensus definition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Mart&#237;nez-Comendador"
                            1 => "F&#46; Estevez-Cid"
                            2 => "M&#46; Gonz&#225;lez Barbeito"
                            3 => "C&#46; Velasco Garc&#237;a de Sierra"
                            4 => "A&#46; Bouzas Mosquera"
                            5 => "C&#46; Barbeito"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/icvts/ivaa299"
                      "Revista" => array:6 [
                        "tituloSerie" => "Interact Cardiovasc Thorac Surg&#46;"
                        "fecha" => "2021"
                        "volumen" => "32"
                        "paginaInicial" => "499"
                        "paginaFinal" => "505"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33881147"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2-year outcomes after transcatheter versus surgical aortic valve replacement in low-risk patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;K&#46; Forrest"
                            1 => "G&#46;M&#46; Deeb"
                            2 => "S&#46;J&#46; Yakubov"
                            3 => "J&#46;D&#46; Rovin"
                            4 => "M&#46; Mumtaz"
                            5 => "H&#46; Gada"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2021.11.062"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol&#46;"
                        "fecha" => "2022"
                        "volumen" => "79"
                        "paginaInicial" => "882"
                        "paginaFinal" => "896"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35241222"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcomes 2 years after transcatheter aortic valve replacement in patients at low surgical risk"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;B&#46; Leon"
                            1 => "M&#46;J&#46; Mack"
                            2 => "R&#46;T&#46; Hahn"
                            3 => "V&#46;H&#46; Thourani"
                            4 => "R&#46; Makkar"
                            5 => "S&#46;K&#46; Kodali"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2020.12.052"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol&#46;"
                        "fecha" => "2021"
                        "volumen" => "77"
                        "paginaInicial" => "1149"
                        "paginaFinal" => "1161"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33663731"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stroke after aortic valve surgery&#58; Results from a prospective cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;R&#46; Mess&#233;"
                            1 => "M&#46;A&#46; Acker"
                            2 => "S&#46;E&#46; Kasner"
                            3 => "M&#46; Fanning"
                            4 => "T&#46; Giovannetti"
                            5 => "S&#46;J&#46; Ratcliffe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Circulation&#46;"
                        "fecha" => "2014"
                        "volumen" => "129"
                        "paginaInicial" => "2253"
                        "paginaFinal" => "2261"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased gradients after aortic valve replacement with the Perceval valve&#58; The role of oversizing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;G&#46; Cerillo"
                            1 => "F&#46; Amoretti"
                            2 => "M&#46; Mariani"
                            3 => "E&#46; Cigala"
                            4 => "M&#46; Murzi"
                            5 => "T&#46; Gasbarri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2017.12.044"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg&#46;"
                        "fecha" => "2018"
                        "volumen" => "106"
                        "paginaInicial" => "121"
                        "paginaFinal" => "128"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29408354"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Current trends of sutureless and rapid deployment valves&#58; An 11-year experience from the Sutureless and Rapid Deployment International Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Berretta"
                            1 => "S&#46; Arzt"
                            2 => "A&#46; Fiore"
                            3 => "T&#46;P&#46; Carrel"
                            4 => "M&#46; Misfeld"
                            5 => "K&#46; Teoh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur J Cardio-thoracic Surg&#46;"
                        "fecha" => "2021"
                        "volumen" => "58"
                        "paginaInicial" => "1054"
                        "paginaFinal" => "1062"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid deployment versus conventional bioprosthetic valve replacement for aortic stenosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Ensminger"
                            1 => "B&#46; Fujita"
                            2 => "T&#46; Bauer"
                            3 => "H&#46; M&#246;llmann"
                            4 => "A&#46; Beckmann"
                            5 => "R&#46; Bekeredjian"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Coll Cardiol&#46;"
                        "fecha" => "2018"
                        "volumen" => "71"
                        "paginaInicial" => "1417"
                        "paginaFinal" => "1428"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A pooled analysis of pacemaker implantation after Perceval sutureless aortic valve replacement"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Moscarelli"
                            1 => "G&#46; Santarpino"
                            2 => "T&#46; Athanasiou"
                            3 => "P&#46; Mastroroberto"
                            4 => "K&#46; Fattouch"
                            5 => "G&#46; Nasso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/icvts/ivab137"
                      "Revista" => array:6 [
                        "tituloSerie" => "Interact Cardiovasc Thorac Surg&#46;"
                        "fecha" => "2021"
                        "volumen" => "33"
                        "paginaInicial" => "501"
                        "paginaFinal" => "509"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34000013"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sutureless aortic valve and pacemaker rate&#58; From surgical tricks to clinical outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Vogt"
                            1 => "M&#46; Moscarelli"
                            2 => "A&#46; Nicoletti"
                            3 => "R&#46; Gregorini"
                            4 => "F&#46; Pollari"
                            5 => "J&#46;M&#46; Kalisnik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2018.12.037"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg&#46;"
                        "fecha" => "2019"
                        "volumen" => "108"
                        "paginaInicial" => "99"
                        "paginaFinal" => "105"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30684479"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/11340096/0000003000000003/v1_202306121237/S113400962200184X/v1_202306121237/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "93312"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/11340096/0000003000000003/v1_202306121237/S113400962200184X/v1_202306121237/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113400962200184X?idApp=UINPBA00004N"
]
Información del artículo
ISSN: 11340096
Idioma original: Español
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 10 2 12
2024 Octubre 88 11 99
2024 Septiembre 55 18 73
2024 Agosto 48 16 64
2024 Julio 58 18 76
2024 Junio 48 15 63
2024 Mayo 61 16 77
2024 Abril 40 13 53
2024 Marzo 27 16 43
2024 Febrero 24 11 35
2024 Enero 37 12 49
2023 Diciembre 19 7 26
2023 Noviembre 22 9 31
2023 Octubre 32 9 41
2023 Septiembre 21 21 42
2023 Agosto 16 19 35
2023 Julio 42 10 52
2023 Junio 51 14 65
2023 Mayo 42 7 49
2023 Abril 18 6 24
2023 Marzo 0 4 4
2023 Febrero 0 5 5
2023 Enero 0 1 1
2022 Diciembre 0 10 10
2022 Noviembre 0 14 14
2022 Octubre 0 20 20
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos