metricas
covid
Buscar en
Cirugía Cardiovascular
Toda la web
Inicio Cirugía Cardiovascular Tratamiento multimodal en la hipertensión pulmonar residual tras tromboendarter...
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Original
Tratamiento multimodal en la hipertensión pulmonar residual tras tromboendarterectomía pulmonar
Multimodal treatment in residual pulmonary hypertension after pulmonary endarterectomy
María Jesús López-Gudea,
Autor para correspondencia
mjgude@gmail.com

Autor para correspondencia.
, Lorena Coronelb, Teresa Velazquez-Martínb, Enrique Pérez-de la Sotaa, Jorge E. Centeno-Rodrígueza, Andrea Eixerés-Estevea, Eva Aguilar-Blancoa, Juan Meca-Aguirrezabalagaa, Pilar Escribano-Subíasb, Christian Muñoz-Guijosaa
a Servicio de Cirugía Cardiaca, Hospital Universitario 12 de Octubre, Madrid, España
b Servicio de Cardiología, Unidad de Hipertensión Pulmonar, Hospital Universitario 12 de Octubre, Madrid, España
Leído
276
Veces
se ha leído el artículo
66
Total PDF
210
Total HTML
Compartir estadísticas
 array:22 [
  "pii" => "S1134009624001086"
  "issn" => "11340096"
  "doi" => "10.1016/j.circv.2024.06.003"
  "estado" => "S200"
  "fechaPublicacion" => "2024-07-09"
  "aid" => "860"
  "copyright" => "Sociedad Española de Cirugía Cardiovascular y Endovascular"
  "copyrightAnyo" => "2024"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:17 [
    "pii" => "S1134009624000834"
    "issn" => "11340096"
    "doi" => "10.1016/j.circv.2024.04.003"
    "estado" => "S200"
    "fechaPublicacion" => "2024-07-09"
    "aid" => "845"
    "copyright" => "Sociedad Española de Cirugía Cardiovascular y Endovascular"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "rev"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Revisi&#243;n</span>"
      "titulo" => "La trompa de elefante congelada para el tratamiento del s&#237;ndrome a&#243;rtico agudo"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "The frozen elephant trunk for acute aortic syndrome"
        ]
      ]
      "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" => "fig0020"
          "etiqueta" => "Figura 4"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr4.jpeg"
              "Alto" => 3036
              "Ancho" => 2508
              "Tamanyo" => 905759
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Disecci&#243;n a&#243;rtica aguda con malperfusi&#243;n visceral por colapso de la luz verdadera en la aorta abdominal&#44; antes y despu&#233;s de la FET&#46;TL&#58; luz verdadera&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Daniel P&#233;rez-Camargo, Lourdes Montero-Cruces, Luis C&#46; Maroto Castellanos"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Daniel"
              "apellidos" => "P&#233;rez-Camargo"
            ]
            1 => array:2 [
              "nombre" => "Lourdes"
              "apellidos" => "Montero-Cruces"
            ]
            2 => array:2 [
              "nombre" => "Luis C&#46;"
              "apellidos" => "Maroto Castellanos"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134009624000834?idApp=UINPBA00004N"
    "url" => "/11340096/unassign/S1134009624000834/v1_202407090419/es/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "S1134009624000032"
    "issn" => "11340096"
    "doi" => "10.1016/j.circv.2024.01.002"
    "estado" => "S200"
    "fechaPublicacion" => "2024-03-01"
    "aid" => "805"
    "copyright" => "Sociedad Espa&#241;ola de Cirug&#237;a Cardiovascular y Endovascular"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "rev"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Revisi&#243;n</span>"
      "titulo" => "Flujometr&#237;a con <span class="elsevierStyleItalic">doppler</span> pulsado en la evaluaci&#243;n intraoperatoria de los injertos coronarios&#46; &#191;Es a&#250;n necesaria&#63;"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Pulsed Doppler flowmetry in the intraoperative evaluation of coronary grafts&#46; It is still necessary&#63;"
        ]
      ]
      "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" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1148
              "Ancho" => 2508
              "Tamanyo" => 190883
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Ley f&#237;sica de Hagen&#8211;Poiseuille esquematizada&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Yasser Colao Jimenez"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Yasser"
              "apellidos" => "Colao Jimenez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134009624000032?idApp=UINPBA00004N"
    "url" => "/11340096/unassign/S1134009624000032/v1_202403010438/es/main.assets"
  ]
  "es" => array:18 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
    "titulo" => "Tratamiento multimodal en la hipertensi&#243;n pulmonar residual tras tromboendarterectom&#237;a pulmonar"
    "tieneTextoCompleto" => true
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Mar&#237;a Jes&#250;s L&#243;pez-Gude, Lorena Coronel, Teresa Velazquez-Mart&#237;n, Enrique P&#233;rez-de la Sota, Jorge E&#46; Centeno-Rodr&#237;guez, Andrea Eixer&#233;s-Esteve, Eva Aguilar-Blanco, Juan Meca-Aguirrezabalaga, Pilar Escribano-Sub&#237;as, Christian Mu&#241;oz-Guijosa"
        "autores" => array:10 [
          0 => array:4 [
            "nombre" => "Mar&#237;a Jes&#250;s"
            "apellidos" => "L&#243;pez-Gude"
            "email" => array:1 [
              0 => "mjgude@gmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Lorena"
            "apellidos" => "Coronel"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Teresa"
            "apellidos" => "Velazquez-Mart&#237;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Enrique"
            "apellidos" => "P&#233;rez-de la Sota"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Jorge E&#46;"
            "apellidos" => "Centeno-Rodr&#237;guez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Andrea"
            "apellidos" => "Eixer&#233;s-Esteve"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Eva"
            "apellidos" => "Aguilar-Blanco"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Juan"
            "apellidos" => "Meca-Aguirrezabalaga"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Pilar"
            "apellidos" => "Escribano-Sub&#237;as"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Christian"
            "apellidos" => "Mu&#241;oz-Guijosa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Cirug&#237;a Cardiaca&#44; Hospital Universitario 12 de Octubre&#44; Madrid&#44; Espa&#241;a"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Cardiolog&#237;a&#44; Unidad de Hipertensi&#243;n Pulmonar&#44; Hospital Universitario 12 de Octubre&#44; Madrid&#44; Espa&#241;a"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Multimodal treatment in residual pulmonary hypertension after pulmonary endarterectomy"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0030"
        "etiqueta" => "Figura 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr6.jpeg"
            "Alto" => 1449
            "Ancho" => 2468
            "Tamanyo" => 122535
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Supervivencia de los pacientes del grupo<span class="elsevierStyleHsp" style=""></span>3 comparada con la de los pacientes de los grupos<span class="elsevierStyleHsp" style=""></span>1 y<span class="elsevierStyleHsp" style=""></span>2&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La hipertensi&#243;n pulmonar tromboemb &#243;lica cr &#243; nica &#40;HPTEC&#41; es una complicaci&#243;n de la embolia aguda de pulm&#243;n que puede aparecer hasta en el 3&#44;2&#37; de los supervivientes&#44; siendo la entidad m&#225;s importante del grupo<span class="elsevierStyleHsp" style=""></span>4 de hipertensi&#243;n pulmonar &#40;HP&#41;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">1</span></a>&#46; La HPTEC se debe a una resoluci&#243;n incompleta de las embolias pulmonares que se organizan dentro del lecho vascular pulmonar y causan diferentes grados de obstrucci&#243;n al flujo sangu&#237;neo&#46; Sin tratamiento&#44; el pron&#243;stico es nefasto&#44; con tasas de supervivencia a 5<span class="elsevierStyleHsp" style=""></span>a&#241;os tan bajas como el 10&#37; en los casos m&#225;s graves<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La tromboendarterectom&#237;a pulmonar &#40;TEA&#41; es el tratamiento de elecci&#243;n y curativo en pacientes seleccionados<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">3</span></a>&#46; El registro internacional demostr&#243; la existencia de una pronunciada curva de aprendizaje quir&#250;rgica e institucional al inicio de un programa de TEA&#44; pero actualmente&#44; en centros con experiencia&#44; la tasa de mortalidad operatoria es de alrededor del 3&#37;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">4&#44;5</span></a>&#44; y la supervivencia a 10<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; del 90&#37;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">La angioplastia pulmonar con bal&#243;n &#40;ABAP&#41; se ha establecido en las &#250;ltimas gu&#237;as cl&#237;nicas como tratamiento de elecci&#243;n para pacientes seleccionados con HPTEC inoperable o HP persistente despu&#233;s de la TEA<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">7</span></a> con excelentes resultados cl&#237;nicos y hemodin&#225;micos<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">La fisiopatolog&#237;a de la HPTEC se describe mediante un modelo bicompartimental&#44; con un componente obstructivo que puede ser accesible quir&#250;rgicamente hasta nivel segmentario&#44; o mediante ABAP a nivel subsegmentario&#44; y una vasculopat&#237;a de peque&#241;o vaso&#46; Esta vasculopat&#237;a afecta tanto a vasos previamente ocluidos y perfundidos por colaterales como a vasos no obstruidos y perfundidos a alta presi&#243;n&#44; y en estos &#250;ltimos los cambios histol&#243;gicos son similares a la HP arterial<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Para tratar el componente de vasculopat&#237;a se han utilizado los vasodilatadores pulmonares disponibles para la HP arterial&#46; Por el momento&#44; solo dos ensayos controlados aleatorizados han mostrado la efectividad en el contexto de HPTEC inoperable o persistente tras TEA&#58; los realizados con riociguat y con treprostinil subcut&#225;neo a dosis altas<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">10-12</span></a>&#46; Las gu&#237;as cl&#237;nicas contemplan&#44; a d&#237;a de hoy&#44; el uso de riociguat&#44; indicaci&#243;n Ib&#44; y el treprostinil en pacientes m&#225;s graves&#44; indicaci&#243;n IIb<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">7</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">La fisiopatolog&#237;a bicompartimental explica la necesidad de terapia multimodal que combine los tres tratamientos disponibles en distintos escenarios de la patolog&#237;a<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">13</span></a>&#46; Uno de ellos es la HP residual o recurrente tras TEA&#46; Seg&#250;n la definici&#243;n utilizada&#44; entre el 5 y el 35&#37; de los pacientes tienen HP residual despu&#233;s de la TEA&#44; lo que les confiere un peor pron&#243;stico<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">7</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">La Unidad Multidisciplinar de Hipertensi&#243;n pulmonar del Hospital Universitario 12 de Octubre es Unidad de Referencia Nacional y Europea en el diagn&#243;stico y tratamiento de pacientes con HP&#46; En este contexto se ha desarrollado la serie de TEA m&#225;s importante a nivel nacional&#44; con muy buenos resultados ya consolidados<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">14</span></a>&#46; Por otra parte&#44; desde el a&#241;o 2013 se incorpor&#243; la ABAP al tratamiento de la HPTEC&#44; siendo tambi&#233;n&#44; en el momento actual&#44; la serie m&#225;s amplia de nuestro pa&#237;s&#44; con excelentes resultados comunicados<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">El objetivo principal de este trabajo es actualizar los resultados inmediatos y a largo plazo de la serie quir&#250;rgica y analizar la evoluci&#243;n a largo plazo en funci&#243;n de la persistencia o no de HP residual&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Poblaci&#243;n</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se trata de un estudio descriptivo retrospectivo&#46; Desde febrero de 1996 hasta diciembre de 2023 hemos realizado 405 TEA consecutivas en 404 pacientes&#46; Todos los pacientes con diagn&#243;stico establecido de HPTEC se presentan en sesi&#243;n de la Unidad Multidisciplinar&#44; 860 hasta diciembre de 2023&#46; Las principales indicaciones para la cirug&#237;a fueron<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">3&#44;7</span></a>&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>clase funcional<span class="elsevierStyleHsp" style=""></span>II-IV de la OMS&#59; b&#41; presi&#243;n en arteria pulmonar media &#40;PAPm&#41; &#62;<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>mmHg o pendiente de la relaci&#243;n entre PAPm y gasto cardiaco &#62;<span class="elsevierStyleHsp" style=""></span>3 en el cateterismo de ejercicio si no hay HP en reposo&#59; c&#41; trombos o lesiones accesibles quir&#250;rgicamente&#44; y d&#41;<span class="elsevierStyleHsp" style=""></span>concordancia entre las lesiones obstructivas y la severidad hemodin&#225;mica&#46; Se consideraron criterios de exclusi&#243;n la no accesibilidad quir&#250;rgica y la presencia de patolog&#237;a grave asociada&#46; Ni la cifra elevada de resistencias vasculares pulmonares &#40;RVP&#41;&#44; ni la insuficiencia cardiaca derecha avanzada&#44; por s&#237; solos&#44; son criterios de exclusi&#243;n<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">16&#44;17</span></a>&#46; A partir de mayo de 2013 los pacientes sin indicaci&#243;n quir&#250;rgica se eval&#250;an en la misma sesi&#243;n para considerar si son susceptibles de tratamiento con ABAP&#44; y hasta diciembre de 2023 se han tratado 213 pacientes&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Los protocolos de diagn&#243;stico y seguimiento est&#225;n publicados en la serie inicial<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">16</span></a> y actualizados seg&#250;n la evidencia actual<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">7</span></a>&#46; Aproximadamente a los seis meses de la TEA se realiza cateterismo cardiaco derecho&#46; Disponemos&#44; a 31 de marzo de 2024&#44; de 301 estudios hemodin&#225;micos de las 405 intervenciones&#46; Para analizar los resultados a largo plazo en funci&#243;n de la persistencia de HP se ha divido esta poblaci&#243;n en&#58; grupo<span class="elsevierStyleHsp" style=""></span>1&#44; pacientes sin HP residual&#59; grupo<span class="elsevierStyleHsp" style=""></span>2&#44; pacientes con HP ligera-moderada&#44; y grupo<span class="elsevierStyleHsp" style=""></span>3&#44; pacientes con HP severa &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; En este caso hemos mantenido la definici&#243;n de HP como PAPm<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>25<span class="elsevierStyleHsp" style=""></span>mmHg utilizada hasta el a&#241;o 2022<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">7</span></a>&#44; puesto que el grueso de la serie se realiz&#243; con esta definici&#243;n&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Los pacientes con HP residual severa o mala evoluci&#243;n cl&#237;nica tras la TEA se presentan en sesi&#243;n con estudio completo para valorar la indicaci&#243;n de reoperaci&#243;n&#44; ABAP o tratamiento m&#233;dico&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">T&#233;cnica quir&#250;rgica</span><p id="par0070" class="elsevierStylePara elsevierViewall">Realizamos la TEA a trav&#233;s de una esternotom&#237;a media&#44; con circulaci&#243;n extracorp&#243;rea&#44; pinzamiento a&#243;rtico y per&#237;odos de parada circulatoria en hipotermia profunda&#44; de forma similar a la t&#233;cnica descrita por el grupo de la Universidad de California en San Diego<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">18</span></a>&#46; El material obtenido en la cirug&#237;a se orden&#243; siguiendo la clasificaci&#243;n anatomoquir&#250;rgica&#44; con valor pron&#243;stico&#44; de este mismo grupo<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">19</span></a> &#40;tipo<span class="elsevierStyleHsp" style=""></span>I&#58; trombos que ocupan las arterias pulmonares principales&#59; tipo<span class="elsevierStyleHsp" style=""></span>II&#58; engrosamiento intimal y fibrosis proximal a las arterias segmentarias&#59; tipo<span class="elsevierStyleHsp" style=""></span>III&#58; afectaci&#243;n tromboemb&#243;lica exclusiva de las arterias segmentarias y subsegmentarias&#59; tipo<span class="elsevierStyleHsp" style=""></span>IV&#58; vasculopat&#237;a arteriolar distal&#41;&#46; La curva de aprendizaje para la intervenci&#243;n se situ&#243; en los primeros 46 casos &#40;1996-2010&#41;&#44; aquellos llevados a cabo en el per&#237;odo de tiempo en que se realizaban menos de 10 procedimientos por a&#241;o<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">18&#44;20</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Estad&#237;stica</span><p id="par0080" class="elsevierStylePara elsevierViewall">Las variables continuas se presentan como media &#177;<span class="elsevierStyleHsp" style=""></span>desviaci&#243;n est&#225;ndar&#44; y las categ&#243;ricas&#44; como frecuencias&#46; La comparaci&#243;n entre variables categ&#243;ricas se analiz&#243; mediante la prueba de la &#967;<span class="elsevierStyleSup">2</span> de Pearson o el estad&#237;stico exacto de Fisher&#46; Las variables cuantitativas se analizaron aplicando la prueba de la t de Student o de la U de Mann-Whitney en funci&#243;n de la normalidad de las distribuciones seg&#250;n la prueba de Shapiro-Wilk&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Los pacientes fueron seguidos hasta el 31 de marzo de 2024&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Las curvas de supervivencia se calcularon mediante el m&#233;todo de Kaplan-Meier&#44; y la comparaci&#243;n entre ellas&#44; con la prueba de rangos logar&#237;tmicos&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Se consider&#243; estad&#237;sticamente significativo un valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Consideraciones &#233;ticas</span><p id="par0105" class="elsevierStylePara elsevierViewall">Los pacientes incluidos en el estudio han firmado un consentimiento informado para la utilizaci&#243;n de sus resultados cl&#237;nicos en publicaciones o para la colaboraci&#243;n en registros nacionales e internacionales de HP&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Serie quir&#250;rgica</span><p id="par0115" class="elsevierStylePara elsevierViewall">En las 405 TEA realizadas la mortalidad hospitalaria fue del 4&#44;5&#37; &#40;19&#47;405&#41;&#46; Las causas fueron insuficiencia respiratoria en 13 pacientes&#44; shock cardiog&#233;nico en 4 y hemorragia pulmonar en 2&#46; Si analizamos la poblaci&#243;n excluyendo los 46 primeros pacientes que constituyen la curva de aprendizaje&#44; la mortalidad de la serie fue del 3&#44;6&#37;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Las principales variables intraoperatorias se resumen en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">La morbilidad m&#225;s importante consisti&#243; en&#58; edema pulmonar de reperfusi&#243;n en 105 pacientes &#40;26&#37;&#41;&#44; insuficiencia cardiaca en 32 &#40;8&#37;&#41;&#44; hemorragia pulmonar en 12 &#40;3&#37;&#41;&#44; accidente cerebrovascular transitorio en 14 pacientes y permanente en 1 paciente &#40;4&#37;&#41; y necesidad de ECMO en 26 pacientes &#40;7&#37;&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">El tiempo medio de seguimiento ha sido 64<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>49<span class="elsevierStyleHsp" style=""></span>meses&#46; La supervivencia acumulada es del 93&#37;&#44; del 91&#37; y del 88&#37; a 3&#44; 5 y 10<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; respectivamente&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Grupo 1</span><p id="par0140" class="elsevierStylePara elsevierViewall">En los pacientes del grupo<span class="elsevierStyleHsp" style=""></span>1 la PAPm &#40;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12 vs&#46; 20<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; descendi&#243; m&#225;s del 50&#37; y las RVP &#40;653<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>370 vs&#46; 179<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>88 dinas&#183;s&#183;cm<span class="elsevierStyleSup">&#8211;5</span>&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; m&#225;s del 60&#37; tras la cirug&#237;a &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">Al final del seguimiento todos los pacientes est&#225;n en clase funcional<span class="elsevierStyleHsp" style=""></span>I o<span class="elsevierStyleHsp" style=""></span>II&#44; excepto un paciente que se encuentra en clase funcional<span class="elsevierStyleHsp" style=""></span>III por patolog&#237;a respiratoria asociada&#46; La mejor&#237;a funcional aparece reflejada en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; Ning&#250;n paciente ha requerido otro tratamiento adicional espec&#237;fico para HP&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">Durante el seguimiento fallecieron 3 pacientes&#58; uno por complicaciones derivadas de una obesidad m&#243;rbida y dos por neoplasia&#46; El tiempo de seguimiento ha sido de 71<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>48<span class="elsevierStyleHsp" style=""></span>meses y la supervivencia acumulada&#44; del 99&#37; a 3 y 5<span class="elsevierStyleHsp" style=""></span>a&#241;os y del 97&#37; a 10<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Grupo 2</span><p id="par0160" class="elsevierStylePara elsevierViewall">En los pacientes del grupo 2 la PAPm &#40;48<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13 vs&#46; 29<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; descendi&#243; un 30&#37; y las RVP &#40;708<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>307 vs&#46; 293<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>111 dinas&#183;s&#183;cm<span class="elsevierStyleSup">&#8211;5</span>&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; m&#225;s del 50&#37; con la TEA&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">En el 30&#37; fue necesario tratamiento vasodilatador pulmonar espec&#237;fico en r&#233;gimen de monoterapia en la mayor&#237;a de ellos&#46; En dos pacientes &#40;3&#37;&#41; pudo indicarse ABAP con tres procedimientos realizados en cada uno de ellos&#46; Los tratamientos no mostraron una mejor&#237;a significativa en la PAPm y las RVP desde la cirug&#237;a &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46; Sin embargo&#44; s&#237; existe mejor&#237;a significativa en la situaci&#243;n funcional de los pacientes &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0170" class="elsevierStylePara elsevierViewall">Durante el seguimiento fallecieron 4 pacientes&#58; dos por complicaciones derivadas de enfermedad respiratoria&#44; uno por neoplasia y el &#250;ltimo por complicaciones de una intervenci&#243;n quir&#250;rgica&#46; El tiempo de seguimiento ha sido de 77<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>43<span class="elsevierStyleHsp" style=""></span>meses y la supervivencia acumulada&#44; del 100&#37;&#44; del 95&#37; y del 95&#37; a 3&#44; 5 y 10<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Grupo 3</span><p id="par0180" class="elsevierStylePara elsevierViewall">Los pacientes del grupo 3 presentan alguna diferencia significativa con respecto al resto de pacientes antes de la intervenci&#243;n&#44; como es la mayor severidad hemodin&#225;mica &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0185" class="elsevierStylePara elsevierViewall">Tras la TEA&#44; en los pacientes del grupo<span class="elsevierStyleHsp" style=""></span>3 la PAPm &#40;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10 vs&#46; 44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; descendi&#243; un 15&#37;&#44; y las RVP &#40;808<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>260 vs&#46; 539<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>215 dinas&#183;s&#183;cm<span class="elsevierStyleSup">&#8211;5</span>&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; un 33&#37;&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Un paciente fue reoperado con TEA&#46; En el 82&#37; fue necesario tratamiento vasodilatador pulmonar espec&#237;fico&#58; en r&#233;gimen de monoterapia el 55&#37;&#44; doble terapia el 33&#37; y triple terapia el 12&#37; de los tratados&#46; La ABAP pudo indicarse en 13 pacientes &#40;21&#37;&#41;&#46; Se realizaron una media de 4 procedimientos por paciente&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">El tratamiento combinado mostr&#243; una mejor&#237;a significativa en la PAPm &#40;44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8 vs&#46; 42<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>mmHg&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;038&#41; y las RVP &#40;539<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>215 vs&#46; 507<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>207 dinas&#183;s&#183;cm<span class="elsevierStyleSup">&#8211;5</span>&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;013&#41; desde la cirug&#237;a &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41;&#46; En el subgrupo que recibi&#243; ABAP el descenso fue a&#250;n mayor &#40;<a class="elsevierStyleCrossRef" href="#fig0025">fig&#46; 5</a>&#41;&#46; La situaci&#243;n funcional al final del seguimiento se objetiva en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0200" class="elsevierStylePara elsevierViewall">Durante el seguimiento fallecieron 10 pacientes&#58; 5 por insuficiencia cardiaca derecha&#44; 2 pacientes por complicaciones derivadas de infecci&#243;n por SARS-CoV-2 y 3 por comorbilidad asociada&#46; El tiempo de seguimiento ha sido de 74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>48<span class="elsevierStyleHsp" style=""></span>meses y la supervivencia&#44; del 92&#37; a los 3<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; del 90&#37; a los 5<span class="elsevierStyleHsp" style=""></span>a&#241;os y del 81&#37; a los 10<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; con diferencia significativa con los grupos anteriores &#40;Log Rank<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0030">fig&#46; 6</a>&#41;&#46;</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discusi&#243;n</span><p id="par0210" class="elsevierStylePara elsevierViewall">La TEA&#44; cuando puede indicarse&#44; es el tratamiento de elecci&#243;n de la HPTEC&#46; Como muestran los resultados de nuestra serie&#44; la m&#225;s importante de Espa&#241;a&#44; la amplia mayor&#237;a de pacientes experimentan mejor&#237;a en los s&#237;ntomas&#44; normalizaci&#243;n de par&#225;metros hemodin&#225;micos y excelente supervivencia a largo plazo&#46; Estos resultados son comparables con datos actuales de los grandes centros especialistas en HPTEC<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">4&#44;6&#44;18</span></a>&#46; En el mayor registro internacional de HPTEC&#44; publicado en 2011&#44; la operabilidad vari&#243; ampliamente entre los centros&#46; Aquellos de alto volumen generalmente ten&#237;an un umbral m&#225;s bajo para realizar TEA y reportaron una mortalidad intrahospitalaria menor al 5&#37;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">18</span></a>&#46; La mortalidad de nuestro registro es del 4&#44;5&#37;&#44; y si tomamos en cuenta la curva de aprendizaje&#44; es del 3&#44;6&#37;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">4&#44;6&#44;18&#44;21&#44;22</span></a>&#46; La baja tasa de mortalidad se debe a una combinaci&#243;n de aumento en la experiencia quir&#250;rgica&#44; selecci&#243;n adecuada de pacientes y manejo multidisciplinar durante todo el proceso&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">La morbilidad m&#225;s relevante en el seguimiento es la HP residual<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">6&#44;23-25</span></a>&#46; Hasta la fecha no existe consenso sobre la definici&#243;n de HP residual&#46; Adem&#225;s&#44; la medici&#243;n de las presiones pulmonares tampoco est&#225; estandarizada&#58; se realiza en diferentes momentos&#44; y en varios centros el cateterismo card&#237;aco derecho no se indica de forma rutinaria&#46; La falta de una definici&#243;n clara y globalmente aceptada hace que la prevalencia real de esta entidad sea muy variable&#44; desde una tasa del 8&#44;2&#37;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">26</span></a> hasta el 41&#44;9&#37;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">22</span></a>&#46; Un metaan&#225;lisis reciente de 25 estudios sobre 4&#46;686 pacientes sometidos a TEA encontr&#243; una frecuencia de HP del 25&#37;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">27</span></a>&#46; Aunque la mayor&#237;a de los estudios utilizaron un valor de corte de la PAPm &#62;<span class="elsevierStyleHsp" style=""></span>25<span class="elsevierStyleHsp" style=""></span>mmHg para definir la hipertensi&#243;n pulmonar residual&#44; algunos utilizaron un valor de 30<span class="elsevierStyleHsp" style=""></span>mmHg o una combinaci&#243;n de PAPm y RVP&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">A pesar de todo&#44; la identificaci&#243;n de esta entidad es de suma relevancia&#44; ya que se encuentra &#237;ntimamente relacionada con la supervivencia a largo plazo&#44; como ha quedado demostrado en nuestro registro&#44; especialmente en aquellos pacientes con HP residual severa&#46; Hallazgos similares fueron reportados por el grupo de Cambridge<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">28</span></a>&#46; En un estudio prospectivo&#44; Cannon et al&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">29</span></a> investigaron la importancia cl&#237;nica de la HP residual y describieron que una PAPm superior a 30<span class="elsevierStyleHsp" style=""></span>mmHg era un umbral por encima del cual con frecuencia se iniciaba tratamiento vasodilatador pulmonar espec&#237;fico&#44; presumiblemente debido al deterioro cl&#237;nico&#46; Adem&#225;s&#44; los mismos autores encontraron que una PAPm &#8805;<span class="elsevierStyleHsp" style=""></span>38<span class="elsevierStyleHsp" style=""></span>mmHg y RVP &#8805;<span class="elsevierStyleHsp" style=""></span>425<span class="elsevierStyleHsp" style=""></span> dinas&#183;s&#183;cm<span class="elsevierStyleSup">&#8211;5</span> se asoci&#243; con un mayor riesgo de muerte&#46; La supervivencia de la serie completa en este grupo fue inferior a la comunicada en nuestro estudio&#58; a 1&#44; 3&#44; 5 y 10<span class="elsevierStyleHsp" style=""></span>a&#241;os fue del 86&#37;&#44; del 84&#37;&#44; del 79&#37; y del 72&#37;&#44; respectivamente&#44; y&#44; por lo tanto&#44; tambi&#233;n la de los pacientes con HP residual severa&#46; Ahora bien&#44; en su serie no hay tratamiento con ABAP en la HP residual&#46; Otros grupos han reportado resultados similares con puntos de corte similares&#44; 34<span class="elsevierStyleHsp" style=""></span>mmHg<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">30</span></a> y 37<span class="elsevierStyleHsp" style=""></span>mmHg&#44; as&#237; como de RVP posoperatoria mayor o igual a 590<span class="elsevierStyleHsp" style=""></span>dinas&#44; como el grupo de Viena<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">31</span></a>&#44; asociados a peor pron&#243;stico&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">En la HP residual&#44; como qued&#243; reflejado en este registro&#44; y en consonancia con registros internacionales<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">6&#44;18&#44;28</span></a>&#44; un perfil hemodin&#225;mico m&#225;s severo antes de la cirug&#237;a predispone a su desarrollo&#46; Esto no significa que por s&#237; sola una hemodin&#225;mica de alto riesgo constituya una contraindicaci&#243;n para el tratamiento quir&#250;rgico&#44; potencialmente curativo&#46; De hecho&#44; estos pacientes sin posibilidad de cirug&#237;a tienen un pron&#243;stico ominoso&#46; Es m&#225;s&#44; los centros m&#225;s experimentados tienen m&#225;s probabilidades de aceptar pacientes con peor hemodin&#225;mica y enfermedad m&#225;s distal&#44; con la consecuencia inevitable de hipertensi&#243;n pulmonar residual&#46; La etiolog&#237;a de la HP residual se atribuye a vasculopat&#237;a&#44; a la imposibilidad de eliminar el material fibr&#243;tico muy distal del &#225;rbol vascular pulmonar&#44; o a ambas<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">9</span></a>&#46; La vasculopat&#237;a es la justificaci&#243;n para el tratamiento m&#233;dico de la HP residual&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Asimismo&#44; la persistencia del material fibr&#243;tico endoluminal se puede tratar con ABAP&#44; si bien es un procedimiento t&#233;cnicamente m&#225;s desafiante en la HP residual que en la HPTEC inoperable<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">32-35</span></a>&#46; Varios estudios retrospectivos de ABAP despu&#233;s de la TEA han mostrado beneficio en la hemodin&#225;mica&#44; la capacidad de ejercicio y los s&#237;ntomas<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">36&#44;37</span></a>&#44; y un reporte reciente de nuestro centro&#44; de pacientes tratados con este procedimiento por HP tras TEA&#44; ha demostrado ser una t&#233;cnica segura<a class="elsevierStyleCrossRefs" href="#bib0375"><span class="elsevierStyleSup">37&#44;38</span></a>&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">En nuestro registro&#44; los pacientes con HP ligera&#47;moderada fueron tratados con ambas estrategias&#44; aunque la ABAP solo pudo indicarse en dos pacientes&#46; El tratamiento no present&#243; un impacto relevante en la hemodin&#225;mica&#44; pero s&#237; mejoraron de manera significativa los s&#237;ntomas&#44; hall&#225;ndose la mayor&#237;a en clase funcional<span class="elsevierStyleHsp" style=""></span>I&#47;II&#44; con descenso significativo de biomarcadores &#40;NtproBNP&#41; y mayor distancia recorrida en test de la marcha de seis minutos&#44; y excelente supervivencia a largo plazo<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Los pacientes del grupo<span class="elsevierStyleHsp" style=""></span>3 se beneficiaron tambi&#233;n de la terapia farmacol&#243;gica y la intervencionista con ABAP&#44; que mostr&#243; no solo una mejor&#237;a en par&#225;metros cl&#237;nicos&#44; sino tambi&#233;n hemodin&#225;micos&#44; con una supervivencia aceptable a largo plazo&#46; Este aspecto es muy relevante&#44; alertando sobre este grupo en particular de la necesidad de un seguimiento estrecho&#44; una conducta activa y un manejo multimodal por equipos con experiencia&#46; Con este manejo combinado de f&#225;rmacos y ABAP se redujo un 17&#37; la PAPm y un 22&#37; las RVP&#44; todo ello a&#241;adido a lo logrado con la cirug&#237;a&#44; como se muestra en la <a class="elsevierStyleCrossRef" href="#fig0025">figura 5</a>&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">M&#225;s all&#225; del desarrollo de HP residual&#44; los resultados de la TEA en centros de referencia son excelentes a largo plazo en pacientes con HPTEC que tienen esta opci&#243;n de tratamiento&#44; en comparaci&#243;n con aquellos considerados inoperables<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">6&#44;18&#44;19</span></a>&#46;</p><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Limitaciones</span><p id="par0255" class="elsevierStylePara elsevierViewall">Se trata de un estudio retrospectivo en un solo centro&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">El abordaje de la HP residual no ha sido igual en toda la serie&#44; comenzando el programa de ABAP en 2013&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conclusiones</span><p id="par0265" class="elsevierStylePara elsevierViewall">Nuestro registro confirma que la cirug&#237;a de tromboendarterectom&#237;a pulmonar es el tratamiento de elecci&#243;n en pacientes con hipertensi&#243;n pulmonar cr&#243;nica&#44; con excelentes resultados a largo plazo&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">El abordaje multidisciplinar y el tratamiento multimodal son imprescindibles en situaciones complejas como la hipertensi&#243;n pulmonar residual tras cirug&#237;a&#44; logrando buenos resultados a largo plazo&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicto de intereses</span><p id="par0275" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres2199555"
          "titulo" => "Resumen"
          "secciones" => array:5 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Objetivos"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Material y m&#233;todos"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Resultados"
            ]
            4 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1846141"
          "titulo" => "Palabras clave"
        ]
        2 => array:3 [
          "identificador" => "xres2199554"
          "titulo" => "Abstract"
          "secciones" => array:5 [
            0 => array:1 [
              "identificador" => "abst0030"
            ]
            1 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Objectives"
            ]
            2 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Material and methods"
            ]
            3 => array:2 [
              "identificador" => "abst0045"
              "titulo" => "Results"
            ]
            4 => array:2 [
              "identificador" => "abst0050"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1846142"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introducci&#243;n"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Material y m&#233;todos"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Poblaci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "T&#233;cnica quir&#250;rgica"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Estad&#237;stica"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Consideraciones &#233;ticas"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0035"
          "titulo" => "Resultados"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Serie quir&#250;rgica"
            ]
            1 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Grupo 1"
            ]
            2 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Grupo 2"
            ]
            3 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Grupo 3"
            ]
          ]
        ]
        7 => array:3 [
          "identificador" => "sec0060"
          "titulo" => "Discusi&#243;n"
          "secciones" => array:1 [
            0 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Limitaciones"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conclusiones"
        ]
        9 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Conflicto de intereses"
        ]
        10 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2024-05-21"
    "fechaAceptado" => "2024-06-10"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1846141"
          "palabras" => array:5 [
            0 => "Riociguat"
            1 => "Angioplastia pulmonar con bal&#243;n"
            2 => "Hipertensi&#243;n pulmonar tromboemb&#243;lica cr&#243;nica"
            3 => "Endarterectom&#237;a pulmonar"
            4 => "Hipertensi&#243;n pulmonar"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1846142"
          "palabras" => array:5 [
            0 => "Riociguat"
            1 => "Balloon pulmonary angioplasty"
            2 => "Chronic thromboembolic pulmonary hypertension"
            3 => "Pulmonary endarterectomy"
            4 => "Pulmonary hypertension"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La cirug&#237;a de tromboendarterectom&#237;a pulmonar es el tratamiento de elecci&#243;n en la hipertensi&#243;n pulmonar tromboemb&#243;lica cr&#243;nica&#46; El tratamiento m&#233;dico o el intervencionismo &#40;angioplastia pulmonar&#41; deben contemplarse en pacientes inoperables o con hipertensi&#243;n pulmonar residual tras cirug&#237;a&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Comunicar los resultados actuales de la serie quir&#250;rgica&#46; Describir la evoluci&#243;n a largo plazo seg&#250;n la persistencia de hipertensi&#243;n pulmonar&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Hasta diciembre de 2023 hemos realizado 405 procedimientos&#46; En 301 pacientes se obtuvo cateterismo cardiaco derecho de control a los 6<span class="elsevierStyleHsp" style=""></span>meses&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La mortalidad hospitalaria fue del 4&#44;5&#37;&#46; En 161 cateterismos &#40;53&#37;&#41; la presi&#243;n media en arteria pulmonar fue inferior o igual a 25<span class="elsevierStyleHsp" style=""></span>mmHg&#46; La supervivencia acumulada en estos pacientes es del 99&#37;&#44; del 99&#37; y del 97&#37; a 3&#44; 5 y 10<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; En 78 casos &#40;26&#37;&#41; la presi&#243;n estuvo entre 26 y 34<span class="elsevierStyleHsp" style=""></span>mmHg&#46; El 30&#37; han necesitado tratamiento con vasodilatadores pulmonares y el 3&#37;&#44; angioplastias pulmonares&#46; La supervivencia acumulada es del 100&#37;&#44; del 95&#37; y del 95&#37; a 3&#44; 5 y 10<span class="elsevierStyleHsp" style=""></span>a&#241;os&#46; En el resto la presi&#243;n fue igual o superior a 35<span class="elsevierStyleHsp" style=""></span>mmHg&#46; El 82&#37; han sido tratados con vasodilatadores pulmonares y el 21&#37;&#44; con angioplastias pulmonares&#46; La supervivencia acumulada es del 92&#37;&#44; del 90&#37; y del 81&#37; a 3&#44; 5 y 10<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; con diferencia significativa con los grupos anteriores &#40;Log Rank<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La cirug&#237;a de tromboendarterectom&#237;a pulmonar es curativa en la mayor&#237;a de pacientes&#46; El abordaje multidisciplinar y el tratamiento multimodal son imprescindibles en situaciones complejas como la hipertensi&#243;n pulmonar residual tras cirug&#237;a&#44; logrando resultados excelentes a largo plazo&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:1 [
            "identificador" => "abst0005"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objetivos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Material y 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"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Pulmonary thromboendarterectomy surgery is the treatment of choice in chronic thromboembolic pulmonary hypertension&#46; Medical treatment or intervention through pulmonary angioplasty should be considered in inoperable patients or with residual pulmonary hypertension after surgery&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objectives</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Communicate the current results of the surgical series&#46; Describe the long-term evolution based on the persistence of pulmonary hypertension&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Until December 2023 we have performed 405 procedures&#46; Right heart catheterization was obtained in 301 patients at 6<span class="elsevierStyleHsp" style=""></span>months&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Hospital mortality was 4&#46;5&#37;&#46; In 161 control catheterizations &#40;53&#37;&#41;&#44; the mean pulmonary artery pressure was less or equal than 25<span class="elsevierStyleHsp" style=""></span>mmHg&#46; The cumulative survival in these patients is 99&#37;&#44; 99&#37; and 97&#37; at 3&#44; 5 and 10<span class="elsevierStyleHsp" style=""></span>years&#46; In 78 cases &#40;26&#37;&#41; the pressure was between 26 and 34<span class="elsevierStyleHsp" style=""></span>mmHg&#46; 30&#37; have needed treatment with pulmonary vasodilators and 3&#37; have required pulmonary angioplasty&#46; The cumulative survival is 100&#37;&#44; 95&#37; and 95&#37; at 3&#44; 5 and 10<span class="elsevierStyleHsp" style=""></span>years&#46; In the rest&#44; the pressure was equal or greater than 35<span class="elsevierStyleHsp" style=""></span>mmHg&#46; 82&#37; have been treated with pulmonary vasodilators and 21&#37; with pulmonary angioplasties&#46; The cumulative survival is 92&#37;&#44; 90&#37; and 81&#37; at 3&#44; 5 and 10<span class="elsevierStyleHsp" style=""></span>years with significant difference with the previous groups &#40;Log Rank<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Pulmonary endarterectomy surgery is curative in the majority of patients&#46; The multidisciplinary approach and multimodal treatment are essential in complex situations such as residual pulmonary hypertension after surgery&#44; achieving excellent long-term results&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:1 [
            "identificador" => "abst0030"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objectives"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Material and methods"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "multimedia" => array:9 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1169
            "Ancho" => 1967
            "Tamanyo" => 91103
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n de pacientes seg&#250;n la persistencia de hipertensi&#243;n pulmonar&#46; CCD&#58; cateterismo cardiaco derecho&#59; mPAP&#58; presi&#243;n media en arteria pulmonar&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 978
            "Ancho" => 3333
            "Tamanyo" => 96181
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Variaci&#243;n hemodin&#225;mica en pacientes del grupo<span class="elsevierStyleHsp" style=""></span>1 al final del seguimiento&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">PAPm&#58; presi&#243;n media en arteria pulmonar&#59; RVP&#58; resistencias vasculares pulmonares&#59; TEA&#58; tromboendarterectom&#237;a pulmonar&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 977
            "Ancho" => 3334
            "Tamanyo" => 107904
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Variaci&#243;n hemodin&#225;mica en pacientes del grupo<span class="elsevierStyleHsp" style=""></span>2 al final del seguimiento&#46;</p> <p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">PAPm&#58; presi&#243;n media en arteria pulmonar&#59; RVP&#58; resistencias vasculares pulmonares&#59; TEA&#58; tromboendarterectom&#237;a pulmonar&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figura 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 980
            "Ancho" => 3333
            "Tamanyo" => 109557
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Variaci&#243;n hemodin&#225;mica en pacientes del grupo<span class="elsevierStyleHsp" style=""></span>3 al final del seguimiento&#46;</p> <p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">PAPm&#58; presi&#243;n media en arteria pulmonar&#59; RVP&#58; resistencias vasculares pulmonares&#59; TEA&#58; tromboendarterectom&#237;a pulmonar&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "fig0025"
        "etiqueta" => "Figura 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 981
            "Ancho" => 3333
            "Tamanyo" => 105203
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Variaci&#243;n hemodin&#225;mica en el subgrupo de pacientes del grupo<span class="elsevierStyleHsp" style=""></span>3 que recibieron angioplastia pulmonar&#46;</p> <p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">ABAP&#58; angioplastia pulmonar con bal&#243;n&#59; PAPm&#58; presi&#243;n media en arteria pulmonar&#59; RVP&#58; resistencias vasculares pulmonares&#59; TEA&#58; tromboendarterectom&#237;a pulmonar</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "fig0030"
        "etiqueta" => "Figura 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr6.jpeg"
            "Alto" => 1449
            "Ancho" => 2468
            "Tamanyo" => 122535
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Supervivencia de los pacientes del grupo<span class="elsevierStyleHsp" style=""></span>3 comparada con la de los pacientes de los grupos<span class="elsevierStyleHsp" style=""></span>1 y<span class="elsevierStyleHsp" style=""></span>2&#46;</p>"
        ]
      ]
      6 => 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="spar0115" class="elsevierStyleSimplePara elsevierViewall">CEC&#58; circulaci&#243;n extracorp&#243;rea&#59; TEA&#58; tromboendarterectom&#237;a pulmonar&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "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">Variables&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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">TEA bilateral &#40;&#37;&#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">93&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">TEA completa &#40;&#37;&#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">97&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 &#40;minutos&#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">211<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>33&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 pinzamiento &#40;minutos&#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">116<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&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 parada &#40;minutos&#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">45<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&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">Clasificaci&#243;n de San Diego &#40;&#37;&#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="" 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>I&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">30&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>II&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">47&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>III&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&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">Procedimientos asociados &#40;&#37;&#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">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3590348.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Variables intraoperatorias</p>"
        ]
      ]
      7 => 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="spar0125" class="elsevierStyleSimplePara elsevierViewall">OMS&#58; Organizaci&#243;n Mundial de la Salud&#59; TM6M&#58; test de la marcha de 6 minutos&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "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">Antes de la TEA&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">Al final del seguimiento&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="elsevierStyleBold">Grupo 1</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><span class="elsevierStyleItalic">Clase funcional OMS &#40;&#37;&#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="" 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><span class="elsevierStyleHsp" style=""></span>I&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&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">86&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><span class="elsevierStyleHsp" style=""></span>II&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">32&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&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><span class="elsevierStyleHsp" style=""></span>III&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">63&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&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><span class="elsevierStyleHsp" style=""></span>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">4&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<span class="elsevierStyleHsp" style=""></span>&#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">TM6M &#40;m&#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">424<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>114&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">490<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>86&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">p<span class="elsevierStyleHsp" style=""></span>&#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">NT-proBNP &#40;pg&#47;ml&#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&#46;002<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;371&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">177<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>165&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">p<span class="elsevierStyleHsp" style=""></span>&#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="elsevierStyleBold">Grupo 2</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><span class="elsevierStyleItalic">Clase funcional OMS &#40;&#37;&#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="" 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><span class="elsevierStyleHsp" style=""></span>I&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&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><span class="elsevierStyleHsp" style=""></span>II&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&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">36&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><span class="elsevierStyleHsp" style=""></span>III&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">70&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">4&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><span class="elsevierStyleHsp" style=""></span>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">6&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<span class="elsevierStyleHsp" style=""></span>&#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">TM6M &#40;m&#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">403<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>109&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">448<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>88&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">p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&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">NT-proBNP &#40;pg&#47;ml&#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&#46;766<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;072&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">280<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>266&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">p<span class="elsevierStyleHsp" style=""></span>&#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="elsevierStyleBold">Grupo 3</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><span class="elsevierStyleItalic">Clase funcional OMS &#40;&#37;&#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="" 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><span class="elsevierStyleHsp" style=""></span>I&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&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><span class="elsevierStyleHsp" style=""></span>II&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">26&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">54&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><span class="elsevierStyleHsp" style=""></span>III&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&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&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><span class="elsevierStyleHsp" style=""></span>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">7&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<span class="elsevierStyleHsp" style=""></span>&#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">TM6M &#40;m&#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">366<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>95&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">430<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>97&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">p<span class="elsevierStyleHsp" style=""></span>&#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">NT-proBNP &#40;pg&#47;ml&#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&#46;172<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;302&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">459<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>516&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">p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3590349.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Situaci&#243;n funcional al final del seguimiento</p>"
        ]
      ]
      8 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0135" class="elsevierStyleSimplePara elsevierViewall">GC&#58; gasto cardiaco&#59; OMS&#58; Organizaci&#243;n Mundial de la Salud&#59; PAD&#58; presi&#243;n de aur&#237;cula derecha&#59; PAPm&#58; presi&#243;n media de arteria pulmonar&#59; RVP&#58; resistencias vasculares pulmonares&#59; TEP&#58; tromboembolismo pulmonar&#59; TM6M&#58; test de la marcha de 6 minutos&#59; TVP&#58; trombosis venosa profunda&#59; VD&#58; ventr&#237;culo derecho&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "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">Variables&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">Grupos 1 y 2&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">Grupo 3&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">Cl&#237;nicas</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>Edad &#40;a&#241;os&#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">55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&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">58<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&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;263&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>Sexo &#40;mujer&#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">41&#37;&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">54&#37;&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;068&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>Antecedentes de TEP&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">80&#37;&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">76&#37;&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;645&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>Antecedentes de TVP&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">45&#37;&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&#37;&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;714&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">Clase funcional de la OMS</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>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">71&#37;&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">74&#37;&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;793&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">S&#237;ncope</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">12&#37;&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&#37;&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;411&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">Hemoptisis</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">5&#37;&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&#37;&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;539&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">TM6M &#40;m&#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">405<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>120&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">366<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>103&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;039&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">NT-proBNP &#40;pg&#47;ml&#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&#46;288<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;679&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&#46;128<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;273&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;614&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">Hipercoagulabilidad</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">32&#37;&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">37&#37;&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;628&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">Anticardiolipinas</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&#37;&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&#37;&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;921&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">Historia de c&#225;ncer</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">5&#37;&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&#37;&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;044&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 desde el diagn&#243;stico a la cirug&#237;a &#40;meses&#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">12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20&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<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>35&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;035&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">Ecocardiogr&#225;ficas</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>Di&#225;metro de VD &#40;mm&#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">44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&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">46<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&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;758&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>TAPSE&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<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&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">17<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&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;062&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>Derrame peric&#225;rdico&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&#37;&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&#37;&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;394&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">Hemodin&#225;micas</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>PAD &#40;mmHg&#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<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&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<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&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;020&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>PAPm &#40;mmHg&#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">44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&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">52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&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"><span class="elsevierStyleHsp" style=""></span>&#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="elsevierStyleHsp" style=""></span>RVP &#40;dinas&#183;s&#183;cm<span class="elsevierStyleSup">&#8211;5</span>&#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">672<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>350&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">818<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>268&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;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="elsevierStyleHsp" style=""></span>GC &#40;l&#47;min&#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">5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&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">4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&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;145&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3590347.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas preoperatorias de los pacientes del grupo 3 respecto al 1 y 2</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:38 [
            0 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism&#58; A contemporary view of the published literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46;M&#46; Ende-Verhaar"
                            1 => "S&#46;C&#46; Cannegieter"
                            2 => "A&#46;V&#46; Noordegraaf"
                            3 => "M&#46; Delcroix"
                            4 => "P&#46; Pruszczyk"
                            5 => "A&#46;T&#46; Mairuhu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Respir J&#46;"
                        "fecha" => "2017"
                        "volumen" => "49"
                        "paginaInicial" => "1601"
                        "paginaFinal" => "1792"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Longterm follow-up of patients with pulmonary thromboembolism&#46; Late prognosis and evolution of hemodynamic and respiratory data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Riedel"
                            1 => "V&#46; Stanek"
                            2 => "J&#46; Widimsky"
                            3 => "I&#46; Prerovsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.81.2.151"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest&#46;"
                        "fecha" => "1982"
                        "volumen" => "81"
                        "paginaInicial" => "151"
                        "paginaFinal" => "158"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7056079"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronic thromboembolic pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;H&#46; Kim"
                            1 => "M&#46; Delcroix"
                            2 => "D&#46;P&#46; Jenkins"
                            3 => "R&#46; Channick"
                            4 => "P&#46; Dartevelle"
                            5 => "P&#46; Jansa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2013.10.024"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Coll Cardiol&#46;"
                        "fecha" => "2013"
                        "volumen" => "62"
                        "numero" => "25 Suppl"
                        "paginaInicial" => "D92"
                        "paginaFinal" => "D99"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24355646"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary endarterectomy&#58; Recent changes in a single institution&#39;s experience of more than 2&#44;700 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;M&#46; Madani"
                            1 => "W&#46;R&#46; Auger"
                            2 => "V&#46; Pretorius"
                            3 => "N&#46; Sakakibara"
                            4 => "K&#46;M&#46; Kerr"
                            5 => "N&#46;H&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2012.04.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg&#46;"
                        "fecha" => "2012"
                        "volumen" => "94"
                        "paginaInicial" => "97"
                        "paginaFinal" => "103"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22626752"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Lankeit"
                            1 => "V&#46; Krieg"
                            2 => "L&#46; Hobohm"
                            3 => "S&#46; Kolmel"
                            4 => "C&#46; Liebetrau"
                            5 => "S&#46; Konstantinides"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Heart Lung Transplant&#46;"
                        "fecha" => "2018"
                        "volumen" => "37"
                        "paginaInicial" => "250"
                        "paginaFinal" => "258"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term outcome of patients with chronic thromboembolic pulmonary hypertension&#58; results from an international prospective registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Delcroix"
                            1 => "I&#46; Lang"
                            2 => "J&#46; Pepke-Zaba"
                            3 => "P&#46; Jansa"
                            4 => "A&#46;M&#46; d&#8217;Armini"
                            5 => "R&#46; Snijder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.115.016522"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation&#46;"
                        "fecha" => "2016"
                        "volumen" => "133"
                        "paginaInicial" => "859"
                        "paginaFinal" => "871"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26826181"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2022 ESC&#47;ERS Guidelines for the diagnosis and treatment of pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Humbert"
                            1 => "G&#46; Kovacs"
                            2 => "M&#46;M&#46; Hoeper"
                            3 => "R&#46; Badagliacca"
                            4 => "R&#46;M&#46;F&#46; Berger"
                            5 => "M&#46; Brida"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/13993003.00879-2022"
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Respir J&#46;"
                        "fecha" => "2023"
                        "volumen" => "61"
                        "paginaInicial" => "2200879"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36028254"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Lang"
                            1 => "B&#46;C&#46; Meyer"
                            2 => "T&#46; Ogo"
                            3 => "H&#46; Matsubara"
                            4 => "M&#46; Kurzyna"
                            5 => "H&#46;A&#46; Ghofrani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/16000617.0119-2016"
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Respir Rev&#46;"
                        "fecha" => "2017"
                        "volumen" => "26"
                        "paginaInicial" => "160119"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28356406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Microvascular disease in chronic thromboembolic pulmonary hypertension&#58; A role for pulmonary veins and systemic vasculature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Dorfm&#252;ller"
                            1 => "S&#46; G&#252;nther"
                            2 => "M&#46;R&#46; Ghigna"
                            3 => "V&#46;T&#46; de Montpreville"
                            4 => "D&#46; Boulate"
                            5 => "J&#46;F&#46; Paul"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00169113"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J&#46;"
                        "fecha" => "2014"
                        "volumen" => "44"
                        "paginaInicial" => "1275"
                        "paginaFinal" => "1288"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25142477"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Riociguat for the treatment of chronic thromboembolic pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;A&#46; Ghofrani"
                            1 => "A&#46;M&#46; D&#8217;Armini"
                            2 => "F&#46; Grimminger"
                            3 => "M&#46;M&#46; Hoeper"
                            4 => "P&#46; Jansa"
                            5 => "N&#46;H&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1209657"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med&#46;"
                        "fecha" => "2013"
                        "volumen" => "369"
                        "paginaInicial" => "319"
                        "paginaFinal" => "329"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23883377"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Subcutaneous treprostinil for the treatment of severe non-operable chronic thromboembolic pulmonary hypertension &#40;CTREPH&#41;&#58; A double-blind&#44; phase 3&#44; randomised controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Sadushi-Kolici"
                            1 => "P&#46; Jansa"
                            2 => "G&#46; Kopec"
                            3 => "A&#46; Torbicki"
                            4 => "N&#46; Skoro-Sajer"
                            5 => "I&#46;A&#46; Campean"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S2213-2600(18)30367-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Respir Med&#46;"
                        "fecha" => "2019"
                        "volumen" => "7"
                        "paginaInicial" => "239"
                        "paginaFinal" => "248"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30477763"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Macitentan for the treatment of inoperable chronic thromboembolic pulmonary hypertension &#40;MERIT-1&#41;&#58; Results from the multicentre&#44; phase<span class="elsevierStyleHsp" style=""></span>2&#44; randomised&#44; double-blind&#44; placebo-controlled study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;A&#46; Ghofrani"
                            1 => "G&#46; Simonneau"
                            2 => "A&#46;M&#46; d&#8217;Armini"
                            3 => "P&#46; Fedullo"
                            4 => "L&#46;S&#46; Howard"
                            5 => "X&#46; Jais"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S2213-2600(17)30305-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Respir Med&#46;"
                        "fecha" => "2017"
                        "volumen" => "5"
                        "paginaInicial" => "785"
                        "paginaFinal" => "794"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28919201"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronic thromboembolic pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;H&#46; Kim"
                            1 => "M&#46; Delcroix"
                            2 => "X&#46; Jais"
                            3 => "M&#46;M&#46; Madani"
                            4 => "H&#46; Matsubara"
                            5 => "E&#46; Mayer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/13993003.01915-2018"
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Respir J&#46;"
                        "fecha" => "2019"
                        "volumen" => "53"
                        "paginaInicial" => "1801915"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30545969"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Manejo de la hipertensi&#243;n pulmonar tromboemb&#243;lica cr&#243;nica&#46; Experiencia de un centro de referencia nacional"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Lopez Gude"
                            1 => "A&#46; Santos-Lozano"
                            2 => "E&#46; P&#233;rez de la Sota"
                            3 => "J&#46; Centeno Rodr&#237;guez"
                            4 => "J&#46;L&#46; P&#233;rez Vela"
                            5 => "M&#46;T&#46; Vel&#225;zquez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cir Cardiov&#46;"
                        "fecha" => "2018"
                        "volumen" => "25"
                        "paginaInicial" => "77"
                        "paginaFinal" => "85"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension&#46; Observational study in a referral unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Vel&#225;zquez"
                            1 => "A&#46; Albarr&#225;n"
                            2 => "I&#46; Hern&#225;ndez"
                            3 => "M&#46;J&#46; L&#243;pez-Gude"
                            4 => "F&#46; Sarnago"
                            5 => "R&#46; Mart&#237;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rec.2018.02.020"
                      "Revista" => array:7 [
                        "tituloSerie" => "Rev Esp Cardiol &#40;Engl Ed&#41;&#46;"
                        "fecha" => "2019"
                        "volumen" => "72"
                        "paginaInicial" => "224"
                        "paginaFinal" => "232"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29857972"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1542356518312709"
                          "estado" => "S300"
                          "issn" => "15423565"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tromboendarterectom&#237;a pulmonar en 106 pacientes con hipertensi&#243;n pulmonar tromboemb&#243;lica cr&#243;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; L&#243;pez Gude"
                            1 => "E&#46; P&#233;rez de la Sota"
                            2 => "A&#46; Forteza Gil"
                            3 => "J&#46; Centeno Rogr&#237;guez"
                            4 => "A&#46; Eixer&#233;s"
                            5 => "M&#46;T&#46; Velazquez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2014.11.012"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol&#46;"
                        "fecha" => "2015"
                        "volumen" => "51"
                        "paginaInicial" => "502"
                        "paginaFinal" => "508"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25605526"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resultados de la tromboendarterectom&#237;a pulmonar en la hipertensi&#243;n pulmonar tromboemb&#243;lica cr&#243;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; L&#243;pez Gude"
                            1 => "E&#46; P&#233;rez de la Sota"
                            2 => "J&#46;L&#46; P&#233;rez Vela"
                            3 => "J&#46; Centeno Rodr&#237;guez"
                            4 => "C&#46; Mu&#241;oz Guijosa"
                            5 => "M&#46;T&#46; Vel&#225;zquez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medcli.2016.12.032"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;&#46;"
                        "fecha" => "2017"
                        "volumen" => "149"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28233561"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical management and outcome of patients with chronic thromboembolic pulmonary hypertension&#58; Results from an international prospective registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Mayer"
                            1 => "D&#46; Jenkins"
                            2 => "J&#46; Lindner"
                            3 => "A&#46; d&#8217;Armini"
                            4 => "J&#46; Kloek"
                            5 => "B&#46; Meyns"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J ThoracCardiovasc Surg&#46;"
                        "fecha" => "2011"
                        "volumen" => "141"
                        "paginaInicial" => "702"
                        "paginaFinal" => "710"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary endarterectomy patient selection&#44; technical challenges&#44; and outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Madani"
                            1 => "E&#46; Mayer"
                            2 => "E&#46; Fadel"
                            3 => "D&#46;P&#46; Jenkins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1513/AnnalsATS.201601-014AS"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Am Thorac Soc&#46;"
                        "fecha" => "2016"
                        "volumen" => "13"
                        "numero" => "Suppl 3"
                        "paginaInicial" => "S240"
                        "paginaFinal" => "S247"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27571005"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term outcome of patients with chronic thromboembolic pulmonary hypertension results from an international prospective registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Delcroix"
                            1 => "I&#46; Lang"
                            2 => "J&#46; Pepke-Zaba"
                            3 => "P&#46;M&#46; Jansa"
                            4 => "A&#46; D&#8217;Armini"
                            5 => "R&#46; Snijder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Circulation&#46;"
                        "fecha" => "2016"
                        "volumen" => "133"
                        "paginaInicial" => "859"
                        "paginaFinal" => "871"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Results from more than 20<span class="elsevierStyleHsp" style=""></span>years of surgical pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension in Denmark"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Korsholm"
                            1 => "A&#46; Andersen"
                            2 => "S&#46; Mellemkj&#230;r"
                            3 => "D&#46;V&#46; Nielsen"
                            4 => "K&#46;E&#46; Klaaborg"
                            5 => "L&#46;B&#46; Ilkj&#230;r"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ejcts/ezx182"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg&#46;"
                        "fecha" => "2017"
                        "volumen" => "52"
                        "paginaInicial" => "704"
                        "paginaFinal" => "709"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28591785"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term outcomes after pulmonary endarterectomy in 499 patients over a 20-year period"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Miyahara"
                            1 => "T&#46;A&#46; Schr&#246;der"
                            2 => "H&#46; Wilkens"
                            3 => "I&#46; Karliova"
                            4 => "F&#46; Langer"
                            5 => "T&#46; Kunihara"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2020.06.122"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Thorac Surg&#46;"
                        "fecha" => "2021"
                        "volumen" => "111"
                        "paginaInicial" => "1585"
                        "paginaFinal" => "1592"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32949609"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0016510702438102"
                          "estado" => "S300"
                          "issn" => "00165107"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome after surgical treatment of chronic thromboembolic pulmonary hypertension&#58; Dealing with different patient subsets&#46; A single-centre experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Nierlich"
                            1 => "A&#46; Hold"
                            2 => "R&#46; Ristl"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ejcts/ezw099"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg&#46;"
                        "fecha" => "2016"
                        "volumen" => "50"
                        "paginaInicial" => "898"
                        "paginaFinal" => "906"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27072006"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perfusion strategy and mid-term results of 58 consecutive pulmonary endarterectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Yan"
                            1 => "S&#46; Lou"
                            2 => "J&#46; Zhu"
                            3 => "S&#46; Liu"
                            4 => "Y&#46; Zhao"
                            5 => "Y&#46; Song"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0267659119831518"
                      "Revista" => array:6 [
                        "tituloSerie" => "Perfusion&#46;"
                        "fecha" => "2019"
                        "volumen" => "34"
                        "paginaInicial" => "475"
                        "paginaFinal" => "481"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30819040"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Residual pulmonary hypertension after pulmonary thromboendarterectomy&#58; Incidence&#44; pathogenesis and therapeutic options"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Godinas"
                            1 => "T&#46; Verbelen"
                            2 => "M&#46; Delcroix"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.21037/acs-2021-pte-11"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Cardiothorac Surg&#46;"
                        "fecha" => "2022"
                        "volumen" => "11"
                        "paginaInicial" => "163"
                        "paginaFinal" => "165"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35433368"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantifying the learning curve for pulmonary thromboendarterectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Sihag"
                            1 => "B&#46; Le"
                            2 => "A&#46;S&#46; Witkin"
                            3 => "J&#46;M&#46; Rodriguez-Lopez"
                            4 => "M&#46;A&#46; Villavicencio"
                            5 => "G&#46;J&#46; Vlahakes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13019-017-0686-1"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Cardiothorac Surg&#46;"
                        "fecha" => "2017"
                        "volumen" => "12"
                        "paginaInicial" => "121"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29284512"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Residual pulmonary hypertension after pulmonary endarterectomy&#58; A meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "W&#46;C&#46; Hsieh"
                            1 => "P&#46; Jansa"
                            2 => "W&#46;C&#46; Huang"
                            3 => "M&#46; Ni&#382;nansk&#253;"
                            4 => "M&#46; Omara"
                            5 => "J&#46; Lindner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jtcvs.2018.04.110"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thorac Cardiovasc Surg&#46;"
                        "fecha" => "2018"
                        "volumen" => "156"
                        "paginaInicial" => "1275"
                        "paginaFinal" => "1287"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29903403"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Survival after pulmonary thromboendarterectomy&#58; Effect of residual pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;H&#46; Freed"
                            1 => "B&#46;M&#46; Thomson"
                            2 => "M&#46; Berman"
                            3 => "S&#46;S&#46;L&#46; Tsui"
                            4 => "J&#46; Dunning"
                            5 => "K&#46;K&#46; Sheares"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jtcvs.2009.12.056"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thorac Cardiovasc Surg&#46;"
                        "fecha" => "2011"
                        "volumen" => "141"
                        "paginaInicial" => "383"
                        "paginaFinal" => "387"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20471039"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dynamic risk stratification of patient long-term outcome after pulmonary endarterectomy&#58; Results from the United Kingdom National Cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;E&#46; Cannon"
                            1 => "L&#46; Su"
                            2 => "D&#46;G&#46; Kiely"
                            3 => "K&#46; Page"
                            4 => "M&#46; Toshner"
                            5 => "E&#46; Swietlik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.115.019470"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation&#46;"
                        "fecha" => "2016"
                        "volumen" => "133"
                        "paginaInicial" => "1761"
                        "paginaFinal" => "1771"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27052413"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term outcome after pulmonary endarterectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;G&#46; Corsico"
                            1 => "A&#46;M&#46; d&#8217;Armini"
                            2 => "I&#46; Cerveri"
                            3 => "C&#46; Klersy"
                            4 => "E&#46; Ansaldo"
                            5 => "R&#46; Niniano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.200801-101OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med&#46;"
                        "fecha" => "2008"
                        "volumen" => "178"
                        "paginaInicial" => "419"
                        "paginaFinal" => "424"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18556630"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46; Ishida"
                            1 => "M&#46; Masuda"
                            2 => "N&#46; Tanabe"
                            3 => "G&#46; Matsumiya"
                            4 => "K&#46; Tatsumi"
                            5 => "N&#46; Nakajima"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jtcvs.2011.09.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thorac Cardiovasc Surg&#46;"
                        "fecha" => "2012"
                        "volumen" => "144"
                        "paginaInicial" => "321"
                        "paginaFinal" => "326"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21992851"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical specimens&#44; haemodynamics and long-term outcomes after pulmonary endarterectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Skoro-Sajer"
                            1 => "G&#46; Marta"
                            2 => "C&#46; Gerges"
                            3 => "G&#46; Hlavin"
                            4 => "P&#46; Nierlich"
                            5 => "S&#46; Taghavi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thoraxjnl-2013-203746"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax&#46;"
                        "fecha" => "2014"
                        "volumen" => "69"
                        "paginaInicial" => "116"
                        "paginaFinal" => "122"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24052543"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Additional percutaneous transluminal pulmonary angioplasty for residual or recurrent pulmonary hypertension after pulmonary endarterectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Shimura"
                            1 => "M&#46; Kataoka"
                            2 => "T&#46; Inami"
                            3 => "R&#46; Yanagisawa"
                            4 => "H&#46; Ishiguro"
                            5 => "T&#46; Kawakami"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2015.01.034"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol&#46;"
                        "fecha" => "2015"
                        "volumen" => "183"
                        "paginaInicial" => "138"
                        "paginaFinal" => "142"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25662076"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Balloon pulmonary angioplasty for the treatment of residual or recurrent pulmonary hypertension after pulmonary endarterectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Araszkiewicz"
                            1 => "S&#46; Darocha"
                            2 => "A&#46; Pietrasik"
                            3 => "R&#46; Pietura"
                            4 => "S&#46; Jankiewicz"
                            5 => "M&#46; Banaszkiewicz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2018.10.066"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol&#46;"
                        "fecha" => "2019"
                        "volumen" => "278"
                        "paginaInicial" => "232"
                        "paginaFinal" => "237"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30409735"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy and safety of balloon pulmonary angioplasty for residual pulmonary hypertension after pulmonary endarterectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Ito"
                            1 => "J&#46; Yamashita"
                            2 => "Y&#46; Sasaki"
                            3 => "S&#46; Ikeda"
                            4 => "S&#46; Suzuki"
                            5 => "N&#46; Murata"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2021.04.013"
                      "Revista" => array:7 [
                        "tituloSerie" => "Int J Cardiol&#46;"
                        "fecha" => "2021"
                        "volumen" => "334"
                        "paginaInicial" => "105"
                        "paginaFinal" => "109"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33839175"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0016510720341948"
                          "estado" => "S300"
                          "issn" => "00165107"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serial right heart catheter assessment between balloon pulmonary angioplasty sessions identify procedural factors that influence response to treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;P&#46; Hug"
                            1 => "J&#46; Gerry Coghlan"
                            2 => "J&#46; Cannon"
                            3 => "D&#46; Taboada"
                            4 => "M&#46; Toshner"
                            5 => "K&#46; Sheares"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Heart Lung Transplant&#46;"
                        "fecha" => "2021"
                        "volumen" => "40"
                        "paginaInicial" => "S1223"
                        "paginaFinal" => "S1234"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Balloon pulmonary angioplasty outcomes in patients previously treated by pulmonary endarterectomy surgery are inferior to those of inoperable patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;C&#46; Kirkby"
                            1 => "M&#46;S&#46; Rodgers"
                            2 => "L&#46; Amaral-Almeida"
                            3 => "K&#46; Sheares"
                            4 => "M&#46; Toshner"
                            5 => "K&#46; Bunclark"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/pul2.12265"
                      "Revista" => array:5 [
                        "tituloSerie" => "Pulm Circ&#46;"
                        "fecha" => "2023"
                        "volumen" => "13"
                        "paginaInicial" => "e12265"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37415805"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effectiveness and safety of balloon pulmonary angioplasty for the treatment of patients with persistent pulmonary hypertension after pulmonary endarterectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;M&#46; Maneiro Melon"
                            1 => "M&#46; Velazquez Martin"
                            2 => "S&#46; Huertas Nieto"
                            3 => "A&#46; Albarran Gonzalez-Trevilla"
                            4 => "F&#46; Sarnago Cebada"
                            5 => "A&#46; Cruz Utrilla"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/jcm12030905"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Med&#46;"
                        "fecha" => "2023"
                        "volumen" => "12"
                        "paginaInicial" => "905"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36769552"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/11340096/unassign/S1134009624001086/v1_202407090419/es/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/11340096/unassign/S1134009624001086/v1_202407090419/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134009624001086?idApp=UINPBA00004N"
]
Información del artículo
ISSN: 11340096
Idioma original: Español
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 3 0 3
2024 Octubre 38 12 50
2024 Septiembre 44 22 66
2024 Agosto 56 13 69
2024 Julio 69 19 88

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