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Experiencia en cirugía cardiaca mínimamente invasiva en un centro cardiovascular
Experience in minimally invasive cardiac surgery in a cardiovascular center
Ubaldo E. Rivas-Aguilara,
Autor para correspondencia
Ubaeri05@gmail.com

Autor para correspondencia.
, Juan C. Rendon-Isazaa, José Julián Escobar-Matallanaa, Omar A. Matar-Khalila, Sharoon Suarez-Ramíreza, Eric E. Vinck-Geermana, Juan Camilo Peláez-Ortizb, Daniela Arbeláez-Lelionb, Eliana M. Cañas-Arenasc
a Department of Cardiovascular Surgery, Cardio VID Clinic, Pontifical Bolivarian University, Medellín, Antioquia, Colombia
b Medical School, Pontifical Bolivarian University, Medellín, Antioquia, Colombia
c Department of Clinical Research, Cardio VID Clinic, Medellín, Antioquia, Colombia
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cirug&#237;a adicional&#44; d&#237;as en la unidad de cuidados intensivos&#44; d&#237;as de estancia hospitalaria y tipo de pr&#243;tesis valvular&#46; <span class="elsevierStyleItalic">Complicaciones&#58;</span> trastornos del ritmo&#44; enfermedad cerebrovascular&#44; di&#225;lisis&#44; colocaci&#243;n de marcapasos permanente&#44; reintervenciones por sangrado&#44; fuga para valvular y&#47;o insuficiencia valvular&#44; hemot&#243;rax&#44; hernia pulmonar&#44; f&#237;stula linf&#225;tica en &#237;ngle&#44; infarto agudo de miocardio &#40;IAM&#41;&#44; mortalidad e infecciones &#40;neumon&#237;a&#44; empiema&#44; infecci&#243;n de sitio operatorio &#91;ISO&#93; t&#243;rax o miembros inferiores y mediastinitis&#41; en los primeros 90 d&#237;as&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Se obtuvieron los datos por medio de una tabla en Excel&#174; con las variables del estudio&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Para las variables cuantitativas se consideraron las medidas de tendencia central &#40;mediana&#44; media&#41; y las medidas de dispersi&#243;n &#40;desviaci&#243;n est&#225;ndar y rango intercuart&#237;lico&#41;&#46; Para la verificaci&#243;n de la normalidad&#44; se us&#243; la prueba de Kolmogorov-Smirnov&#44; las variables cualitativas se expresaron en frecuencias absolutas y relativas&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Para el an&#225;lisis de datos se utiliz&#243; el paquete estad&#237;stico SPSS&#174; versi&#243;n 25&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0040" class="elsevierStylePara elsevierViewall">De 846 pacientes&#44; el 55&#44;4&#37; &#40;469&#41; fueron varones y el 44&#44;6&#37; &#40;377&#41; mujeres&#44; la mediana para la edad e IMC fue de 60 y 25&#44; respectivamente&#44; el 82&#44;3&#37; ten&#237;an comorbilidades siendo la hipertensi&#243;n arterial y dislipidemia las m&#225;s frecuentes &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">El cambio valvular a&#243;rtico fue la cirug&#237;a m&#225;s frecuente con 399 pacientes &#40;47&#44;2&#37;&#41;&#44; seguido por el cambio de v&#225;lvula mitral 201 &#40;23&#44;9&#37;&#41;&#44; reparo de v&#225;lvula mitral 173 &#40;20&#44;4&#37;&#41;&#44; cierre de comunicaci&#243;n interauricular &#40;CIA&#41; 31 &#40;3&#44;7&#37;&#41;&#44; reparo de v&#225;lvula tric&#250;spidea 14 &#40;1&#44;7&#37;&#41;&#44; resecci&#243;n de tumor 10 &#40;1&#44;2&#41;&#44; revascularizaci&#243;n mioc&#225;rdica &#40;RVM&#41; 9 &#40;1&#44;1&#37;&#41;&#44; cambio de v&#225;lvula tric&#250;spide 4 &#40;0&#44;5&#37;&#41;&#44; reparo de v&#225;lvula a&#243;rtica 9 &#40;1&#44;1&#37;&#41; y reparo de v&#225;lvula pulmonar 1 &#40;0&#44;1&#37;&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">En el 26&#37; de los casos se hizo una cirug&#237;a adicional&#59; el reparo o cambio de v&#225;lvula tric&#250;spide fue el m&#225;s frecuente en un 78&#44;8&#37; asociado a cirug&#237;a de v&#225;lvula mitral&#44; otros procedimientos fueron cierre de CIA&#44; resecci&#243;n de auriculilla y&#47;o cirug&#237;a de MAZE&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Las pr&#243;tesis implantadas fueron en el 88&#44;9&#37; biol&#243;gicas y mec&#225;nicas el 11&#44;9&#37;&#44; no hubo cambios entre la FEVI pre y postoperatoria&#44; 24 pacientes se convirtieron a esternotom&#237;a media&#44; de estos 14 pacientes fueron por cambio de v&#225;lvula a&#243;rtica &#40;<a class="elsevierStyleCrossRefs" href="#tbl0010">tablas 2 y 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Con la experiencia se identific&#243; una disminuci&#243;n en la media del tiempo de pinza de 86&#44;5<span class="elsevierStyleHsp" style=""></span>min hasta 78<span class="elsevierStyleHsp" style=""></span>min &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Noventa y tres pacientes &#40;10&#44;9&#37;&#41; sin antecedentes de FA lo presentaron en el postoperatorio &#40;POP&#41; y 31 &#40;3&#44;6&#37;&#41; pacientes con bloqueo A-V POP&#44; de los cuales 8 &#40;25&#37;&#41; requirieron marcapasos permanente&#59; la mayor&#237;a de los pacientes con bloquero ten&#237;an cirug&#237;a de cambio valvular a&#243;rtico &#40;62&#37;&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Veintinueve &#40;3&#46;4&#37;&#41; pacientes presentaron complicaciones infecciosas&#58; neumon&#237;a 13 &#40;1&#44;5&#37;&#41; seguido por 9 pacientes de ISO en t&#243;rax y 4 pacientes para ISO de miembros inferiores&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Veinticinco pacientes presentaron eventos neurol&#243;gicos&#44; fueron 12 &#40;48&#37;&#41; de cambio de v&#225;lvula a&#243;rtica y 10 &#40;40&#37;&#41; cambio de v&#225;lvula mitral&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">El 40&#37; de los pacientes con di&#225;lisis en el postoperatorio ya ten&#237;an alg&#250;n tipo de insuficiencia renal antes de la cirug&#237;a&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Se identificaron 13 pacientes con fuga para valvular leve&#58; 8 &#40;61&#37;&#41; por cambio a&#243;rtico y 5 &#40;39&#37;&#41; en mitral&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">La mortalidad global fue de 32 pacientes &#40;3&#44;8&#37;&#41; distribuidos por enfermedades en&#58; 27 con falla biventricular&#44; 3 <span class="elsevierStyleItalic">shock</span> s&#233;ptico y 2 con infarto agudo de miocardio &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">No se ha logrado demostrar una diferencia significativa en la mortalidad cuando comparamos MICS con la cirug&#237;a convencional&#44; sin embargo&#44; hay una recuperaci&#243;n m&#225;s r&#225;pida&#44; menor trauma&#44; dolor&#44; hemoderivados e infecci&#243;n&#44; trastornos del ritmo&#44; sangrados&#44; etc&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">El tipo de pr&#243;tesis depende de la elecci&#243;n del paciente&#44; la edad y las comorbilidades&#44; la mayor&#237;a son biol&#243;gicas entendiendo que contamos con una poblaci&#243;n en la que 9 de cada 10 pacientes son mayores de 65 a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">6&#44;7</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Hay que superar algunos retos en MICS de RVM para que sea reproducible como contar con m&#225;s experiencia en t&#233;cnicas con y sin bomba&#44; t&#233;cnicas endosc&#243;picas y completar una curva de aprendizaje adem&#225;s del apoyo institucional para los insumos<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">1&#44;2</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">La FEVI baja en el POP est&#225; relacionada con reingresos por falla cardiaca y hay una relaci&#243;n para la mortalidad con funci&#243;n disminuida y cambio mitral por insuficiencia<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">8&#44;9</span></a>&#46; Encontramos una FEVI perioperatoria buena&#44; pero se necesita de un an&#225;lisis de riesgos para establecer una relaci&#243;n entre esto y la baja frecuencia de morbimortalidad&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">La conversi&#243;n a esternotom&#237;a en la MICS para cambio valvular es del 3&#37;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">10</span></a> y hasta un 6&#44;5&#37; en RVM <a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">11</span></a> por ser una t&#233;cnica practicada con menos frecuencia&#59; encontramos en nuestro estudio un 2&#44;8&#37; relacionado generalmente con sangrado a la apertura en t&#243;rax compatible con lo descrito en la literatura<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">10&#8211;12</span></a>&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">La prevalencia de FA en el POP es igual o mayor al 30&#37; y no hay una diferencia estad&#237;sticamente significativa entre MICS vs&#46; esternotom&#237;a<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">13</span></a>&#44; hay variables que aumentan el riesgo de presentarlo como&#58; edad&#44; tiempo de CEC mayor de 120<span class="elsevierStyleHsp" style=""></span>min&#44; FEVI menor del 55&#37;&#44; cirug&#237;a doble combinada<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">14</span></a>&#46; Encontramos el 10&#37; de FA en el POP&#44; esto podr&#237;a tener alguna relaci&#243;n con variables favorables para no presentarla como la edad&#44; FEVI y escaso n&#250;mero de cirug&#237;as combinadas&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">La estancia hospitalaria&#44; las trasfusiones y la di&#225;lisis fueron bajas en comparaci&#243;n con la cirug&#237;a convencional acorde con lo descrito en otros art&#237;culos<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">15&#44;16</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">La mediastinitis es un indicativo de buena calidad en atenci&#243;n hospitalaria cuando es menor del 2&#37;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">17</span></a>&#59; en este estudio fue del 0&#44;1&#37; y est&#225; relacionada a los pacientes con conversi&#243;n a esternotom&#237;a&#44; lo que demuestra no solo para los pacientes de minitoracotom&#237;a y esternotom&#237;a las medidas tomadas en el perioperatorio garantizan que sea una cirug&#237;a con bajo riesgo de infecciones&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">EL porcentaje de pacientes con fistula linf&#225;ticas es muy variable<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">18</span></a><span class="elsevierStyleSup">&#46;</span>&#44; sin embargo&#44; tenemos un 3&#44;6&#37; que es un porcentaje bajo dentro de lo reportado&#44; lo que s&#237; representa un problema que m&#225;s del 50&#37; presentan recurrencias<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">18</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En cuanto a otras complicaciones las fugas para valvulares contamos con un resultado aceptable del 3&#44;2&#37; ya que pueden llegar al 8&#37;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">19</span></a>&#44; y est&#225; relacionada con el tipo de enfermedad inicial en la v&#225;lvula&#44; la cantidad de calcio&#44; la morfolog&#237;a del anillo y la t&#233;cnica quir&#250;rgica&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">La tasa de mortalidad&#44; infarto agudo de miocardio&#44; enfermedad cerebro vascular son muy bajas y no encontramos una tendencia clara&#59; Se ha demostrado que la MICS es segura y brinda ventajas en un subconjunto de pacientes de edad avanzada&#44; obesos y de alto riesgo en infecciones o dehiscencia esternal<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">20&#44;21</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Limitantes</span><p id="par0150" class="elsevierStylePara elsevierViewall">Hay 1&#46;223 pacientes con MICS desde sus inicios hasta el a&#241;o 2022&#59; el 70&#37; &#40;846&#41; con criterios de inclusi&#243;n para este estudio y dadas las condiciones del sistema de salud colombiano algunos pacientes no se pueden seguir a largo plazo por la misma instituci&#243;n&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusi&#243;n</span><p id="par0155" class="elsevierStylePara elsevierViewall">Esta experiencia es una de las m&#225;s grandes en Latinoam&#233;rica que incluye cirujanos de experiencia mayor a una d&#233;cada&#44; con bajas complicaciones y mortalidad comparables a lo descrito en la literatura&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Consideraciones &#233;ticas</span><p id="par0160" class="elsevierStylePara elsevierViewall">Este es un estudio en el que no se realiza ninguna intervenci&#243;n a una persona por que los datos se recogen directamente desde la carpeta cl&#237;nica electr&#243;nica&#44; por lo que es un estudio de bajo riesgo&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Financiaci&#243;n</span><p id="par0165" class="elsevierStylePara elsevierViewall">Los autores declaran no haber recibido ayuda financiera para la realizaci&#243;n de este trabajo&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicto de intereses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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    "fechaRecibido" => "2024-06-17"
    "fechaAceptado" => "2024-09-01"
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            1 => "Cambio de v&#225;lvula a&#243;rtica"
            2 => "Cambio de v&#225;lvula mitral"
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            1 => "Aortic valve replacement"
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    "resumen" => array:2 [
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La cirug&#237;a m&#237;nimamente invasiva &#40;MICS&#41;&#44; se viene desarrollando desde hace 50 a&#241;os&#44; y est&#225; relacionada con resultados aceptables&#46; En este estudio se presenta la experiencia en procedimientos quir&#250;rgicos m&#237;nimamente invasivos entre los a&#241;os 2011 a 2022 en un centro cardiovascular de Colombia&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Metodolog&#237;a</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio de tipo observacional&#44; descriptivo&#44; longitudinal&#44; retrospectivo en pacientes con enfermedad valvular o isquemia mioc&#225;rdica&#44; se les realiz&#243; cirug&#237;a card&#237;aca m&#237;nimamente invasiva &#40;MICS&#41; entre los a&#241;os 2011 y 2022 a los que cumpl&#237;an con los criterios de elegibilidad&#44; para responder a &#191;C&#243;mo ha sido la experiencia en la cirug&#237;a cardiaca m&#237;nimamente invasiva en un centro cardiovascular de Colombia en los &#250;ltimos 12 a&#241;os&#63;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se encontraron 846 pacientes que cumplieron con los criterios de inclusi&#243;n&#44; siendo el 55&#37; varones y el 45&#37; mujeres&#44; con una edad media de 60 a&#241;os&#44; el procedimiento m&#225;s frecuente fue cambio valvular a&#243;rtico &#40;47&#44;2&#37;&#41;&#44; seguido de cambio y reparo de v&#225;lvula mitral con el 23&#44;9 y el 20&#44;4&#37;&#44; respectivamente&#44; con la experiencia hay una disminuci&#243;n en el tiempo de pinza&#44; las complicaciones m&#225;s frecuentes fueron fibrilaci&#243;n auricular &#40;FA&#41; con el 10&#44;9&#37;&#44; reintervenci&#243;n por sangrado con el 6&#44;4&#37;&#44; infecciones con un 3&#44;4&#37; y con una mortalidad global del 3&#44;8&#37;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En nuestra experiencia encontramos que los resultados de este estudio son comparables con los pa&#237;ses desarrollados&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Minimally invasive surgery &#40;MICS&#41;&#44; has been in development for 50 years and is associated with acceptable results&#46; In this study&#44; the experience in minimally invasive surgical procedures between 2011 and 2022 in a cardiovascular center in Colombia is presented&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methodology</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Observational&#44; descriptive&#44; longitudinal&#44; retrospective study in patients with valvular disease or myocardial ischemia and underwent minimally invasive cardiac surgery &#40;MICS&#41; between 2011 and 2022 who meet the eligibility criteria&#44; to answer the question&#58; How has been the experience in minimally invasive cardiac surgery in a cardiovascular center in Colombia in the last 12 years&#63;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We found 846 patients who met the inclusion criteria&#44; 55&#37; men and 45&#37; women&#44; with a mean age of 60 years&#44; the most frequent procedure was aortic valve replacement &#40;47&#46;2&#37;&#41; followed by mitral valve replacement and repair with 23&#46;9&#37; and 20&#46;4&#37; respectively&#44; with experience there is a decrease in the clamp time&#44; the most frequent complications were atrial fibrillation &#40;AF&#41; 10&#46;9&#37;&#44; reoperation for bleeding 6&#46;4&#37;&#44; infections with 3&#46;4&#37;&#44; with an overall mortality of 3&#46;8&#37;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In our experience we found that the results of this study are comparable with those of developed countries&#46;</p></span>"
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masculino&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">469 &#40;55&#44;4&#41;&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>Femenino&nbsp;\t\t\t\t\t\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">377 &#40;44&#44;6&#41;&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">&#205;ndice masa corporal-mediana &#40;RIC&#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">24&#44;2 &#40;22&#44;3-27&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbilidades&#44; n &#40;&#37;&#41;</span></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>Fibrilaci&#243;n auricular &#40;FA&#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">111 &#40;13&#44;1&#41;&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>Bloqueo&nbsp;\t\t\t\t\t\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 &#40;0&#44;5&#41;&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">Flutter</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;0&#44;8&#41;&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">Diabetes mellitus</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">82 &#40;9&#44;7&#41;&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">Dislipidemia</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">189 &#40;22&#44;3&#41;&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">Hipertensi&#243;n arterial</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">231 &#40;27&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Enfermedad renal cr&#243;nica</span></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>Tasa de filtraci&#243;n glomerular mayor 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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;1&#44;2&#41;&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>Tasa de filtraci&#243;n glomerular menor 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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \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">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tipo de abordaje</th></tr><tr title="table-row"><th class="td" title="\n
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                  \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">Tipo de procedimiento&nbsp;\t\t\t\t\t\t\n
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                  \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">N &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mini toracotom&#237;a anterolateral izquierda&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">Mini toracotom&#237;a anterolateral derecha&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">Peri areolar&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">Mini esternotom&#237;a superior&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">RVM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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&nbsp;\t\t\t\t\t\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&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">Cambio de v&#225;lvula de aorta&nbsp;\t\t\t\t\t\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">399 &#40;47&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">355 &#40;88&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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 &#40;12&#37;&#41;&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">Reparo de v&#225;lvula de aorta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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&nbsp;\t\t\t\t\t\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;100&#37;&#41;&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">Cambio de v&#225;lvula mitral&nbsp;\t\t\t\t\t\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">201 &#40;23&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">188 &#40;93&#37;&#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">15 &#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&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">Reparo de v&#225;lvula mitral&nbsp;\t\t\t\t\t\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">173 &#40;20&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\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">159 &#40;91&#37;&#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">14 &#40;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&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">Cambio de v&#225;lvula tric&#250;spide&nbsp;\t\t\t\t\t\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 &#40;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Reparo de v&#225;lvula tric&#250;spide&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">31 &#40;3&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Flutter</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;0&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>ISO t&#243;rax&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">9 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>ISO miembros inferiores&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">4 &#40;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Empiema&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;0&#44;1&#41;&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
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                  \t\t\t\t"><span class="elsevierStyleItalic">F&#237;stula linf&#225;tica&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">31 &#40;3&#44;6&#41;&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
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;0&#44;5&#41;&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
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                  \t\t\t\t"><span class="elsevierStyleItalic">ACV&#44; n &#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">25 &#40;3&#44;0&#41;&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
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                  \t\t\t\t"><span class="elsevierStyleItalic">Di&#225;lisis&#44; n &#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">15 &#40;1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;2&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemot&#243;rax&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36 &#40;4&#44;3&#41;&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
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Leve&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">27 &#40;3&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Marcapasos&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16 &#40;1&#44;9&#41;&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
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Mortalidad global&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;3&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Complicaciones &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>846&#41;</p>"
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                            3 => "M&#46;M&#46; Weber"
                            4 => "R&#46;A&#46; Grimm"
                            5 => "E&#46;H&#46; Blackstone"
                            6 => "D&#46;M&#46; Cosgrove III"
                            7 => "M&#46;K&#46; Chung"
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ISSN: 11340096
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