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array:23 [ "pii" => "S0025775300712759" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71275-9" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71275" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2000" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Med Clin. 2000;114:299-301" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1538 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 1373 "PDF" => 160 ] ] "itemSiguiente" => array:18 [ "pii" => "S0025775300712760" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71276-0" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71276" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Med Clin. 2000;114:302-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3757 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 3618 "PDF" => 133 ] ] "es" => array:7 [ "idiomaDefecto" => true "titulo" => "Tratamiento oncológico activo de la enfermedad neoplásica avanzada y terminal" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "302" "paginaFinal" => "307" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jaime Sanz Ortiz, Fernando Rivera Herrero, Ana de Juan Ferré, M.<span class="elsevierStyleSup">a</span> Eugenia Vega Villegas" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Jaime" "apellidos" => "Sanz Ortiz" ] 1 => array:2 [ "nombre" => "Fernando Rivera" "apellidos" => "Herrero" ] 2 => array:2 [ "nombre" => "Ana de Juan" "apellidos" => "Ferré" ] 3 => array:2 [ "nombre" => "M.<span class="elsevierStyleSup">a</span>" "apellidos" => "Eugenia Vega Villegas" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300712760?idApp=UINPBA00004N" "url" => "/00257753/0000011400000008/v1_201307291447/S0025775300712760/v1_201307291447/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0025775300712747" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71274-7" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71274" "copyright" => "Elsevier España, S.L." 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"tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "297" "paginaFinal" => "298" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José María Peña" "autores" => array:1 [ 0 => array:2 [ "nombre" => "José" "apellidos" => "María Peña" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300712747?idApp=UINPBA00004N" "url" => "/00257753/0000011400000008/v1_201307291447/S0025775300712747/v1_201307291447/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Sustitución valvular urgente en la endocarditis infecciosa: evolución hospitalaria y a largo plazo. Análisis de 45 pacientes" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "299" "paginaFinal" => "301" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Josep Maria Alegret, Xavier Borràs, Concepción Alonso, Francesc Carreras, Mercè Gurguí, María Luisa Cámara, Blai Coll, Guillem Pons-Lladó" "autores" => array:8 [ 0 => array:3 [ "nombre" => "Josep Maria" "apellidos" => "Alegret" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff00015" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Xavier" "apellidos" => "Borràs" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff00005" ] ] ] 2 => array:3 [ "nombre" => "Concepción" "apellidos" => "Alonso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff00005" ] ] ] 3 => array:3 [ "nombre" => "Francesc" "apellidos" => "Carreras" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff00005" ] ] ] 4 => array:3 [ "nombre" => "Mercè" "apellidos" => "Gurguí" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff00010" ] ] ] 5 => array:3 [ "nombre" => "María Luisa" "apellidos" => "Cámara" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff00005" ] ] ] 6 => array:3 [ "nombre" => "Blai" "apellidos" => "Coll" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff00015" ] ] ] 7 => array:3 [ "nombre" => "Guillem" "apellidos" => "Pons-Lladó" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff00005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Departament de Cardiologia i Cirurgia Cardiaca" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff00005" ] 1 => array:3 [ "entidad" => "Unitat de Malalties Infeccioses. Hospital de la Santa Creu i Sant Pau. Barcelona" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff00010" ] 2 => array:3 [ "entidad" => "Departament de Medicina Interna. Secció de Cardiologia. Hospital Universitari de Sant Joan. Reus. Tarragona" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff00015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. J.M. Alegret Colomé. Secció de Cardiologia. Departament de Medicina Interna. Hospital Universitari de Sant Joan. Sant Joan, s/n. 43201 Reus. Tarragona." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Urgent valve heart replacement in infectious endocarditis: short and long-term prognosis. Analysis of 45 patients" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-07-12" "fechaAceptado" => "2000-01-20" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec221302" "palabras" => array:2 [ 0 => "Endocarditis infecciosa" 1 => "Sustitución valvular" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Definir en nuestro medio la evolución de los pacientes afectados de endocarditisinfecciosa que requieren una sustitución valvular urgente.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Analizamos 45 pacientes consecutivos que requirieron sustitución valvulardurante el ingreso hospitalario por endocarditis infecciosa, 32 correspondieron a endocarditissobre válvula nativa, 7 a protésica precoz y 6 a protésica tardía. Se ha realizado un seguimientoa largo plazo clínico y ecocardiográfico.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En 39 casos, la sustitución valvular debió realizarse antes de finalizar el tratamientoantibiótico. Las principales indicaciones fueron insuficiencia cardíaca refractaria (24 pacientes)y shock (11 pacientes). La mortalidad global fue del 24%: 19% en endocarditis sobre válvulanativa, 43% en protésica precoz y 33% en protésica tardía. La primera causa de muertefue el shock séptico (46%). Se han seguido 31 de los 4 supervivientes durante una media de 65 (DE 49) meses, registrándose 2 recidivas y 6 fallecimientos (1 muerte súbita y 2 por endocarditis). El 72% de los pacientespresenta una clase I de la NYHA. Se detectó una dehiscencia significativa en el 17%(38% en el grupo con endocarditis protésica).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La sustitución valvular urgente en la endocarditis infecciosa es una situación gravey con elevada mortalidad. El pronóstico a largo plazo es aceptable, aunque algunos pacientespresentaron dehiscencias significativas, especialmente en endocarditis protésicas.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To define the evolution of patients with infective endocarditis who require urgentvalve replacement in our environment.</p> <span class="elsevierStyleSectionTitle">Patients and Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We followed 45 consecutive cases of infective endocarditis that requirevalve replacement during their hospitalization. 32 patients had native valve infective endocarditis,7 early prosthesis valve endocarditis and 6 late prosthesis valve endocarditis. Patients werefollowed for a long-term period, clinical and echocardiographycally.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In 39 cases valve replacement was performed before ending antibiotic therapy. Themain indications for surgery were refractory heart failure (24 patients) and shock (11 patients).The mortality rate was 24%: 19% in native valve infective endocarditis, 43% in early prostheticvalve endocarditis and 33% in late prosthesis valve endocarditis. The first cause of deathwas septic shock (46%). We followed 31 over 34 survivors for a mean time 65 (DS 49)months. We found two relapses and six deaths (1 sudden death, 2 endocarditis) and 72% ofpatients presented class I NYHA. We detected 17% prosthetic leaks (34% in the prostheticvalve endocarditis group).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The need of urgent valve replacement in the context of infective endocarditis isassociated with a high mortality rate, and should be considered a serious condition. Long termprognosis is, however, acceptable, although 17% of patients had prosthesis leak, specially thosewith prosthetic valve endocarditis.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib00005" "etiqueta" => "1." 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