Coronary artery disease involving chronic occlusions and bifurcation lesions continues to be a challenge for the interventional cardiologist. The improvement in the techniques has allowed a higher success rate, however, the best intervention strategy is unknown in this subgroup of patients with chronic occlusions and associated bifurcation lesions. We present the case of a patient in whom, in an angiography for study of chest pain, a chronic total occlusion and a bifurcation lesion were evidenced and were successfully treated by coronary intervention.

Coronary artery disease involving chronic occlusions and bifurcation lesions continues to be a challenge for the interventional cardiologist. The improvement in the techniques has allowed a higher success rate, however, the best intervention strategy is unknown in this subgroup of patients with chronic occlusions and associated bifurcation lesions. We present the case of a patient in whom, in an angiography for study of chest pain, a chronic total occlusion and a bifurcation lesion were evidenced and were successfully treated by coronary intervention.

Heart failure with preserved ejection fraction (HFpEF) is a frequent and overlooked medical condition that represents a great challenge for diagnosis and treatment. Current data shows a temporal trend towards a higher prevalence of HFpEF, even above heart failure with reduced ejection frac- tion (HFrEF). The pathophysiology of HFpEF is heterogeneous and involves several factors such as genetics, lifestyle, and cardiac and non-cardiac comorbidities. These factors result in remodeling, maladaptation and cardiac stiffness, that later on cause dyspnea, exercise intolerance, and fatigue. Although the mortality outcome of HFpEF is as high as HFrEF, no speci c therapy has demonstrat- ed overall bene t in these patients; which is why future therapies will bet on an individualized approach according to the patients phenotype.

Heart failure with preserved ejection fraction (HFpEF) is a frequent and overlooked medical condition that represents a great challenge for diagnosis and treatment. Current data shows a temporal trend towards a higher prevalence of HFpEF, even above heart failure with reduced ejection frac- tion (HFrEF). The pathophysiology of HFpEF is heterogeneous and involves several factors such as genetics, lifestyle, and cardiac and non-cardiac comorbidities. These factors result in remodeling, maladaptation and cardiac stiffness, that later on cause dyspnea, exercise intolerance, and fatigue. Although the mortality outcome of HFpEF is as high as HFrEF, no speci c therapy has demonstrat- ed overall bene t in these patients; which is why future therapies will bet on an individualized approach according to the patients phenotype.

Advanced heart failure is a major health problem for which heart transplantation or left ventricular assist devices are the only effective treatments. Intra-aortic balloon pump inserted using femoral artery access as a bridge to heart transplantation is still frequently used, but has the disadvantage of limiting the patient’s movements, hence exposing him or her to the hazards of immobility and threatening the success of the procedure or hindering recovery. Access through the subclavian artery has become an attractive alternative since it doesn’t impair the patient’s mobility, and there is increasing evidence supporting its use. We present the first case of subclavian counterpulsation balloon implantation in a cardiovascular care center in Colombia.

Advanced heart failure is a major health problem for which heart transplantation or left ventricular assist devices are the only effective treatments. Intra-aortic balloon pump inserted using femoral artery access as a bridge to heart transplantation is still frequently used, but has the disadvantage of limiting the patient’s movements, hence exposing him or her to the hazards of immobility and threatening the success of the procedure or hindering recovery. Access through the subclavian artery has become an attractive alternative since it doesn’t impair the patient’s mobility, and there is increasing evidence supporting its use. We present the first case of subclavian counterpulsation balloon implantation in a cardiovascular care center in Colombia.

Objective.  Evaluate the change of lactate levels and its prognostic role in the postoperative period of patients undergoing pulmonary thromboendarterectomy. Methods. Retrospective study between 2001 and 2019. Patients older than 18 years and who underwent pulmonary thromboendarterectomy were included. The U Mann Whitney test was performed to evaluate the change between lactate levels, and Cox regression analysis to evaluate the relationship with mortality. Areas under the curve were constructed for lactate levels. Results. Seventy-three patients were operated on during the study period. Median age was 51 years, 55% female. The median lactate on days 1 was 4.65 mml/L and on day 2 it was 1.62 mml/L with a change of 2.87 mml/L. No differences were found between the levels measured on day 1 and 2 between the people who died and those who did not on day 30. In the multivariate regressio...

Objective.  Evaluate the change of lactate levels and its prognostic role in the postoperative period of patients undergoing pulmonary thromboendarterectomy. Methods. Retrospective study between 2001 and 2019. Patients older than 18 years and who underwent pulmonary thromboendarterectomy were included. The U Mann Whitney test was performed to evaluate the change between lactate levels, and Cox regression analysis to evaluate the relationship with mortality. Areas under the curve were constructed for lactate levels. Results. Seventy-three patients were operated on during the study period. Median age was 51 years, 55% female. The median lactate on days 1 was 4.65 mml/L and on day 2 it was 1.62 mml/L with a change of 2.87 mml/L. No differences were found between the levels measured on day 1 and 2 between the people who died and those who did not on day 30. In the multivariate regressio...