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Jordi Mercé

Publications and source records attributed to Jordi Mercé.

5 recordsLinked to original sources

[Clinical characteristics and outcome of infective endocarditis in individuals of the general population managed at a teaching hospital without cardiac surgery facilities. Study of 120 cases].

INTRODUCTION AND OBJECTIVES: To assess the clinical characteristics and management of infective endocarditis at a teaching hospital without cardiac surgery facilities. METHODS: Descriptive case-control study looking at trends. Risk factors, the occurrence of complications, the rate of referral for cardiac surgery, and the mortality rate were assessed. RESULTS: The study included 120 patients referred between 1990 and 2004, with a mean age of 50.8 (17.8) years (67.6% men). Disease incidence did not change throughout the study. Some 55% of infective endocarditis cases were from the ordinary general population, 25% were intravenous drug users, and 20% were of nosocomial origin. The number in the last category had increased over time. The most commonly isolated microorganism was Staphylococcus aureus. Around 83% of patients presented with a severe complication, with cardiac failure and septic metastasis being the most common. The in-hospital mortality rate was 19.2%. Acute renal failure (odds ratio 6.7, 95% confidence interval, 1.9-24) and perivalvular abscess (odds ratio 9.2, 95% confidence interval, 1.6-54) were independent predictors of death. The introduction in 2002 of a multidisciplinary infective endocarditis team, which included a consultant cardiac surgeon, was associated with a significant increase in referrals for surgery, from 14.5% to 34.5% (P=.03), though in-hospital mortality was not significantly altered, decreasing from 20.9% to 13.8% (P=.4). CONCLUSIONS: The occurrence of acute renal failure and perivalvular abscess worsen the prognosis of infective endocarditis. The introduction of a multidisciplinary infective endocarditis team altered management of the disease and increased referrals for cardiac surgery.

Adult↗

Cardiovascular abnormalities in hyperthyroidism: a prospective Doppler echocardiographic study.

PURPOSE: We investigated the prevalence and clinical importance of cardiovascular abnormalities in patients with hyperthyroidism. METHODS: All consecutive patients diagnosed with hyperthyroidism during a period of 24 months were included in the study. Medical history, complete physical examination results, electrocardiographic findings, laboratory determinations, and Doppler echocardiographic findings were obtained for all patients within 24 hours of diagnosis, and after euthyroidism had been achieved. Age- and sex-matched controls also were studied. RESULTS: Thirty-nine patients (mean [+/-SD] age, 52 +/- 20 years; range, 25 to 86 years; 72% women), and 39 age- and sex-matched controls, were included. Atrial fibrillation was present in 7 patients (18%). Moderate or severe mitral or tricuspid regurgitation, or both, were present in 9 patients (23%) and in only 1 control (3%; P= 0.01). Mean pulmonary arterial systolic pressure was 38 +/- 12 mm Hg (range, 17 to 64 mm Hg) in patients and 27 +/- 4 mm Hg (range, 19 to 37 mm Hg) in controls (P= 0.001). Sixteen patients (41%) and 1 control (3%) had pulmonary arterial systolic pressure >or=35 mm Hg. Left ventricular systolic dysfunction was detected in 1 patient. After correction of hyperthyroidism, a significant decrease in pulmonary arterial systolic pressure was observed, and the levels became similar to those of controls. CONCLUSION: In patients with hyperthyroidism, there is a high prevalence of pulmonary hypertension and atrioventricular valve regurgitation. These abnormalities usually correct after treatment for hyperthyroidism.

Adult↗

Radiofrequency catheter ablation of an incessant supraventricular tachycardia in a premature neonate.

A 32-week, premature neonate with incessant supraventricular tachycardia and hemodynamic compromise who failed to respond to antenatal and postnatal antiarrhythmic therapy underwent successful radiofrequency catheter ablation (RCA) of a concealed left free-wall accessory pathway when the infant was 4-days-old and weighed only 1,840 grams. At follow-up performed 60 days after the procedure, the infant remained free of any drug, in sinus rhythm, and in normal hemodynamic condition.

Adult↗