Biomedical subjects

Ramón Ribes

Publications and source records attributed to Ramón Ribes.

4 recordsLinked to original sources

PubMed2006

MRI of focal splenic lesions without and with dynamic gadolinium enhancement.

OBJECTIVE: Our purpose was to identify the MR features of focal splenic lesions with an emphasis on enhancement patterns. The addition of a contrast-enhanced dynamic sequence to unenhanced MR images improves the study of focal splenic lesions. The analysis of the MR features along with the clinical history permits either the characterization of the most common splenic lesions or improvement in the detection of malignant diseases. CONCLUSION: Dynamic contrast-enhanced MRI improves the detection and characterization of focal splenic lesions.

Adult↗

PubMed2004

Evaluation of cardiac tumors with magnetic resonance imaging.

Primary cardiac neoplasms are rare, and are more commonly benign than malignant. However, metastases are by far the most common cardiac neoplasms. MRI allows evaluation of myocardial infiltration, pericardial involvement and/or extracardiac extension. MRI overcomes the usual limitations of echocardiography and assesses more accurately changes in cardiac function. Specific tumoral characterization is only possible in cases of myxoma, lipoma, fibroma and hemangioma. Suggestive features of malignancy are right side location, extracardiac extension, inhomogeneity in signal intensity of the tumor and pericardial effusion. The use of intravenous contrast material improves tumor characterization and depiction of tumor borders. MRI also allows differentiation of tumor from other nontumoral masses such as intracavitary tumors or fibromuscular elements of the posterior wall of the right atrium.

Contrast Media↗

PubMed2004

[Incidence and clinical impact of pulmonary homograft dysfunction after the Ross procedure].

INTRODUCTION AND OBJECTIVES: We analyzed the incidence, risk factors and clinical impact of pulmonary homograft dysfunction after the Ross procedure in our patients. PATIENTS AND METHOD: All patients were evaluated at 3, 6 and 12 months, and annually thereafter. Patients with a transhomograft pressure gradient greater than 30 mmHg were referred for cardiac magnetic resonance imaging. RESULTS: At the end of the study, 9 patients (11.8%) showed a transhomograft pressure gradient >30 mmHg after a mean period of 15.3 months post-surgery. Mean transhomograft pressure gradient was 19.8 (16.2%) (range, 2-100 mmHg). All patients were in functional class I, except 2 who were in New York Heart Association class II with severe stenosis. These 2 patients were treated percutaneously with stent placement and no reoperation. No association was found between clinical outcome and sex, age or homograft diameter. We found a trend toward greater perioperative use of plasma, platelets and red cells in the group of patients in comparison to controls, although the difference was significant only for postoperative use of plasma (1.7 [3] vs 5.5 [5.3] units; P<0.05). Cardiac magnetic resonance imaging showed stenosis predominantly in the body of the homograft, whereas the valvular component itself remained competent. Right ventricular hypertrophy was mild or very mild in 7 patients and moderate in 2. CONCLUSIONS: The incidence of some degree of pulmonary homograft dysfunction after the Ross procedure was non-negligible, but its clinical impact seems to be slight. Patients with severe stenosis were treated successfully via a percutaneous approach. The use of blood products might be a risk factor for the development of this complication.

Adolescent↗

PubMedDate not supplied

The Ross procedure.

BACKGROUND: The search for the ideal substitute for the aortic valve led Donald Ross to develop the pulmonary autograft concept in 1967. A historical, technical, and scientific review of this surgical option is presented together with our clinical experience. MATERIALS AND METHODS: The literature is reviewed to identify the advantages and pitfalls of the Ross procedure over the last decades. We also present our clinical experience with 92 patients operated between 1997 and May 2003. RESULTS: Of the total, 70.65% (n = 65) were males, mean age was 29.32 +/- 11.9 years, with 20 patients under 16 and 6 patients under 10 years. Twenty-five patients (27.17%) had 31 previous interventions. There were 41 associated procedures in 34 patients. Perioperative mortality was 2.17% (two patients). Eight patients required reexploration for bleeding, one required an aortocoronary bypass, and one a permanent pacemaker. Follow-up was 97% with 2.71 patients/year (average 32.55 +/- 19.01 months). Two patients required autograft replacement, one suffered a 44-mm dilatation of the autograft, and one 13-year-old girl developed autograft endocarditis. Six patients suffered severe homograft stenosis (>50 mmHg), two were treated percutaneously, and one required replacement. Combined freedom from reintervention is 93.56 +/- 2.81% at 5 years. CONCLUSIONS: The Ross procedure is a mature concept with thousands of patients operated worldwide and a cumulative experience of over 30 years. Although we believe that it is the procedure of choice in the pediatric population, women in child-bearing age, and substantial subgroups of adult patients, efforts must continue to minimize the incidence of auto- and homograft failure in the long term.

Adolescent↗