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Dive into the research topics where F. Hornero is active.

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Featured researches published by F. Hornero.


Circulation | 2003

Midterm Clinical and Echocardiographic Results With Patch Glue Repair of Left Ventricular Free Wall Rupture

Sergio Cánovas; Eric Lim; María José Dalmau; María Bueno; José Buendía; F. Hornero; Oscar Gil; Rafael López García; Rafael Payá; José J. Pérez; Ildefonso Echanove; José Anastasio Montero

Background—Left ventricular free wall rupture (LVFWR) is a dramatic complication after myocardial infarction. We present our mid-term clinical and echocardiographic results of LVFWR with an epicardial patch without cardiopulmonary bypass. Methods—From February 1993 to May 2001, 17 patients underwent surgery for LVFWR. The mean age±SD of 12 males and 5 females was 68±10 years. All patients presented for emergency surgery with cardiac tamponade confirmed on echocardiography. After opening the chest and identification of the site of rupture, a Goretex patch was fashioned and applied with enbucrilate surgical glue. Results—Effective control of bleeding was achieved in all cases. There were no on-table deaths. The operative (30 day) mortality was 23.5% (4/17). One death occurred because of patch failure, two because of cardiogenic shock, and one from pneumonia. On follow-up at a median of 2.2 years (interquartile range, 1.1 to 4.3 years), two further deaths occurred, one from myocardial infarction and another of undetermined etiology. Echocardiography did not reveal any evidence of restriction to left ventricular free wall motion. Conclusions—Patch glue repair is expedient, simple and effective; with no adverse effects on mid-term ventricular dynamics. In view of superior published results to infarctectomy and repair with extra corporeal circulation, it should be considered to be the initial procedure of choice for the surgical repair of LVFWR.


Interactive Cardiovascular and Thoracic Surgery | 2002

Biatrial radiofrequency ablation for atrial fibrillation: epicardial and endocardial surgical approach.

F. Hornero; José A. Montero; Sergio Cánovas; María Bueno

Radiofrequency energy applied by means of surgical probes permits the ablation of atrial fibrillation (AF). This study presents our initial experience on 55 consecutive cardiac patients with permanent AF with radiofrequency ablation through biatrial epicardial and endocardial surgical approach. At discharge, 8.1% of the patients had persistent AF-atrial flutter. Hospital incidence of arrhythmias were, 9% of paroxysmal atrial fibrillation, 10.9% of atrial flutter, and 34.5% of persistent atrial fibrillation. After a mean follow-up of 7 months, 83.6% patients have recovered sinus rhythm, and echocardiographic biatrial contraction was re-established in 73%. Biatrial radiofrequency ablation applied from the endocardium and the epicardium has achieved satisfactory results, without increasing the surgical risk.


European Journal of Cardio-Thoracic Surgery | 2003

Surgery for left ventricular free wall rupture: patch glue repair without extracorporeal circulation.

Sergio Cánovas; Eric Lim; F. Hornero; José A. Montero

Left ventricular free wall rupture is a dramatic complication after myocardial infarction. We present our experience with the simple, expedient technique of patch glue repair without extracorporeal circulation. Access is obtained via median sternotomy. Evacuation of blood and haematoma is undertaken and a Goretex patch exceeding the size of infarct is fashioned. The patch is applied to the epicardium using enbrucrilate surgical glue instilled with gentle pressure against the beating heart. We performed this technique on 17 patients from 1993 to 2001, with a operative (30-day) mortality of 23.5% with a post-discharge survival of 85% at 2.2 years.


Revista Espanola De Cardiologia | 2003

Recambio valvular aórtico en pacientes mayores de 70 años: determinantes de mortalidad temprana

Rafael García Fuster; José Anastasio Montero; Oscar Gil; F. Hornero; José Buendía; Rafael Payá; Sergio Cánovas; María José Dalmau; María Bueno

Introduction and objectives. There is controversy regarding the risk factors associated with early death in geriatric patients undergoing aortic valve replacement. We analyzed the risks in these patients and established an accurate model for predicting in-hospital mortality. Patients and method. Univariate and multivariate analyses were made of the risk factors associated with early death in a group of 129 patients older than 70 years who underwent aortic valve replacement (May 1994-June 2001). The variables obtained by multivariate logistic regression were combined to produce an equation for the prediction of early death. The equation was tested using a receiver operating characteristic curve. Results. Univariate analysis identified four factors related to early death: NYHA III-IV (p 1.90 m 2 , 20% for < 1.40 m 2 ). The estimated mortality with the predictive model was 7.06%, which was similar to the observed mortality of 7.80% (area under the ROC curve 0.87) and better than estimates obtained with the EuroSCORE (6.5%; area under the ROC curve 0.56). Conclusions. Risk factors associated with early death after aortic valve replacement in geriatric patients include functional status, aortic regurgitation, and small body surface area. Our model based on these factors accurately predicted operative mortality in our patients. Gender, prosthesis size, and pump time were not identified as risk factors.


Revista Espanola De Cardiologia | 2002

Ventajas de la revascularización miocárdica sin circulación extracorpórea en pacientes de riesgo

Rafael García Fuster; José A. Montero; Oscar Gil; F. Hornero; Sergio Cánovas; María José Dalmau; María Bueno

Introduction and objectives. Myocardial revascularization without cardiopulmonary bypass has been shown to reduce operative morbi-mortality. We report our recent experience with this novel technique in order to evaluate its theoretical advantages in comparison with conventional surgery. Patients and methods. This retrospective analysis included 547 consecutive patients undergoing isolated myocardial revascularization from December 1997 through November 2000. One hundred twenty-one offpump patients were compared to 426 undergoing cardiopulmonary bypass. Logistic regression analysis was performed to find predictors of mortality, transfusion, postoperative atrial fibrillation and length of hospital stay. Results. Off-pump patients were at greater risk: they were older, with a lower ejection fraction and a higher prevalence of unstable angina, heart failure and associated comorbidity. Off-pump surgery reduced transfusions (1 ± 1 vs 1,9 ± 2 blood units; p < 0.0001) and postoperative hospital stays (8.9 ± 5 vs 11,3 ± 7 days; p < 0.001). The off-pump group showed a trend toward reduced morbidity but the technique did not decrease hospital mortality. Cardiopulmonary bypass was an independent predictor of blood transfusion and longer hospital stay. Short-term follow-up revealed no significant differences in recurring angina or patency rates. Conclusions. Off-pump coronary bypass surgery is a good option in high-risk patients because it reduces the incidence of perioperative transfusion and the length of hospitalization. Furthermore, it showed a trend toward reduced morbidity. Mortality was not significantly higher in spite of the higher risk of the patients. Long-term longitudinal follow-up is mandatory to assess the true effectiveness of this technique.


Interactive Cardiovascular and Thoracic Surgery | 2003

Scimitar syndrome: multislice computer tomography with three-dimensional reconstruction.

F. Hornero; Sergio Cánovas; Jorge Estornell; Vicente Cervera

Improved resolution of cardiovascular imaging techniques allows better assessment of the morphology of cardiovascular malformations. Multi-slice computer tomography with three-dimensional reconstruction provides both static and dynamic images with high temporal and spatial resolution. We present a three-dimensional reconstruction of scimitar syndrome using multi-slice computer tomography.


Cirugía Cardiovascular | 2010

20. Implantación de homoinjerto pulmonar por trombosis de prótesis tricúspide

A. García Peláez; Alejandro Vázquez; E. Martín; F. Hornero; R. García Fuster; Sergio Cánovas; Oscar Gil; Juan Martínez-León

Mujer de 39 anos, que ingresa desde otro centro con clinica de insuficiencia cardiaca congestiva (New York Heart Association [NYHA] III) y diagnostico ecocardiografico de protesis mecanica tricuspide disfuncionante. Entre los antecedentes destaca adiccion a drogas via parenteral, hepatitis C, cirrosis hepatica estadio Child B y endocarditis tricuspidea, que requirio tratamiento quirurgico a los 21 y 27 anos, implantandose en ambos casos una valvula mecanica. Tratamiento con anticoagulantes de forma irregular, con periodos de no ingesta. La ecografia transesofagica (ETE) informa de trombosis de la protesis con fijacion de ambos discos, procediendo al explante de la valvula. Se implanta un homoinjerto pulmonar de 27 mm, soportado sobre un conducto de dacron, el cual se sutura a la cara auricular del anillo tricuspideo. Alta a los 5 dias del postoperatorio sin incidencias, con ETE que informa de gradiente ligero transprotesico (< 3 mmHg).


Cirugía Cardiovascular | 2010

Recambio valvular aórtico transcatéter: Análisis de pacientes descartados

A. García Peláez; Alejandro Vázquez; E. Martín; Oscar Gil; Sergio Cánovas; R. García-Fuster; F. Hornero; Juan Martínez-León

La mejora de la calidad de vida de la sociedad actual genera una poblacion cada vez mas envejecida, y con ello el aumento de las enfermedades degenerativas, asi como de las morbilidades asociadas. Ello exige el desarrollo de tecnicas que produzcan una menor agresion quirurgica a estos pacientes. El recambio valvular aortico transcateter actualmente permite tratar a aquellos pacientes con valvulopatia aortica que presentan un elevado riesgo quirurgico. Es una tecnica en auge, aumentando paulatinamente los pacientes que son sometidos a esta tecnica. Sin embargo, no todos los pacientes son candidatos a este procedimiento, bien por dificultades tecnicas asociadas a la anatomia del paciente, bien por la necesidad de una mayor oferta tecnologica de la industria. La mayoria de las publicaciones actuales se centran en los resultados y complicaciones asociadas a la tecnica, no existiendo en la literatura actual una revision de casos que analice los resultados quirurgicos de aquellos pacientes que han sido descartados para la misma. Realizamos una revision de 19 casos incluidos en programa de recambio valvular aortico transcateter, en los que la tecnica fue desestimada, incluyendose en lista de espera para cirugia convencional. Analizamos las causas por las que fueron rechazados, riesgo quirurgico, morbilidades asociadas, el manejo posterior de estos pacientes, asi como de los resultados quirurgicos.


Cirugía Cardiovascular | 2008

Cirugía de las arritmias en las cardiopatías congénitas

F. Hornero

La propia fisiopatologia de las cardiopatias congenitas y el impacto de algunas correcciones quirurgicas pueden predisponer al desarrollo de arritmias cardiacas, que incluyen taquicardia supraventricular macrorreentrante, flutter , fibrilacion auricular, taquicardia auricular ectopica, taquicardia ventricular, sindrome del seno enfermo, bloqueo auriculoventricular y muerte subita, entre otras. En la actualidad el tratamiento definitivo de estas arritmias y su profilaxis durante la correccion quirurgica son procesos eficaces, con baja morbilidad y gran beneficio clinico para el paciente. En este trabajo se revisa el estado actual del tratamiento quirurgico de las arritmias en las cardiopatias congenitas.


European Journal of Cardio-Thoracic Surgery | 2001

Extensive dissection in left coronary artery

F. Hornero; María José Dalmau; Sergio Cánovas; José A. Montero

A 32-year-old male with an acute coronary syndrome. Early coronary angiography showed an occlusion at the middle level of the left anterior interventricular artery. A primary percutaneous transluminal coronary angioplasty implanting a stent due to sub-optimal balloon results, obtaining a good angiographic result (TIMI III flow), and the patient was asymptomatic. Angiographic control was performed at 24 h showing extensive coronary dissection at the left main, left anterior descending, first diagonal, circumflex, first and second obtuse marginal arteries (Fig. 1). The probable mechanism was progressive spontaneous retrograde dissection from a segment of the stent. Four urgent coronary artery bypass grafts were performed. The postoperative course was uneventful, and the patient was discharged on the 10th day. After 2 years of follow-up, the patient is asymptomatic. European Journal of Cardio-thoracic Surgery 20 (2001) 1232

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Oscar Gil

University of Valencia

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E. Martín

University of Valencia

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María Bueno

University of Salamanca

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Eric Lim

Imperial College London

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