Acute dissection of the aorta, although not common, has early and highly lethal complications. The type A dissection is treated with surgery. Patients with type B dissections are treated with surgery if they have complications like rupture, growth or visceral ischemia. Surgery, however, has complications such as spinal cord ischemia. Endovascular grafts have less mortality and complications. We report a 59 years old male patient with a type B dissection complicated with rupture. He was treated successfully with the placement of an endoluminal graft. He was discharged five days after the procedure in good conditions. After one year of follow up, the patient remains asymptomatic.
Robotic mitral valve repair and closure of atrial septal defect. Report of 13 procedures Background: Robot-assisted minimally invasive heart surgery is an effective alternative when compared with classical approaches. It has a low mortality and postoperative complications and its long-term durability is comparable with conventional techniques. Aim: To report short-and long-term results with the use of a robot-assisted transthoracic approach. Patients and Methods: Review of patients undergoing heart surgery between 2015 and 2019 using a robot assisted minimally invasive technique in a single center. We analyzed demographic characteristics, surgical and early ultrasound results. Results: Thirteen procedures were reviewed, nine mitral valve repairs (MVR) in patients aged 61 ± 21 years (seven males) and four atrial septal defect (ASD) closures in patients aged from 24 to 52 years (three men). For MVR, the average extracorporeal circulation and myocardial ischemia times were 120 ± 20.9 and 89 ± 21 minutes, respectively. The median hospitalization was four days. Two cases of MVR had postoperative complications. There was no mortality. All cases showed improvement in their symptoms. Ultrasound findings showed no postoperative mitral insufficiency except in one case. Conclusions: We report very good results in both complex mitral repair and CIA closure, comparable to centers with high standards in minimally invasive robot-assisted heart surgery.
Las acciones militares desplegadas por los virreyes Abascal y Pezuela contra los principales focos de la insurgencia sudamericana estuvieron marcadas por la movilización de sus respectivos componentes locales. En el caso específico del reino de Chile, dichas colectividades no solo conformaron sus propias fuerzas militares, sino que además participaron activamente en el diseño y puesta en escena de la contrarrevolución. La naturaleza de aquella “reacción monarquista”, así como las distintas prácticas desplegadas en su seno, nos revelan la existencia de complejas configuraciones sociales en las que diversos sectores vieron en la guerra un mecanismo de acumulación económica –a la vez que una fuente de legitimidad– en un tiempo en el que la monarquía borbónica contaba aún con un amplio aliciente en el imaginario político de aquellas poblaciones. La ponencia analiza las características que revistió este proceso, a través de la reconstrucción de las principales prácticas económicas y fiscales, junto con las redes relacionales que involucraron a los principales protagonistas de la guerra. Por un lado, destacamos las estrategias paternalistas de las autoridades locales y virreinales en el restablecimiento de la autoridad real, situación que convivió con los discursos de la oficialidad en torno a una justificación moral de su accionar.
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