We present a 45-year-old woman with supraventricular tachycardia. During placement of diagnostic catheters, an interruption of the inferior vena cava was suspected. An MRI confirmed the interruption of the inferior vena cava above the level of the renal veins with azygos vein continuation up to the superior vena cava. Catheter ablation was performed using a superior approach via the left subclavian vein.

Azygos vein

Supraventricular Tachycardia

Cardiac Ablation

10.1093/europace/euq069

Cite

Citations (13)

Poster session 3: Device and heart failure monitoring

EP Europace (2009)

Jorge Toquero Ramos Vanessa Moñivas Palomero V. Castro Urda Vitelio Augusto Mariona Montero Ignacio Fernández Lozano

10.1093/europace/euq226

Cite

Citations (0)

Membrana de circulación extracorpórea veno-arterial para ablación de tormenta eléctrica en shock cardiogénico: caso clínico

Revista chilena de cardiología (2022)

Rodrigo Mella Luis Quiñiñir Víctor Neira Juan Carlos Bahamondes Rodrigo Miranda

Se presenta el caso clÃnico de un paciente que presenta un infarto del miocardio con trombolisis no exitosa y posterior implantaciÃ³n de 2 stents coronarios quien desarrolla, algunos dÃas despuÃ©s, una tormenta elÃ©ctrica ventricular. Una ablaciÃ³n de la taquicardia se realizÃ³ bajo ECMO, con buen resultado. Se detalla la descripciÃ³n del caso, revisa y discute el tema.

10.4067/s0718-85602022000100034

Cite

Citations (0)

REVISITANDO MINTZBERG: FATOS E FOLCLORE NO TRABALHO GERENCIAL PELA PERSPECTIVA DE GESTORES DE UMA MULTINACIONAL

Revista Eletrônica de Estratégia & Negócios (2016)

Cíntia Rodrigues de Oliveira Medeiros Darlan Agusto Wimmersberger Rodrigo Miranda

Com o intuito de contribuir para os estudos sobre o trabalho gerencial, realizamos esta pesquisa com o objetivo de caracterizar o trabalho do gestor contemporâneo, na perspectiva de gestores de uma multinacional, à luz dos estudos de Mintzberg sobre o que é fato e folclore no trabalho gerencial. Para tanto, adotamos a abordagem qualitativa e entrevistamos cinco gestores de uma unidade de uma multinacional do segmento de agronegócio. Para a análise do material empírico utilizamos a técnica de análise de conteúdo. Os resultados deste trabalho apontam para a confirmação das formulações de Mintzberg a respeito do trabalho gerencial.

10.19177/reen.v8e2201586-122

Cite

Citations (3)

Online Social Networks and the New Organizational Spaces

Journal of technology management & innovation (2013)

Cíntia Rodrigues de Oliveira Medeiros Cristiane Betanho Jacquelaine Florindo Borges Rodrigo Miranda Verônica Angélica Freitas de Paula

We analyzed the 'virtuality' of the social space and the boundaries of organizations from the emergence and dissemination of online social networking.The purpose is to identify how the use of social networks by 10 Brazilian companies enables the redefinition and expansion of organizational space.For the analysis of the data, we used the theory of social space of Lefebvre ( 2004), which defines three moments of space social production: the imagined space, the lived space and the perceived space.The methodological qualitative approach is done by document analysis from the websites of the companies.We show that the organizational space has new contours with the adoption of online social networks and we analyzed four spatial metaphors: the square, the museum, the temple and the market.

10.4067/s0718-27242013000300014

Cite

Citations (4)

A giant seroma inducing changes in the position of the pacemaker

Cardiology Journal (2024)

Fabiola Schafer M Tapia Enrique Bellolio Rodrigo Miranda

Seroma

Position (finance)

10.5603/cj.98287

Cite

Citations (0)

Stopping versus continuing acetylsalicylic acid before coronary artery bypass surgery: A systematic review and meta-analysis of 14 randomized controlled trials with 4499 patients

European Journal of Cardio-Thoracic Surgery (2017)

Michel Pompeu Sá Artur Freire Soares Rodrigo Miranda Mayara Lopes Araújo Alexandre Motta Menezes

This study aimed to evaluate the efficacy and safety of continuing versus stopping aspirin [acetylsalicylic acid (ASA)] preoperatively in patients undergoing coronary artery bypass graft surgery. MEDLINE, EMBASE, CENTRAL/Cochrane Controlled Trials Register (CCTR), ClinicalTrials.gov, Scientific Electronic Library Online (SciELO), Literatura Latino Americana em Ciências da Saúde (LILACS), Google Scholar and reference lists of relevant articles were searched for randomized controlled trials that reported efficacy outcomes of myocardial infarction and mortality, and safety outcomes of blood loss, packed red blood cell transfusion and surgical re-exploration were compared between groups. Fourteen studies fulfilled our eligibility criteria and included a total of 4499 patients (2329 for 'continuing ASA' and 2170 for 'stopping ASA'). In the pooled analysis, continuing aspirin therapy did not reduce the risk of myocardial infarction [risk ratio 0.834, 95% confidence interval (CI) 0.688–1.010; P = 0.063] or operative mortality (risk ratio 1.384, 95% CI 0.727–2.636; P = 0.323). Preoperative ASA increased postoperative chest tube drainage (mean difference 143 ml, 95% CI 39–248 ml; P = 0.007) and packed red blood cell transfusion (mean difference 142 ml, 95% CI 55–228; P = 0.001) but did not increase the risk of surgical re-exploration (risk ratio 1.316, 95% CI 0.910–1.905; P = 0.145). This meta-analysis found no statistically significant difference regarding the risk of operative mortality and myocardial infarction between the 'continuing ASA' and 'stopping ASA' strategies. On the other hand, the mean volume of blood loss and packed red blood cell transfusion was higher in the 'continuing ASA' group, but this finding did not translate into higher risk of reoperation for bleeding.

10.1093/ejcts/ezx293

Cite

Citations (13)

A cutaneous lesion mimicking pacemaker infection

Journal of Arrhythmia (2023)

Fabiola Schafer Lilia Antonio Andrés Díaz Rodrigo Miranda

A 69-year-old woman with a past medical history of 5-year-old dual-chamber pacemaker implantation because of symptomatic sick sinus syndrome presented with swelling, erythema, and pain at the upper part of the pacemaker pocket (Figure 1A). Physical examination revealed a swollen, erythematous and painful skin lesion. She was afebrile without signs of systemic infection. The inflammatory skin lesion was over the site where the pacemaker leads run from the pulse generator to the subclavian vein insertion. Pacemaker leads were easily palpable under the skin lesion, so infection of them was suspected. She was treated with cefadroxil for 14 days with poor response. Indeed, the lesion changed to a violaceous color and increased in size along with a superficial ulceration and fluid discharge (Figure 1B). A surgical revision was indicated. Laboratory tests, chest x-ray, and echocardiogram were all within normal limits. An ultrasound scan of the skin lesion showed a hypoechoic and heterogeneous nodule with well-defined borders with no internal vascularity located in the dermis and subcutaneous tissue without compromise of deeper tissue and pacemaker pocket (Figure 1C). Fluoroscopy showed that the skin lesion was over the upper part of the pocket where the leads run (Figure 1D). Excision of the skin lesion was performed and revision of the area did not show compromise of the pacemaker leads. Skin biopsy informed a cutaneous fistula due to epidermal inclusion cyst (EIC; Figure 2A,B). The patient was treated with 10 days of oral flucloxacillin with complete clinical resolution. A close follow-up has shown complete remission and no signs of infection after cessation of the antibiotic treatment. A later cardiac implantable electronic device (CIED) infection could be secondary to bacteremia, or local factors such as inflammatory response or chronic trauma. An early diagnosis and treatment that involves antimicrobial therapy and complete device system removal are essentials in terms of morbidity and mortality. Nevertheless, some CIED infections can sometimes be difficult to diagnose and distinguish from other pathological processes. On the other hand, some inflammatory skin lesions may mimic CIED infections and their diagnosis are not always clear. Because of that, it is necessary to take a multidisciplinary approach in order to find a correct diagnosis. Also, complementary imagen tests (ultrasound or CT scan) can show if there is a compromise of the pacemaker pocket and define the extension of the lesion. In our case, an ultrasound scan was a useful tool to support a site revision with tissue samples sent to histopathological study instead of complete device system removal. Although pacemaker leads were initially suspected to be the primary site of infection, the surgical revision did not show compromise of them. Fortunately, the inflammatory skin lesion which was close to the pacemaker leads did not produce a secondary infection of them. We highlight the importance of taking a skin biopsy when unusual cutaneous findings are presented. The histopathological result can unravel the nature of the process. The clinical presentation of a device-related infection is often variable, ranging from subclinical device infections to a straightforward presentation with localized swelling, erythema, pain, device exposure, and purulent discharge along with fever and leukocytosis. This variable clinical setting can sometimes make the correct diagnosis difficult because other skin disorders can mimic a CIED infection. The differential diagnosis of CIED infections is: fluid collections (hematoma, pseudochyliform fluid), superficial infections (herpes zoster, cellulitis), allergic contact dermatitis, benign tumors (lipoma), and malignancies.1-3 As far as we know, EIC mimicking a pacemaker-related infection has not been reported previously. EIC is an extremely rare condition that occurs secondary to implantation and proliferation of epidermal cells into the dermis and subcutaneous tissue because of injury such as surgery, puncture and trauma.4, 5 EIC has been reported after anesthetic infiltration, lumbar puncture, laparoscopic or abdominal surgery, and percutaneous procedures.4, 5 In our case, the trauma produced by puncture due to local anesthetic infiltration or during Seldinger technique for lead implantation can be the etiology of this particular EIC that can occur several years after surgery. The puncture could remove epidermal cells from epidermis or cells located inside the pocket during pocket creation to deeper tissues. A multidisciplinary approach is required when a presumed CIED infection presents unusual cutaneous findings. Also, complementary imagen tests and histopathological study are necessary for unraveling the nature of the process. We highlight to keep in mind the differential diagnosis of a CIED infection in order to avoid unnecessarily complete device system removal. None of the authors have conflicts of interest to report regarding this manuscript. Not applicable. The patient has given signed consent for publication of the case. Not applicable.

Erythema

Ectasia

10.1002/joa3.12819

Cite

Citations (1)

Effects of atorvastatin therapy in heart failure: Oxidative stress, inflammation, endothelial dysfunction and exercise capacity

Rodrigo Miranda Pablo Castro Hugo Verdejo Douglas Greig Hernán Alejandro Alcaíno Olivares

Endothelial Dysfunction

Source

Cite

Citations (0)