The intervention was carried out by the Hemodynamics service team of the most important hospital in the province.
Through the reference and counter-reference system under which the Neuquén health system operates and networking, the Hemodynamics service team at the Castro Rendón hospital last week placed a percutaneous pulmonary valve on a woman from Zapala. It is the first health institution to perform this type of intervention in Patagonia, which consists of the placement of a valve through catheterization, thus avoiding high-risk surgery.
Castro Rendón continues to add complexity and in this case, this innovative practice was coordinated by the Hemodynamics, Adult Cardiology and Pediatric Cardiology services, coordinated with Dr. Alejandro Peirone, head of the Hemodynamics Service and the Pediatric Cardiology section of the Hospital Private University of Córdoba, head of the Child and Adult Congenital Heart Disease Program and the Cardiovascular department of the Children’s Hospital of Córdoba. The team was completed with pediatric hemodynamicists Oscar Vagnola and Emilio Alvarellos.
“Congenital heart diseases become more complex as they progress, so it is very important to have the sensitivity of the cardiologists who treat the person to analyze the indication guidelines for the placement of this type of valve, which is very expensive. – Vagnola explained – it is a very modern valve and Dr. Peirone is the one with the most experience in Argentina in this regard.
Peirone, a pediatric hemodynamic doctor, explained: “These patients are adults or adolescents with congenital heart disease, which occurs in 7 out of every 1,000 live births. These congenital heart diseases often require surgical corrections, which do not last a lifetime, but rather develop dysfunctions, especially in this patient’s pathology called Tetralogy of Fallot, which caused dysfunction or poor function of her pulmonary valve. ”
“This valve that goes towards the lungs had a narrowness that did not allow blood to pass through, also generating a deficiency in coaptation so that blood returns.”
This dysfunction generates symptoms in patients such as early fatigue, palpitations and arrhythmias, among others, which is why it is important to restore the competence of this valve.
“Until a few years ago, the only way to cure was surgery, that is, you had to reopen the chest, stop the heart, place extracorporeal circulation, but reintervention in these patients is much higher risk than first interventions,” said Peirone and added: “A decade ago, valves began to be placed by the percutaneous method, which means doing it by catheterization, through the patient’s groin.”
The professionals stated that these techniques are very new, challenging and constantly evolving, given that new valves appear every day with characteristics that make patients benefit even more.
“The importance lies in the paradigm shift that occurred in Neuquén, because for the first time in a patient with congenital heart disease who needed a reintervention, a high-risk surgery could be avoided and a valve was placed through the patient’s vein with very good results. result”.
“The patient, who is a 40-year-old woman and who has been treated in this hospital since she was little, was discharged 24 hours after admission, her heart did not have to stop; It was done with a beating heart and the procedure lasted approximately two hours with the explanations of the case, because as it was the first valve we were all much slower, step by step and explaining so that the local colleagues in the hemodynamics room had everything clear to take. the procedure,” he added.
“This is a technique for penetrating medical products called proctoring, that is, a person who has special training accompanies a local group to introduce the technique. When that local group carries out these techniques on their own and considers that they are ready and able, they will begin to do it alone; and thus they will help in the future to disseminate the technique,” he assured.
“The team included hemodynamicists, nurses, technicians, anesthesiologists, cardiologists, congenital heart disease specialists, imaging team and coronary unit for recovery. The hospital’s health team has a very good predisposition in all of this and this is how we achieve correct learning,” said Vagnola.
Likewise, Alejandra Farrell, head of the Children’s Cardiology Service, expressed her pride and thanked: “This experience in our hospital is great because being able to respond to a patient of ours, from Neuquén, from Patagonia, is fabulous and having a suitable person come as For us, Dr. Peirone is brilliant because we are not only responding to one of our patients, but we are also training ourselves so that tomorrow we can solve it with our own team.”
“It is important to highlight that the hospital’s congenital heart disease group is very dynamic and is making great progress, it has clear objectives, it is achieving them and it also plans to increase complexity from the surgical point of view, from the arrhythmias and from the treatment, which the positions itself in an ABC1 in the country, given that there are not many centers that have stable cardiovascular surgeons like here with the capacity to resolve low and medium complexity, stable hemodynamicists with a lot of experience, electrophysiologists and intensive care doctors thinking about advancing in advanced techniques in very serious patients,” added Peirone and highlighted the fetal medicine program carried out by Castro Rendón, with the possibility of seeing the diagnosis of these congenital heart diseases from the womb.
Furthermore, Vagnola explained: “After the intervention, we held a meeting, in which we invited adult and pediatric cardiologists from the public and private Health System of Neuquén and Río Negro, and the HPN teams to participate, given that the dissemination of these “Advances are essential to continue growing in medicine and being able to respond to patients.”
Finally, he remarked: “This makes the Hemodynamics service grow, it makes the complexity of the Cardiology service grow, and this is even more valuable because it is in the public health system of the province where an advanced and highly efficient technique can be performed. high price. For me it is great and I am very grateful to work with this team and that they have invited me to be part, where I can teach them what I have learned for 40 years and the good thing is to bring doctors who are younger than me and who will be able to continue to accompany this growth.”
