Estimulación medular para la angina de pecho: Observaciones alejadas

Autores/as

  • Oscar Alberto Stella Hospital Español de Buenos Aires. Argentina

DOI:

https://doi.org/10.47924/neurotarget2009316

Palabras clave:

angina de pecho, angor pectoris, Estimulación medular, síndrome X coronario

Resumen

Introducción: La angina crónica refractaria es definida como el dolor torácico por insuficiencia coronaria que no puede ser controlada por la medicación habitual ni por las técnicas de revascularización, pero sí por la estimulación medular.

Material y método: Entre 1999 y 2000 a tres pacientes con edades entre 52 y 62 años y ubicados en las clases III y IV, según la Clasificación Funcional de la New York Heart Association (NYHA-FC), se les sometió a estimulación medular con un electrodo tetrapolar tipo placa colocado en el espacio epidural a nivel de T1, paramediano izquierdo, a través de una minilaminectomía medial; luego, en ese mismo tiempo quirúrgico, se conectó el electrodo a un generador de pulsos programable. Todos habían tenido por lo menos una cirugía de puente aorto coronario. Una de los pacientes era portadora del síndrome X coronario; los otros dos, varones, tenían dolor anginoso severo.

Resultados: En un seguimiento a largo a largo plazo se observó una mejoría según la NYHA-FC (de 3,5 a 2,2) y los puntajes de la EVA. No hubo complicaciones y los exámenes clínicos demostraron claramente una mejoría en la calidad de vida y en la realización de actividad física, mejoría del segmento ST en el ECG, disminución significativa de la ingesta de nitratos y reducción en el tiempo y frecuencia de los períodos e internamiento hospitalario.

Conclusiones: Aunque pequeño este estudio, demuestra el efecto beneficioso de la EM para la angina crónica refractaria. Este procedimiento es considerado como tratamiento adicional de primera línea para estos pacientes por la European Society of Cardiology y un comité conjunto de la American College of Cardiology y la American Heart Association le asigna un nivel de evidencia Clase IIB.

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2009-11-01

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1.
Stella OA. Estimulación medular para la angina de pecho: Observaciones alejadas. NeuroTarget [Internet]. 1 de noviembre de 2009 [citado 22 de noviembre de 2024];4(3):25-31. Disponible en: https://neurotarget.com/index.php/nt/article/view/316

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