Mitral valve repair in infective endocarditis is not inferior to valve replacement: results from a Spanish nationwide prospective registry
Por:
Cuerpo, GP, Valerio, M, Pedraz, A, Rodriguez-Abella, H, Mestres, CA, Obrador, EQ, Gonzalez-Calle, A, Alvarez, RR, Garcia, PM, Bouza, E, Sanchez, FF, Noureddine, M, Rosas, G, Lima, JD, Aramendi, J, Bereciartua, E, Blanco, MJ, Blanco, R, Boado, MV, Lazaro, MC, Crespo, A, Goikoetxea, J, Iruretagoyena, JR, Zuazabal, JI, Lopez-Soria, L, Montejo, M, Nieto, J, Rodrigo, D, Rodriguez, D, Rodriguez, R, Vitoria, Y, Voces, R, Lopez, MVG, Georgieva, RI, Ojeda, G, Bailon, IR, Morales, JR, Cuende, AM, Echeverria, T, Fuerte, A, Gaminde, E, Goenaga, MA, Idigoras, P, Iribarren, JA, Yarza, AI, Urkola, XK, Reviejo, C, Carrasco, R, Climent, V, Llamas, P, Merino, E, Plazas, J, Reus, S, Alvarez, N, Bravo-Ferrer, JM, Castelo, L, Cuenca, J, Llinares, P, Rey, EM, Mayo, MR, Sanchez, E, Regueiro, DS, Martinez, FJ, Alonso, MD, Castro, B, Rosado, DG, Duran, MD, Gomez, MAM, Lacalzada, J, Nassar, I, Ciezar, AP, Iglesias, JMR, Alvarez, VA, Costas, C, de la Hera, J, Suarez, JF, Fraile, LI, Arguero, VL, Menendez, JL, Bajo, PM, Morales, C, Torrico, AM, Palomo, C, Martinez, BP, Esteban, AR, Garcia, RR, Asensio, MT, Almela, M, Ambrosioni, J, Azqueta, M, Brunet, M, Bodro, M, Cartana, R, Falces, C, Fita, G, Fuster, D, de la Maria, CG, Hernandez-Meneses, M, Perez, JL, Marco, F, Miro, JM, Moreno, A, Nicolas, D, Ninot, S, Quintana, E, Pare, C, Pereda, D, Pericas, JM, Pomar, JL, Ramirez, J, Rovira, I, Sandoval, E, Sitges, M, Soy, D, Tellez, A, Tolosana, JM, Vidal, B, Vila, J, Adan, I, Bermejo, J, Celemin, D, Caballero, GC, Pinto, AG, Montero, AD, Cruz, AF, Mansilla, AG, Leoni, MEG, Ramallo, VG, Hernandez, MK, Hualde, AM, Marin, M, Martinez-Selles, M, Menarguez, MC, Munoz, P, Rincon, C, Rodriguez-Abella, H, Rodriguez-Creixems, M, Pinilla, B, Pinto, A, Valerio, M, Vazquez, P, Moreno, EV, Antorrena, I, Loeches, B, Quiros, AM, Moreno, M, Ramirez, U, Baston, VR, Romero, M, Saldana, A, Balbin, JA, Castillo, CA, Arnaiz, A, Revillas, FA, Belaustegui, MC, Farinas, MC, Farinas-Alvarez, C, Izquierdo, RG, Garcia, I, Rico, CG, Gutierrez-Cuadra, M, Diez, JG, Pajaron, M, Parra, JA, Teira, R, Zarauza, J, Dominguez, F, Pavia, PG, Gonzalez, J, Orden, B, Ramos, A, Centella, T, Hermida, JM, Moya, JL, Martin-Davila, P, Navas, E, Oliva, E, del Rio, A, Ruiz, S, Tenorio, CH, Delia, MA, Araji, O, Barquero, JM, Jambrina, RC, de Cueto, M, Acebal, JG, Mendez, I, Morales, I, Lopez-Cortes, LE, de Alarcon, A, Garcia, E, Haro, JL, Lepe, JA, Lopez, F, Luque, R, Alonso, LJ, Azcarate, P, Gutierrez, JMA, Blanco, JR, Villegas, AC, Garcia-Alvarez, L, Oteo, JA, Sanz, M, de Benito, N, Gurgui, M, Pacho, C, Pericas, R, Pons, G, Alvarez, M, Fernandez, AL, Martinez, A, Prieto, A, Regueiro, B, Tijeira, E, Vega, M, Blasco, AC, Mollar, JC, Arana, JCG, Uriarte, OG, Lopez, AM, de Zarate, ZO, Matos, JAU, Dominguez, GG, Sanchez-Porto, A, Leal, JMA, Vazquez, EG, Torres, AH, Blazquez, A, Valenzuela, GD, Alonso, A, Aramburu, J, Calvo, FE, Rodriguez, AM, Tarabini-Castellani, P, Galvez, EH, Bellido, CM, Pau, JL, Sepulveda, MA, Sierra, PT, Iqbal-Mirza, SZ, Alcolea, EC, Yanez, IK, Ballesta, AP, Escobar, EM, Monje, AP, Cabrera, VS, Garcia, DV, Asenjo, MA, Luna, CC, Morcillo, JN, Seco, MCP, Gelabert, AV, Guallar, CA, Abad, NF, Mangas, PG, Adell, MM, Ruiz, MPP, Porres, JC, Vidal, BA, Trigueros, NC, Espin, MJD, Caro, JAG, Sanchez, RJ, Almazan, AJ, Freire, AO, Gonzalez, MV, Ramis, PP, Blanco, MAR, Bordes, ERD, Bonet, LV, Munera, MCH, Garaizabal, EE, Martinez, AT, Luque, JCS
Publicada:
1 jul 2019
Resumen:
IntroductionInfective endocarditis (IE) still carries high morbidity and mortality and frequently requires surgery. The benefit of mitral valve repair (MVr) in the setting of IE is yet to be proven. The goal of this study was to assess the results of MVr in patients with IE after a minimum follow-up of 1year.MethodsThis study is based on a Spanish nationwide prospective registry that included patients operated on for native mitral valve IE. The collaborating Institutions pooled their pre-, peri-, and postoperative data into the database of the GAMES group [Grupo de Apoyo al Manejo de la EndocarditiS (Group for support and management of infective endocarditis)].ResultsData from 27 hospitals were recorded and 3524 cases of active IE identified between 2008 and 2016. There were 1513 cases of mitral IE, of which 898 involved native valves. Of these, 437 patients underwent surgical treatment, and 369 completed the 1-year follow-up. The valve was repaired in 68 cases (18.4%). Preoperative groups were comparable (EuroSCORE MVr 7.7 vs MVR 8.0; p=ns). Mortality in the repair group was inferior to that in the replacement group (16.2% vs 27.2%, p=0.058). At 1year, mortality remained higher in the replacement group: 3.7% vs 2.9%. Relapse of the infection was slightly more frequent in the repair group (7.1% vs 3.7%; p=ns), although this did not lead to higher rates of reintervention (MVr/MVR: 2.9% vs 4.9%).ConclusionMVr is an attractive option for specific patients with IE and does not seem to negatively impact on relapses.
Filiaciones:
Cuerpo, GP:
Hosp Gen Univ Gregorio Maranon, Serv Cirugia Cardiaca, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Dept Cardiac Surg, Madrid, Spain
Valerio, M:
Hosp Gen Univ Gregorio Maranon, Serv Microbiol Clin & Enfermedades Infecciosas, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Pedraz, A:
Hosp Gen Univ Gregorio Maranon, Serv Cirugia Cardiaca, Madrid, Spain
Rodriguez-Abella, H:
Hosp Gen Univ Gregorio Maranon, Serv Cirugia Cardiaca, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Mestres, CA:
Univ Zurich, Univ Hosp Zurich, Dept Cardiovasc Surg, Zurich, Switzerland
Obrador, EQ:
Hosp Clin Barcelona, Serv Cirugia Cardiovasc, Barcelona, Spain
Gonzalez-Calle, A:
Hosp Univ Virgen del Rocio, Serv Cirugia Cardiaca, Unidad Corazon, Seville, Spain
Alvarez, RR:
Hosp Univ Cruces, Serv Microbiol & Enfermedades Infecciosas, Bilbao, Spain
Garcia, PM:
Hosp Gen Univ Gregorio Maranon, Serv Microbiol Clin & Enfermedades Infecciosas, Madrid, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
CIBERES, CIBER Enfermedades Resp, CB06-06-0058, Madrid, Spain
Univ Complutense Madrid, Fac Med, Madrid, Spain
Bouza, E:
Hosp Gen Univ Gregorio Maranon, Serv Microbiol Clin & Enfermedades Infecciosas, Madrid, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
CIBERES, CIBER Enfermedades Resp, CB06-06-0058, Madrid, Spain
Univ Complutense Madrid, Fac Med, Madrid, Spain
Sanchez, FF:
Hosp Costa del Sol, Marbella, Spain
Noureddine, M:
Hosp Costa del Sol, Marbella, Spain
Rosas, G:
Hosp Costa del Sol, Marbella, Spain
Lima, JD:
Hosp Costa del Sol, Marbella, Spain
Aramendi, J:
Hosp Univ Cruces, Bilbao, Spain
Bereciartua, E:
Hosp Univ Cruces, Bilbao, Spain
Blanco, MJ:
Hosp Univ Cruces, Bilbao, Spain
Blanco, R:
Hosp Univ Cruces, Bilbao, Spain
Boado, MV:
Hosp Univ Cruces, Bilbao, Spain
Lazaro, MC:
Hosp Univ Cruces, Bilbao, Spain
Crespo, A:
Hosp Univ Cruces, Bilbao, Spain
Goikoetxea, J:
Hosp Univ Cruces, Bilbao, Spain
Iruretagoyena, JR:
Hosp Univ Cruces, Bilbao, Spain
Zuazabal, JI:
Hosp Univ Cruces, Bilbao, Spain
Lopez-Soria, L:
Hosp Univ Cruces, Bilbao, Spain
Montejo, M:
Hosp Univ Cruces, Bilbao, Spain
Nieto, J:
Hosp Univ Cruces, Bilbao, Spain
Rodrigo, D:
Hosp Univ Cruces, Bilbao, Spain
Rodriguez, D:
Hosp Univ Cruces, Bilbao, Spain
Rodriguez, R:
Hosp Univ Cruces, Bilbao, Spain
Vitoria, Y:
Hosp Univ Cruces, Bilbao, Spain
Voces, R:
Hosp Univ Cruces, Bilbao, Spain
Lopez, MVG:
Hosp Univ Virgen de la Victoria, Malaga, Spain
Georgieva, RI:
Hosp Univ Virgen de la Victoria, Malaga, Spain
Ojeda, G:
Hosp Univ Virgen de la Victoria, Malaga, Spain
Bailon, IR:
Hosp Univ Virgen de la Victoria, Malaga, Spain
Morales, JR:
Hosp Univ Virgen de la Victoria, Malaga, Spain
Cuende, AM:
Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain
Echeverria, T:
Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain
Fuerte, A:
Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain
Gaminde, E:
Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain
Goenaga, MA:
Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain
Idigoras, P:
Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain
Iribarren, JA:
Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain
Yarza, AI:
Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain
Urkola, XK:
Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain
Reviejo, C:
Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain
Carrasco, R:
Hosp Gen Univ Alicante, Alicante, Spain
Climent, V:
Hosp Gen Univ Alicante, Alicante, Spain
Llamas, P:
Hosp Gen Univ Alicante, Alicante, Spain
Merino, E:
Hosp Gen Univ Alicante, Alicante, Spain
Plazas, J:
Hosp Gen Univ Alicante, Alicante, Spain
Reus, S:
Hosp Gen Univ Alicante, Alicante, Spain
Alvarez, N:
Complejo Hosp Univ A Coruna, La Coruna, Spain
Bravo-Ferrer, JM:
Complejo Hosp Univ A Coruna, La Coruna, Spain
Castelo, L:
Complejo Hosp Univ A Coruna, La Coruna, Spain
Cuenca, J:
Complejo Hosp Univ A Coruna, La Coruna, Spain
Llinares, P:
Complejo Hosp Univ A Coruna, La Coruna, Spain
Rey, EM:
Complejo Hosp Univ A Coruna, La Coruna, Spain
Mayo, MR:
Complejo Hosp Univ A Coruna, La Coruna, Spain
Sanchez, E:
Complejo Hosp Univ A Coruna, La Coruna, Spain
Regueiro, DS:
Complejo Hosp Univ A Coruna, La Coruna, Spain
Martinez, FJ:
Complejo Hosp Univ Huelva, Huelva, Spain
Alonso, MD:
Hosp Univ Canarias, Canarias, Spain
Castro, B:
Hosp Univ Canarias, Canarias, Spain
Rosado, DG:
Hosp Univ Canarias, Canarias, Spain
Duran, MD:
Hosp Univ Canarias, Canarias, Spain
Gomez, MAM:
Hosp Univ Canarias, Canarias, Spain
Lacalzada, J:
Hosp Univ Canarias, Canarias, Spain
Nassar, I:
Hosp Univ Canarias, Canarias, Spain
Ciezar, AP:
Hosp Reg Univ Malaga, Malaga, Spain
Iglesias, JMR:
Hosp Reg Univ Malaga, Malaga, Spain
Alvarez, VA:
Hosp Univ Cent Asturias, Oviedo, Spain
Costas, C:
Hosp Univ Cent Asturias, Oviedo, Spain
de la Hera, J:
Hosp Univ Cent Asturias, Oviedo, Spain
Suarez, JF:
Hosp Univ Cent Asturias, Oviedo, Spain
Fraile, LI:
Hosp Univ Cent Asturias, Oviedo, Spain
Arguero, VL:
Hosp Univ Cent Asturias, Oviedo, Spain
Menendez, JL:
Hosp Univ Cent Asturias, Oviedo, Spain
Bajo, PM:
Hosp Univ Cent Asturias, Oviedo, Spain
Morales, C:
Hosp Univ Cent Asturias, Oviedo, Spain
Torrico, AM:
Hosp Univ Cent Asturias, Oviedo, Spain
Palomo, C:
Hosp Univ Cent Asturias, Oviedo, Spain
Martinez, BP:
Hosp Univ Cent Asturias, Oviedo, Spain
Esteban, AR:
Hosp Univ Cent Asturias, Oviedo, Spain
Garcia, RR:
Hosp Univ Cent Asturias, Oviedo, Spain
Asensio, MT:
Hosp Univ Cent Asturias, Oviedo, Spain
Almela, M:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Ambrosioni, J:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Azqueta, M:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Brunet, M:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Bodro, M:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Cartana, R:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Falces, C:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Fita, G:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Fuster, D:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
de la Maria, CG:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Hernandez-Meneses, M:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Perez, JL:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Marco, F:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Miro, JM:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Moreno, A:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Nicolas, D:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Ninot, S:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Quintana, E:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Pare, C:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Pereda, D:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Pericas, JM:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Pomar, JL:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Ramirez, J:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Rovira, I:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Sandoval, E:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Sitges, M:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Soy, D:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Tellez, A:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Tolosana, JM:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Vidal, B:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Hosp Gen Univ Santa Lucia, Cartagena, Spain
Vila, J:
Univ Barcelona, Hosp Clin, IDIBAPS, Barcelona, Spain
Adan, I:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Bermejo, J:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Celemin, D:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Caballero, GC:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Pinto, AG:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Montero, AD:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Cruz, AF:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Mansilla, AG:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Leoni, MEG:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Ramallo, VG:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Hernandez, MK:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Hualde, AM:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Marin, M:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Martinez-Selles, M:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Menarguez, MC:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Munoz, P:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Rincon, C:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Rodriguez-Abella, H:
Hosp Gen Univ Gregorio Maranon, Serv Cirugia Cardiaca, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Rodriguez-Creixems, M:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Pinilla, B:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Pinto, A:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Valerio, M:
Hosp Gen Univ Gregorio Maranon, Serv Microbiol Clin & Enfermedades Infecciosas, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Vazquez, P:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Moreno, EV:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Antorrena, I:
Hosp Univ La Paz, Madrid, Spain
Loeches, B:
Hosp Univ La Paz, Madrid, Spain
Quiros, AM:
Hosp Univ La Paz, Madrid, Spain
Moreno, M:
Hosp Univ La Paz, Madrid, Spain
Ramirez, U:
Hosp Univ La Paz, Madrid, Spain
Baston, VR:
Hosp Univ La Paz, Madrid, Spain
Romero, M:
Hosp Univ La Paz, Madrid, Spain
Saldana, A:
Hosp Univ La Paz, Madrid, Spain
Balbin, JA:
Hosp Univ Marques de Valdecilla, Santander, Spain
Castillo, CA:
Hosp Univ Marques de Valdecilla, Santander, Spain
Arnaiz, A:
Hosp Univ Marques de Valdecilla, Santander, Spain
Revillas, FA:
Hosp Univ Marques de Valdecilla, Santander, Spain
Belaustegui, MC:
Hosp Univ Marques de Valdecilla, Santander, Spain
Farinas, MC:
Hosp Univ Marques de Valdecilla, Santander, Spain
Farinas-Alvarez, C:
Hosp Univ Marques de Valdecilla, Santander, Spain
Izquierdo, RG:
Hosp Univ Marques de Valdecilla, Santander, Spain
Garcia, I:
Hosp Univ Marques de Valdecilla, Santander, Spain
Rico, CG:
Hosp Univ Marques de Valdecilla, Santander, Spain
Gutierrez-Cuadra, M:
Hosp Univ Marques de Valdecilla, Santander, Spain
Diez, JG:
Hosp Univ Marques de Valdecilla, Santander, Spain
Pajaron, M:
Hosp Univ Marques de Valdecilla, Santander, Spain
Parra, JA:
Hosp Univ Marques de Valdecilla, Santander, Spain
Teira, R:
Hosp Univ Marques de Valdecilla, Santander, Spain
Zarauza, J:
Hosp Univ Marques de Valdecilla, Santander, Spain
Dominguez, F:
Hosp Univ Puerta de Hierro, Madrid, Spain
Pavia, PG:
Hosp Univ Puerta de Hierro, Madrid, Spain
Gonzalez, J:
Hosp Univ Puerta de Hierro, Madrid, Spain
Orden, B:
Hosp Univ Puerta de Hierro, Madrid, Spain
Ramos, A:
Hosp Univ Puerta de Hierro, Madrid, Spain
Centella, T:
Hosp Univ Ramon y Cajal, Madrid, Spain
Hermida, JM:
Hosp Univ Ramon y Cajal, Madrid, Spain
Moya, JL:
Hosp Univ Ramon y Cajal, Madrid, Spain
Martin-Davila, P:
Hosp Univ Ramon y Cajal, Madrid, Spain
Navas, E:
Hosp Univ Ramon y Cajal, Madrid, Spain
Oliva, E:
Hosp Univ Ramon y Cajal, Madrid, Spain
del Rio, A:
Hosp Univ Ramon y Cajal, Madrid, Spain
Ruiz, S:
Hosp Univ Ramon y Cajal, Madrid, Spain
Tenorio, CH:
Hosp Univ Virgen de las Nieves, Granada, Spain
Delia, MA:
Hosp Univ Virgen Macarena, Seville, Spain
Araji, O:
Hosp Univ Virgen Macarena, Seville, Spain
Barquero, JM:
Hosp Univ Virgen Macarena, Seville, Spain
Jambrina, RC:
Hosp Univ Virgen Macarena, Seville, Spain
de Cueto, M:
Hosp Univ Virgen Macarena, Seville, Spain
Acebal, JG:
Hosp Univ Virgen Macarena, Seville, Spain
Mendez, I:
Hosp Univ Virgen Macarena, Seville, Spain
Morales, I:
Hosp Univ Virgen Macarena, Seville, Spain
Lopez-Cortes, LE:
Hosp Univ Virgen Macarena, Seville, Spain
de Alarcon, A:
Hosp Univ Virgen del Rocio, Seville, Spain
Garcia, E:
Hosp Univ Virgen del Rocio, Seville, Spain
Haro, JL:
Hosp Univ Virgen del Rocio, Seville, Spain
Lepe, JA:
Hosp Univ Virgen del Rocio, Seville, Spain
Lopez, F:
Hosp Univ Virgen del Rocio, Seville, Spain
Luque, R:
Hosp Univ Virgen del Rocio, Seville, Spain
Alonso, LJ:
Hosp San Pedro, Logrono, Spain
Azcarate, P:
Hosp San Pedro, Logrono, Spain
Gutierrez, JMA:
Hosp San Pedro, Logrono, Spain
Blanco, JR:
Hosp San Pedro, Logrono, Spain
Villegas, AC:
Hosp San Pedro, Logrono, Spain
Garcia-Alvarez, L:
Hosp San Pedro, Logrono, Spain
Oteo, JA:
Hosp San Pedro, Logrono, Spain
Sanz, M:
Hosp San Pedro, Logrono, Spain
de Benito, N:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Gurgui, M:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Pacho, C:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Pericas, R:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Pons, G:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Alvarez, M:
Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain
Fernandez, AL:
Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain
Martinez, A:
Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain
Complejo Hosp Univ Albacete, Albacete, Spain
Prieto, A:
Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain
Regueiro, B:
Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain
Tijeira, E:
Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain
Vega, M:
Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain
Blasco, AC:
Hosp Santiago Apostol, Vitoria, Spain
Mollar, JC:
Hosp Santiago Apostol, Vitoria, Spain
Arana, JCG:
Hosp Santiago Apostol, Vitoria, Spain
Uriarte, OG:
Hosp Santiago Apostol, Vitoria, Spain
Lopez, AM:
Hosp Santiago Apostol, Vitoria, Spain
de Zarate, ZO:
Hosp Santiago Apostol, Vitoria, Spain
Matos, JAU:
Hosp Santiago Apostol, Vitoria, Spain
Dominguez, GG:
Hosp SAS Linea Concepcion, Cadiz, Spain
Sanchez-Porto, A:
Hosp SAS Linea Concepcion, Cadiz, Spain
Leal, JMA:
Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain
Vazquez, EG:
Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain
Torres, AH:
Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain
Blazquez, A:
Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain
Valenzuela, GD:
Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain
Alonso, A:
Hosp Txagorritxu, Vitoria, Spain
Aramburu, J:
Hosp Txagorritxu, Vitoria, Spain
Calvo, FE:
Hosp Txagorritxu, Vitoria, Spain
Rodriguez, AM:
Hosp Txagorritxu, Vitoria, Spain
Tarabini-Castellani, P:
Hosp Txagorritxu, Vitoria, Spain
Galvez, EH:
Hosp Virgen de la Salud, Toledo, Spain
Bellido, CM:
Hosp Virgen de la Salud, Toledo, Spain
Pau, JL:
Hosp Virgen de la Salud, Toledo, Spain
Sepulveda, MA:
Hosp Virgen de la Salud, Toledo, Spain
Sierra, PT:
Hosp Virgen de la Salud, Toledo, Spain
Iqbal-Mirza, SZ:
Hosp Virgen de la Salud, Toledo, Spain
Alcolea, EC:
Hosp Rafael Mendez, Lorca Murcia, Spain
Yanez, IK:
Hosp Rafael Mendez, Lorca Murcia, Spain
Ballesta, AP:
Hosp Rafael Mendez, Lorca Murcia, Spain
Escobar, EM:
Hosp Univ San Cecilio, Granada, Spain
Monje, AP:
Hosp Univ San Cecilio, Granada, Spain
Cabrera, VS:
Hosp Univ San Cecilio, Granada, Spain
Garcia, DV:
Hosp Univ San Cecilio, Granada, Spain
Asenjo, MA:
Hosp Son Llatzer, Palma De Mallorca, Spain
Luna, CC:
Hosp Son Llatzer, Palma De Mallorca, Spain
Morcillo, JN:
Hosp Son Llatzer, Palma De Mallorca, Spain
Seco, MCP:
Hosp Son Llatzer, Palma De Mallorca, Spain
Gelabert, AV:
Hosp Son Llatzer, Palma De Mallorca, Spain
Guallar, CA:
Hosp Univ Miguel Servet, Zaragoza, Spain
Abad, NF:
Hosp Univ Miguel Servet, Zaragoza, Spain
Mangas, PG:
Hosp Univ Miguel Servet, Zaragoza, Spain
Adell, MM:
Hosp Univ Miguel Servet, Zaragoza, Spain
Ruiz, MPP:
Hosp Univ Miguel Servet, Zaragoza, Spain
Porres, JC:
Hosp Univ Miguel Servet, Zaragoza, Spain
Vidal, BA:
Hosp Gen Univ Santa Lucia, Cartagena, Spain
Trigueros, NC:
Hosp Gen Univ Santa Lucia, Cartagena, Spain
Espin, MJD:
Hosp Gen Univ Santa Lucia, Cartagena, Spain
Caro, JAG:
Hosp Gen Univ Santa Lucia, Cartagena, Spain
Sanchez, RJ:
Hosp Gen Univ Santa Lucia, Cartagena, Spain
Almazan, AJ:
Hosp Gen Univ Santa Lucia, Cartagena, Spain
Freire, AO:
Hosp Gen Univ Santa Lucia, Cartagena, Spain
Gonzalez, MV:
Hosp Gen Univ Santa Lucia, Cartagena, Spain
Ramis, PP:
Hosp Univ Son Espases, Palma De Mallorca, Spain
Blanco, MAR:
Hosp Univ Son Espases, Palma De Mallorca, Spain
Bordes, ERD:
Hosp Univ Son Espases, Palma De Mallorca, Spain
Bonet, LV:
Hosp Univ Son Espases, Palma De Mallorca, Spain
Munera, MCH:
Complejo Hosp Univ Albacete, Albacete, Spain
Garaizabal, EE:
Complejo Hosp Univ Albacete, Albacete, Spain
Martinez, AT:
Complejo Hosp Univ Albacete, Albacete, Spain
Luque, JCS:
Complejo Hosp Univ Albacete, Albacete, Spain
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