Currently, Dr. Fernando Goglar, vascular surgeon, is the only specialist in treating trauma cases in this vital artery on the island.
Fernando Goglar, Vascular Surgeon
Belinda Z. Burgos GonzálezLatin Agency for News Medicine and Public Health
A retrospective study between 2011 and 2020 demonstrated the efficacy of a minimally invasive vascular technique in patients presenting with trauma to the aorta.
The aorta is the main artery that carries blood from the heart to the rest of the body. However, blood leaves the heart through the aortic valve.
The data for this study of Medicine and Public Health (MSP) was disclosed by Dr. Fernando Goglar, vascular surgeon and professor at the Medical Sciences Campus (RCM). The study included data from the Accident Hospital Registry at the Medical Center to verify the health of all patients.
The bumps can be penetrating or blunt, when it’s a car accident, among other things.
The specialist explained that in the event of trauma to the aorta, prior to a thoracotomy – a type of surgery to open the chest wall -, however, those who cannot tolerate this type of intervention may benefit from endovascular repair, compared to a catheter procedure.
“In endovascular repair, a tube is inserted through the femoral artery along with a mesh for blood to pass through. The doctor explains that this procedure does not obstruct blood flow.
More than 13,000 surgical interventions were performed during this period. Of this number, 72 patients underwent an aortic intervention, among those 72, 68 were severely traumatized and there were four penetrating injuries, and those 68 had suffered severe trauma in the chest area and one of the abdominal aorta, “the deputy director also explained to the accident hospital from 2004 to 2008.
“Open surgery has many risks, a much higher mortality rate of 23% and the risk of paraplegia, because when this procedure was performed, the blood flow in the spinal cord decreased and there were young people who were intervened in this way and of course after that the doctor said” for a while they were not able From moving their lower limbs. ”
“Of the 4 penetrating cases, two were from the thoracic aorta and one from the abdomen,” the doctor said, adding that until March 2021, he had to intervene in about four cases of aortic injury in Puerto Rico, only in your class that performs this type of procedure. .
The specialist stressed the need to detect aortic injuries in a timely manner because it is a vital scenario for the patient’s life and the type of procedure that is considered a candidate must be known, given that the comorbidities that may have an important role at the time of the intervention surgically.
The advantage of Puerto Rico over the United States
Dr. Joglar emphasized that the data from this study shows the advantage of the techniques used in the island versus those used in the United States, as the risk of death in Puerto Rico from the technique of repairing the aorta from the inside is only 4%, compared to 7.2% in the United States, according to data from the studies. Published and noted.
We have some data published in terms of mortality. It was 89.8% of young people, with an average age of 37 years. 94% had severe trauma. With these data we prove that this type of intervention can be done in Puerto Rico with good results. ”He emphasized.
Another important fact in the study is that the data emerged is that bovine arch is predominant in the anatomy of these patients who underwent surgery. This occurs when the left carotid artery has a common stem with the epicardial artery.
“We have seen that 34% of our patients who undergo the study have a bovine arch and this is higher than what we expect because what has been described in the literature is that between 10 and 15% of cases are described. This type of patient is prone to suffering from aneurysms,” he said. He described it, adding that he would expand his research by looking into why Puerto Ricans have this type of anatomical arch that can predispose to dangerous conditions such as aneurysms.