<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0484-7903</journal-id>
<journal-title><![CDATA[Revista mexicana de anestesiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. mex. anestesiol.]]></abbrev-journal-title>
<issn>0484-7903</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Anestesiología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0484-79032023000200140</article-id>
<article-id pub-id-type="doi">10.35366/110202</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Endarterectomía carotídea en paciente con estenosis aórtica crítica. Importancia de la anestesia regional y del neuromonitoreo]]></article-title>
<article-title xml:lang="en"><![CDATA[Carotid endarterectomy in a patient with critical aortic stenosis. Importance of regional anesthesia and transoperative neurological monitoring]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lazcano-Díaz]]></surname>
<given-names><![CDATA[Emmanuel Adrián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Escamilla-Ríos]]></surname>
<given-names><![CDATA[Dania E]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres Maldonado]]></surname>
<given-names><![CDATA[Arely Seir]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Manzur-Sandoval]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villalobos-Pedroza]]></surname>
<given-names><![CDATA[Montserrat]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rojas-Velasco]]></surname>
<given-names><![CDATA[Gustavo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Cardiología «Ignacio Chávez» Unidad de Terapia Intensiva cardiovascular ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Nacional de Cardiología «Ignacio Chávez» Departamento de Anestesiología ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Nacional de Rehabilitación Departamento de Anestesiología ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Nacional de Cardiología «Ignacio Chávez» Departamento de Cardiología Clínica ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2023</year>
</pub-date>
<volume>46</volume>
<numero>2</numero>
<fpage>140</fpage>
<lpage>143</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0484-79032023000200140&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0484-79032023000200140&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0484-79032023000200140&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La estenosis carotídea (EC) ocurre en 13% de los pacientes con estenosis valvular aórtica (EVA). El riesgo de evento vascular cerebral (EVC), en los pacientes con EC significativa sometidos a cirugía valvular cardíaca, puede aumentar hasta 11%. Someter a un paciente con EVA crítica y fracción de eyección del ventrículo izquierdo (FEVI) disminuida a endarterectomía carotídea es todo un reto anestésico, cuyo principal objetivo es evitar la hipotensión y el bajo gasto cardíaco. La anestesia regional es una opción para estos pacientes. Presentamos el caso de un hombre de 70 años con diagnóstico de EC significativa y EVA crítica con disfunción ventricular izquierda, al que se realizó endarterectomía carotídea con bloqueo del plexo cervical superficial por alto riesgo de colapso circulatorio. Dicha estrategia anestésica permitió mantener al paciente despierto durante la cirugía, al valorar continuamente su estado neurológico. Asimismo, se documentaron los cambios transoperatorios en el NIRS (Near-infrared spectroscopy) cerebral y Doppler transcraneal (DTC), los cuales se correlacionaron con el estado clínico del paciente. En un segundo tiempo se hizo cambio valvular aórtico sin complicaciones. En este caso destaca la importancia de la anestesia regional y el monitoreo neurológico con Doppler transcraneal, en pacientes sometidos a endarterectomía carotídea con alto riesgo quirúrgico por EVA crítica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Carotid stenosis occurs in 13% of patients with aortic valve stenosis. The risk of stroke in patients with significant carotid stenosis undergoing heart valve surgery may increase to 11%. Proposing a patient with critical aortic valve stenosis and left ventricular dysfunction to carotid endarterectomy is an anesthetic challenge, where the objective is to avoid hypotension and low cardiac output. Regional anesthesia is an option for these patients. Due to the high incidence of intraoperative stroke during carotid endarterectomy, continuous neurological monitoring is of relevance. We present the case of a 70-year-old man diagnosed with significant carotid stenosis and critical aortic valve stenosis and left ventricular dysfunction who underwent carotid endarterectomy with superficial cervical plexus block due to a high risk of circulatory collapse. In addition, this anesthetic strategy made it possible to keep the patient awake during surgery, and to continuously assess their neurological status. Likewise, transoperative changes in brain NIRS and transcranial Doppler were documented, which correlated with the patient&#8217;s clinical status. In a second time, aortic valve replacement was performed without complications. This case highlights the importance of regional anesthesia and neurological monitoring in patients undergoing carotid endarterectomy with high surgical risk due to critical aortic valve stenosis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[estenosis carotídea]]></kwd>
<kwd lng="es"><![CDATA[estenosis valvular aórtica]]></kwd>
<kwd lng="es"><![CDATA[anestesia regional]]></kwd>
<kwd lng="es"><![CDATA[Doppler transcraneal]]></kwd>
<kwd lng="en"><![CDATA[carotid stenosis]]></kwd>
<kwd lng="en"><![CDATA[aortic valve stenosis]]></kwd>
<kwd lng="en"><![CDATA[regional anesthesia]]></kwd>
<kwd lng="en"><![CDATA[transcranial Doppler]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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