Innovación en cardiología intervencionista

Dr. José R. Rumoroso

05/05/2020

Introductor deflectable bidireccional Nagare

El introductor deflectable bidireccional Nagare (Terumo, Japón) es un catéter que permite navegar en todas las cámaras cardiacas de manera controlada. El movimiento de la vaina es bidireccional gracias a la tecnología TrueVector: el dispositivo está fabricado con una malla coaxial, a diferencia de otros que tienen en su interior unas guías que se traccionan proximalmente con el mango para mover la punta del catéter. La malla, recubierta de Klevar, se mueve libremente y, al ser traccionada proximalmente con el mango, permite deflectar solo el extremo con precisión y estabilidad, evitando el clásico efecto látigo de otros catéteres similares. En estos, la deflexión es de todo el catéter, no solo de la punta; esto es una mejora interesante.

El introductor deflectable bidireccional Nagare consta de una vaina de diámetro externo de 12 French e interno de 8,8 French, con una longitud de catéter efectiva de 73,7 cm. Sus medidas permiten introducir otros dispositivos en su interior. Lleva un dilatador con transición suave para guía de 0,032’’. La deflexión sobre su eje longitudinal llega a 90° y 180° con un radio de giro de 25 mm.

Este dispositivo está indicado para realizar punciones transeptales controladas. Los procedimientos intervencionistas estructurales que se llevan a cabo en el lado izquierdo del corazón requieren en muchas ocasiones una punción posterior y baja del septo interauricular. Con una vaina deflectable de este tipo se puede controlar mejor el lugar de punción.

Palabras clave: introductor deflectable, punción transeptal. Keywords: steereble sheath, transseptal puncture.

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SELECT a.id,a.asset_id,a.title,a.alias,a.introtext,a.fulltext,a.state,a.catid,a.created,a.created_by,a.created_by_alias,CASE WHEN a.modified = '0000-00-00 00:00:00' THEN a.created ELSE a.modified END as modified,a.modified_by,a.checked_out,a.checked_out_time,a.publish_up,a.publish_down,a.images,a.urls,a.attribs,a.version,a.ordering,a.metakey,a.metadesc,a.access,a.hits,a.metadata,a.featured,a.language,`fp`.`featured_up`,`fp`.`featured_down`,`c`.`title` AS `category_title`,`c`.`alias` AS `category_alias`,`c`.`access` AS `category_access`,`c`.`language` AS `category_language`,`c`.`lft` AS `category_lft`,`c`.`lft` AS `category_ordering`,`u`.`name` AS `author`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,ROUND(v.rating_sum / v.rating_count, 0) AS rating,`v`.`rating_count` AS `rating_count` FROM `yzfp0_content` AS `a` LEFT JOIN `yzfp0_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` INNER JOIN `yzfp0_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `yzfp0_users` AS `u` ON `u`.`id` = `a`.`created_by` LEFT JOIN `yzfp0_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `yzfp0_content_rating` AS `v` ON `v`.`content_id` = `a`.`id` WHERE `a`.`id` = 2238 AND `c`.`published` > 0 AND (`a`.`state` = 1 AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= '2025-11-09 10:14:47') AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` = '0000-00-00 00:00:00' OR `a`.`publish_down` > '2025-11-09 10:14:47'))283μs5.3KB/libraries/regularlabs/src/Article.php:101Copy
SELECT c.id FROM yzfp0_content AS c LEFT JOIN yzfp0_contentitem_tag_map AS tm ON c.id = tm.content_item_id WHERE tm.tag_id IS NULL AND c.language = 'es-ES' AND c.created > (SELECT created FROM yzfp0_content WHERE id = 361) ORDER BY c.created ASC LIMIT 131.26ms536B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:168Copy
SELECT c.id FROM yzfp0_content AS c LEFT JOIN yzfp0_contentitem_tag_map AS tm ON c.id = tm.content_item_id WHERE tm.tag_id IS NULL AND c.language = 'es-ES' AND c.created < (SELECT created FROM yzfp0_content WHERE id = 361) ORDER BY c.created DESC LIMIT 110.96ms536B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:168Copy
SELECT `catid`,`alias`,`language` FROM `yzfp0_content` WHERE `id` = '360'217μs656B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:227Copy
SELECT `alias` FROM `yzfp0_categories` WHERE `id` = '20'119μs536B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:239Copy
SELECT `catid`,`alias`,`language` FROM `yzfp0_content` WHERE `id` = '440'116μs656B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:227Copy
SELECT `alias` FROM `yzfp0_categories` WHERE `id` = '20'103μs536B/plugins/content/dms3articlenavigation/dms3articlenavigation.php:239Copy
SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`334μs3.97KBParams/libraries/src/Categories/Categories.php:375Copy
SELECT r.* FROM yzfp0_rereplacer AS r WHERE r.published = 1 AND (r.area = 'component' OR r.params LIKE '%\"use_xml\":\"1\"%') ORDER BY r.ordering, r.id287μs1.48KB/plugins/system/rereplacer/src/Items.php:97Copy
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SELECT `c2`.`language`,CONCAT_WS(':', `c2`.`id`, `c2`.`alias`) AS `id`,CONCAT_WS(':', `ca`.`id`, `ca`.`alias`) AS `catid` FROM `yzfp0_content` AS `c` INNER JOIN `yzfp0_associations` AS `a` ON `a`.`id` = `c`.`id` AND `a`.`context` = :context INNER JOIN `yzfp0_associations` AS `a2` ON `a`.`key` = `a2`.`key` INNER JOIN `yzfp0_content` AS `c2` ON `a2`.`id` = `c2`.`id` INNER JOIN `yzfp0_categories` AS `ca` ON `c2`.`catid` = `ca`.`id` AND `ca`.`extension` = :extension2 WHERE `c`.`id` = :id AND c2.access IN (1,5) AND c2.language != 'es-ES' AND (c2.publish_up IS NULL OR c2.publish_up <= '2025-11-09 10:14:47') AND (c2.publish_down IS NULL OR c2.publish_down >= '2025-11-09 10:14:47') AND c2.state = 1381μs1.48KBParams/libraries/src/Language/Associations.php:145Copy
SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `yzfp0_categories` AS `s` INNER JOIN `yzfp0_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`373μs3.97KBParams/libraries/src/Categories/Categories.php:375Copy
SELECT `m`.`id`,`m`.`title`,`m`.`module`,`m`.`position`,`m`.`content`,`m`.`showtitle`,`m`.`params`,`mm`.`menuid` FROM `yzfp0_modules` AS `m` LEFT JOIN `yzfp0_modules_menu` AS `mm` ON `mm`.`moduleid` = `m`.`id` LEFT JOIN `yzfp0_extensions` AS `e` ON `e`.`element` = `m`.`module` AND `e`.`client_id` = `m`.`client_id` WHERE ( ( (`m`.`published` = 1 AND `e`.`enabled` = 1 AND `m`.`client_id` = :clientId AND `m`.`access` IN (:preparedArray1,:preparedArray2)) AND (`m`.`publish_up` IS NULL OR `m`.`publish_up` <= :publishUp)) AND (`m`.`publish_down` IS NULL OR `m`.`publish_down` >= :publishDown)) AND (`mm`.`menuid` = :itemId OR `mm`.`menuid` <= 0) AND `m`.`language` IN (:preparedArray3,:preparedArray4) ORDER BY `m`.`position`,`m`.`ordering`1.53ms212.34KBParams/libraries/src/Cache/Controller/CallbackController.php:51Copy
SELECT `a`.`menutype`,`a`.`title` FROM `yzfp0_menu_types` AS `a` WHERE `a`.`client_id` = 0152μs1KB/libraries/gantry5/src/classes/Gantry/Framework/Menu.php:138Copy
SELECT m.id, m.alias, m.path AS route, m.level, m.parent_id FROM yzfp0_menu AS m WHERE m.menutype = 'menu-es-new' AND m.parent_id > 0 AND m.client_id = 0 AND m.published >= 0 ORDER BY m.lft353μs1.61KB/libraries/gantry5/src/classes/Gantry/Framework/Menu.php:791Copy
SHOW FULL COLUMNS FROM `yzfp0_content`335μs1.77KB/libraries/vendor/joomla/database/src/Mysqli/MysqliDriver.php:539Copy
SELECT field.name,'https://recintervcardiol.org/es/innovacion-en-cardiologia-intervencionista/introductor-deflectable-bidireccional-nagare\n[786] RegularLabs.Plugin.System.ArticlesAnywhere.DataGroups.Field.getFieldNames\n[781] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_fields` AS `field` WHERE field.context = 'com_content.article'290μs17.81KB/plugins/system/articlesanywhere/src/Database.php:125Copy
SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/innovacion-en-cardiologia-intervencionista/introductor-deflectable-bidireccional-nagare\n[838] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[888] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 361 LIMIT 1163μs704B/plugins/system/articlesanywhere/src/Database.php:125Copy
SELECT category.id,'https://recintervcardiol.org/es/innovacion-en-cardiologia-intervencionista/introductor-deflectable-bidireccional-nagare\n[280] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getUnpublishedCategoryIds\n[728] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_categories` AS `category` LEFT JOIN `yzfp0_categories` AS `parent` ON `category`.`parent_id` = `parent`.`id` WHERE `category`.`extension` = 'com_content' AND (`category`.`published` IN (0,-1,-2) OR `parent`.`published` IN (0,-1,-2)) GROUP BY category.id269μs592B/plugins/system/articlesanywhere/src/Database.php:125Copy
SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/innovacion-en-cardiologia-intervencionista/introductor-deflectable-bidireccional-nagare\n[900] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getArticleIdsByFilters\n[346] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE ((`article`.`state` = 1 AND (`article`.`publish_up` IS NULL OR `article`.`publish_up` <= '2025-11-09 10:14:47') AND (`article`.`publish_down` IS NULL OR `article`.`publish_down` = '0000-00-00 00:00:00' OR `article`.`publish_down` > '2025-11-09 10:14:47')) AND `article`.`access` IN (1,5) AND `article`.`language` IN ('es-ES','*')) AND `article`.`id` = 361 AND `article`.`catid` != 121 ORDER BY FIELD(article.id, 361)165μs592B/plugins/system/articlesanywhere/src/Database.php:125Copy
SELECT `article`.`id` AS `article.id`,`article`.`title` AS `article.title`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/innovacion-en-cardiologia-intervencionista/introductor-deflectable-bidireccional-nagare\n[902] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[888] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 361 ORDER BY `article`.`publish_up` IS NULL, CAST(`article`.`publish_up` AS CHAR(1)) = '', CAST(`article`.`publish_up` AS CHAR(10)) = '0000-00-00', CAST(`article`.`publish_up` AS SIGNED INTEGER) = 0, CAST(`article`.`publish_up` AS SIGNED INTEGER) DESC, `article`.`publish_up` DESC LIMIT 1145μs768B/plugins/system/articlesanywhere/src/Database.php:125Copy
SELECT `alias`,`catid` FROM yzfp0_content WHERE `id` = :key134μs1.37KBParams/libraries/src/Component/Router/Rules/PreprocessRules.php:123Copy
SELECT `article`.`id` AS `article.id`,'https://recintervcardiol.org/es/innovacion-en-cardiologia-intervencionista/introductor-deflectable-bidireccional-nagare\n[838] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[888] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 361 LIMIT 1141μs592B/plugins/system/articlesanywhere/src/Database.php:125Copy
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SELECT a.id FROM yzfp0_categories AS a WHERE `a`.`id` IN (20) AND `a`.`extension` = 'com_content' AND `a`.`id` NOT IN (121) AND `a`.`access` IN (1,5) AND `a`.`published` IN (1) AND `a`.`language` IN ('es-ES','*')149μs11.52KB/libraries/gantry5/src/classes/Gantry/Joomla/Object/Finder.php:203Copy
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SELECT a.* FROM yzfp0_categories AS a WHERE id IN (20) ORDER BY lft244μs3KB/libraries/gantry5/src/classes/Gantry/Joomla/Object/AbstractObject.php:548Copy
SELECT COUNT(*) FROM yzfp0_content AS a INNER JOIN yzfp0_categories AS c ON c.id = a.catid WHERE `a`.`catid` NOT IN (121) AND ((a.publish_up IN ('0000-00-00 00:00:00', '1000-01-01 00:00:00') OR a.publish_up IS NULL) OR a.publish_up <= '2025-11-09 10:14:47') AND ((a.publish_down IN ('0000-00-00 00:00:00', '1000-01-01 00:00:00') OR a.publish_down IS NULL) OR a.publish_down >= '2025-11-09 10:14:47') AND a.state >= 1 AND `a`.`access` IN (1,5) AND `c`.`access` IN (1,5) AND `a`.`state` IN (1) AND `a`.`language` IN ('es-ES','*') AND `a`.`catid` IN (20) ORDER BY a.`publish_up` DESC465μs536B/libraries/gantry5/src/classes/Gantry/Joomla/Object/Finder.php:222Copy
SELECT a.id FROM yzfp0_content AS a INNER JOIN yzfp0_categories AS c ON c.id = a.catid WHERE `a`.`catid` NOT IN (121) AND ((a.publish_up IN ('0000-00-00 00:00:00', '1000-01-01 00:00:00') OR a.publish_up IS NULL) OR a.publish_up <= '2025-11-09 10:14:47') AND ((a.publish_down IN ('0000-00-00 00:00:00', '1000-01-01 00:00:00') OR a.publish_down IS NULL) OR a.publish_down >= '2025-11-09 10:14:47') AND a.state >= 1 AND `a`.`access` IN (1,5) AND `c`.`access` IN (1,5) AND `a`.`state` IN (1) AND `a`.`language` IN ('es-ES','*') AND `a`.`catid` IN (20) ORDER BY a.`publish_up` DESC LIMIT 8426μs648B/libraries/gantry5/src/classes/Gantry/Joomla/Object/Finder.php:203Copy
SELECT a.* FROM yzfp0_content AS a WHERE id IN (2637,2603,2604,1319,1285,1284,1247,1246) ORDER BY id272μs35.2KB/libraries/gantry5/src/classes/Gantry/Joomla/Object/AbstractObject.php:548Copy
SELECT `article`.`id` AS `article.id`,`article`.`catid` AS `article.catid`,`article`.`language` AS `article.language`,'https://recintervcardiol.org/es/innovacion-en-cardiologia-intervencionista/introductor-deflectable-bidireccional-nagare\n[902] RegularLabs.Plugin.System.ArticlesAnywhere.Articles.getValuesByArticleIds\n[888] RegularLabs.Plugin.System.ArticlesAnywhere.Database.getResults\n[103] RegularLabs.Plugin.System.ArticlesAnywhere.Helpers.DB.__callStatic' as 'query_comment' FROM `yzfp0_content` AS `article` WHERE `article`.`id` = 361 ORDER BY `article`.`publish_up` IS NULL, CAST(`article`.`publish_up` AS CHAR(1)) = '', CAST(`article`.`publish_up` AS CHAR(10)) = '0000-00-00', CAST(`article`.`publish_up` AS SIGNED INTEGER) = 0, CAST(`article`.`publish_up` AS SIGNED INTEGER) DESC, `article`.`publish_up` DESC LIMIT 1158μs704B/plugins/system/articlesanywhere/src/Database.php:125Copy
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infoplg_system_j2xml - plgSystemJ2xml::__construct
infoplg_system_basicauth - plgSystemBasicauth::__construct
infoplg_system_basicauth - PHP_SAPI: fpm-fcgi
infoplg_system_basicauth - authorization:
infoplg_system_basicauth - plgSystemBasicauth::onAfterRoute
infoplg_system_j2xml - plgSystemJ2xml::onAfterDispatch
infoplg_system_basicauth - plgSystemBasicauth::onBeforeRender

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