[Perspective of heart transplantation in advanced congenital cardiopathy: report of a case]. / La perspectiva del trasplante cardiaco en la cardiopatía congénita avanzada: a propósito de un caso.

Heart transplantation is an infrequent treatment modality in advanced congenital cardiopathy. We present the case of a 17-years old youngster coursing with a dilated Fallot's tetralogy, in terminal stage, who was subjected to an orthotopic heart transplantation. We present the most relevant data on his management during the 53 months after the surgery and discuss the long-term perspectives, which are comparable to those expected in transplanted patients due to other cardiac disorders.

[Struma cordis: first case in Mexico]. / Struma cordis: primer caso en México.

The Intracardiac ectopic thyroid is an extremely rare condition and there is no previous report on this subject in Mexico. This is the case of a 33 years old woman, with normal thyroid function. She was found to have an intracardiac tumor in the interventricular septum. The intraoperative biopsy showed typical thyroid follicules; tumor removal left a septal defect that was closed with a dacron patch suture. Two years follow-up showed normal echocardiographic images, good clinical status an normal thyroid functioning. A brief review of the literature is included.

[Permanent pacemakers in children. The indications, complications and long-term follow-up]. / Marcapasos permanentes en niños. Indicaciones, complicaciones y seguimiento a largo plazo.

Definitive pacemakers were placed in 27 children from June 1970 to October 1988. The indication for the pacemakers was congenital auriculoventricular block in 12 patients who were symptomatic; 8 were children with postoperative auriculoventricular block; 4 had developed complete auriculoventricular block from myocardiopathies and 3 from idiopathic sick-sinus syndrome. Two patients died: one 4 months after placement of the pacemaker due to unrelated causes, and the other 14 years later due to fracture of the electrode. There were 23 who were reoperated for different reasons but the most frequent was battery failure in 8 patients and pacemaker malfunction in 4 patients. The electrode was implanted in the epicardium in 21 patients and via subclavian vein into the endocardium in 6 cases. The growth and development physically and mentally were normal during the follow-up of these children. The average follow-up period was 55.6 months.

[Familial myxoma. Report of a case and review of the literature]. / Mixoma familiar. Informe de un caso y revisión de la literatura.

This is a report of two family members (mother and her first son) with atrial myxoma detected by echocardiography, computed axial tomography and cardiac catheterization, the former located in the left atrium and the latter in the right ventricle. They were successfully treated with heart surgery. We emphasize the need to detect myxoma in the other members of the family, especially when it is of multicentric localization.

[Permanent auricular paralysis. Report of 2 cases with different response to auricular stimulation]. / Parálisis auricular permanente. Informe de dos casos con diferente respuesta a la estimulación auricular.

Two well documented cases of permanent atrial standstill are reported. Both fulfilled the diagnostic criteria of absence of electrical and mechanical atrial activity. The importance of response to electrical stimuli and escape rhythm is discussed within the context of a severe, irreversible and evolutive disease.

[Myxoma of the right ventricle. Report of a case operated on]. / Mixoma del ventrículo derecho. Informe de un caso operado.

A case of right ventricular tumor in a 14 year old male is presented. Congestive heart failure and a systolic pulmonary murmur due to right ventricular obstruction were the main symptoms. The diagnosis was confirmed by echocardiogram (M mode) and right ventricular angiography. The surgical treatment was curative and the histological exam revealed a myxoma.

[Sudden cardiac death recorded during ambulatory electrocardiography]. / Muerte cardíaca súbita registrada durante electrocardiografía ambulatoria.

Two patients who had sudden unexpected death while being monitored by a Holter electrocardiograph apparatus are reported. The first patient with heart disease of unknown etiology initially developed first degree A-V block, progressive left bundle branch block and finally asystole. The second patient with previous coronary artery disease and recent myocardial infarction revealed multifocal ventricular extrasystoles with frequent bigeminism and trigeminism which ended in ventricular tachycardia and fibrillation. Emphasis is made on the necessity of detecting those high risk patients and establishing preventive post-hospitalization care to modify the evolution and prognosis in this group of patients.

[Aortic atresia. Presentation of 7 cases]. / Atresia aórtica. Presentación de 7 casos.

The clinical and anatomic findings of 7 patients with aortic atresia were studied. All cases had usual atrial arrangement, atrioventricular and ventriculoarterial concordance. All but one had an intact ventricular septum. All cases presented a hypoplastic left ventricle, and in one, a mitral atresia was found. The clinical diagnosis was made by means of cardiac catheterization and angiocardiography. The presence of a patent ductus arteriosus, the size of the atrial and ventricular septal defects, the diameter of the ascending aorta, pulmonary vascular resistances and right ventricular function are all factors that influence the survival in the patients with aortic atresia.

Conducto arterioso persistente derecho y arco aortico derecho tipo I. Informe de un caso. / Right patent ductus arterious and right aortic arch type I. Report of a case

Se presenta un caso raro de persistencia del conducto arterioso derecho, con arco aortico a la derecha, sin otras malformaciones.Se reviso la literatura encontrando unicamente cinco casos similares. En estos casos el estudio hemodinamico es fundamental para precisar el diagnostico, descartar anomalias asociadas y realiza el tratamiento quirurgico a traves de toracotomia derecha

Fistula arteriovenosa renal postnefrectomia. / Post-nephrectomy renal arteriovenous fistula

Se presenta un caso de fistula arteriovenosa renal postnefrectomia. Las manifestaciones clinicas fueron de insuficiencia cardiaca, hipertension arterial y la presencia de un soplo continuo grado IV/VI en la region lumbar derecha. El diagnostico se comprobo mediante aortografia lumbar.El tratamiento consistio en ligadura de la arteria renal derecha. Con ello se observo desaparicion de la insuficiencia cardiaca, aunque persitio la hipertension arterial, misma que respondio adecuadamente al tratamiento medico

Cierre quirurgico del conducto arterioso en recien nacidos de pretermino Cinco anos de experiencia / Surgical closure of patent ductus arteriosus in pre-term newborn infants: 5 years' experience

Se refere la experiencia de los primeros cinco anos de trabajo en la Unidad de Cuidados Intensivos Neonatales del Centro Hospitalario 20 de Noviembro del ISSSTE, en el diagnostico y tratamiento quirurgico del conducto arterioso persistente en neonatos con sindrome de dificultad respiratoria sometidos a ventilacion mecanica. Se senalan los datos clinicos para su diagnostico; la edad gestacional, peso, dia promedio en que se efectuo el diagnostico, dia promedio en que fueron sometidos a la cirugia y se comparan estos datos observando su influencia entre el grupo de supervivientes y el grupo que sufrio una defuncion temprana

Alternativa en el manejo del conducto arterioso persistente con indometacina en recien nacidos de pretermino. / Alternatives to the treatment of patent ductus arteriosus with indomethacin in pre-term newborn infants

En una serie de 42 recien nacidos de pretermino con diagnostico de sindrome de dificultad respiratoria y conducto arterioso persistente tratados con indometacina, se analizan los factores que pudieran determinar la respuesta a la indometacina en tres grupos de peso (Grupo I: 1,250g; grupo II: > 1,250g y < 2,000 g y grupo III: 2,001 g < ou igual 2,500 g). Se determino que estadisticamente fue significativa pala hipotesis planteada, la dosis de indometacina empleada y la edad postnatal al momento de iniciar la administracion del farmaco. Estos resultados plantean la alternativa de emplear la via de administracion intravenosa preferentemente sobre la oral, debera considerarse aumentar la dosis del farmaco y finalmente, despues de la primera semana de vida, se recomienda que el farmaco se emplee a dosis repetidas con intervalos cortos

[Indomethacin and persistent ductus arterious in the pre-term newborn infant with respiratory insufficiency]. / Indometacina y conducto arterioso persistente en el recién nacido de pretérmino con insuficiencia respiratoria.

Forty-two cases of preterm infants with respiratory distress syndrome who developed congestive heart failure secondary to large arteriovenous shunt across permeable ductus arteriosus and who were treated with indomethacin are presented. The cases were divided into three groups according to birth weight: group I less than 1,200 g, group II between 1,250 and 2,000 g and group III from 2,000 to 2,500 g. Satisfactory results were obtained by either ductal closure or by important reduction in the left to right shunt with disappearance of the congestive failure in 37.5% of group 1, 71% in group II and 69% in group III. We concluded that indomethacin is the treatment of choice for patients weighing more than 1,050 g and over 30 weeks gestational age and that surgical ligation is the treatment of choice in patients under this weight and gestational age.

[Auricular flutter associated with interauricular communication in an infant]. / Flutter auriular asociado a comunicación interauricular en un lactante.

A case of a two year old child with atrial flutter diagnosed at four months of age is presented. The child also had a large atrial septal defect. We were not able to convert the atrial flutter to sinus rhythm with medical treatment of electroshock. However, it did respond to mechanical stimulation during cardiac catheterization. The atrial septal defect was repaired and the patient has not had a recurrence of the flutter.

[Massive mitral valve insufficiency caused by thrombosis in a Björk-Shiley prosthesis. Report of a case]. / Insuficiencia mitral masiva por trombosis en una prótesis de Björk-Shiley. Presentación de un caso.

This is a case of a 25 year old male with rheumatic heart disease who after 8 months of mitral valve replacement developed bacterial endocarditis complicated by severe valve malfunction due to a thrombus in the valve ring. The patient was correctly anticoagulated since the time the valve replacement, it was felt that the infection was responsible for the thrombus formation. The patient was reoperated and the valve changed for another of the same size and model. The need for prompt diagnosis and surgical intervention is emphasized in cases of prosthesis malfunction.