[An index internal diameter ductus arteriosus/body surface area as a need for closure of duct in the preterm newborn]. / Un índice del diámetro interno del conducto arterioso/superficie corporal como necesidad de cierre del conducto en el recién nacido de pretérmino.

OBJECTIVE: To determine a rate of internal diameter (ID), the narrowest of ductus arteriosus (DA)/body surface area (BSA) in preterm newborns (PTNB) for need for closure of DA either medically or surgically. MATERIAL AND METHODS: Prospective (cohort), held in a Neonatology Service in February 2010 to January 2011. Inclusion criteria were PTNB from 28 to 36 weeks of gestation from 0 to 28 days after birth, which confirmed diagnosis of patent ductus arteriosus (PDA) by echocardiogram, taking the narrowest ID, who did not present heart complex congenital or other major malformations in other systems without pulmonary arterial hypertension, that had not received drug treatment with prostaglandin inhibitors to close the DA. The exclusion criteria for complications of mechanical ventilation (air leaks, atelectasis, etc.) before measurements. BSA was determined based on their weight and height. There were two comparison groups during its evolution, those who finally merited either closure medical or surgical closure or was indicated but the poor conditions of the patient by the same PDA mainly, the procedure was not carried out (Group A) and Group B, those that are not operated or not medically closed DA not being hemodynamically significant [corrected]. Statistical analysis was performed using descriptive statistics and inferential. Significance levels were set at p < 0.05. RESULTS: The study population consisted of 32 patients who were divided into two groups: group A of 13 patients and group B with 19 patients. The study population characteristics between the two groups showed significant difference only in the Apgar Score for the Group B. In multivariate analysis found statistically significant as need for closure of DA only a index ID DA/ BSA when it was > 14. CONCLUSIONS: It is important to take into account a number of known ways to assess whether the DA is hemodynamically significant and therefore should be closed medically or surgically and according to this study, a parameter to requiring its closure is an index ID DA/BSA with a value > 14.

[Percutaneous closure of inter-atrial communication with the Amplatzer device. Experience with 42 cases]. / Cierre percutáneo de la comunicación inter-atrial con dispositivo de Amplatzer. Experiencia de 42 casos.

We report our experience on 42 patients treated with atrial septal defect (ASD) occlusion using Amplatzer device. Thirty patients were females and 12 were males, mean ages 26.5-years-old +/- 12 years (interval from 7 to 69 years). Average weight was 57.1 +/- 13.8 kg (32.3-85.0 kg). Forty-two devices (ranging diameters from 13 mm to 40 mm) were deployed, 40 of which were placed successfully and attempts were unsuccessful in two cases (diameter devices 36 mm and 40 mm, respectively). We used the "balloon on the left or right upper pulmonary vein" in 5 patients, achieving good deployment. Echocardiography showed total occlusion in 37 patients (93.5%), trivial leak in 2 (4.7%), and light leak in 1 patient (2.3%). Follow up was at 1 to 12 months (mean 6.5). Total occlusion was observed at one month on both patients with trivial leak, and at 6 months on the patient with light leak. Failure to deploy the device appropriately on the two patients with unsuccessful result was due to unfavorable anatomy: very large defects in both cases (occluder size 36 mm and 40 mm), very thin postero-superior 6 mm rim on one of them and aortic rim absence on the other one. Stretched diameters were 34 mm and 38 mm on patients with 36 mm and 40 mm devices, respectively. Both of them were sent to surgery. We conclude that percutaneus closure of atrial septal defect with the Amplatzer device is a save and have good results.

Cierre percutáneo de la comunicación inter-atrial con dispositivo de Amplatzer: experiencia de 42 casos / Percutaneous closure of inter-atrial communication with the Amplatzer device: experience with 42 cases

We report our experience on 42 patients treated with atrial septal defect (ASD) occlusion using Amplatzer device. Thirty patients were females and 12 were males, mean ages 26.5-years-old +/- 12 years (interval from 7 to 69 years). Average weight was 57.1 +/- 13.8 kg (32.3-85.0 kg). Forty-two devices (ranging diameters from 13 mm to 40 mm) were deployed, 40 of which were placed successfully and attempts were unsuccessful in two cases (diameter devices 36 mm and 40 mm, respectively). We used the [quot ]balloon on the left or right upper pulmonary vein[quot ] in 5 patients, achieving good deployment. Echocardiography showed total occlusion in 37 patients (93.5%), trivial leak in 2 (4.7%), and light leak in 1 patient (2.3%). Follow up was at 1 to 12 months (mean 6.5). Total occlusion was observed at one month on both patients with trivial leak, and at 6 months on the patient with light leak. Failure to deploy the device appropriately on the two patients with unsuccessful result was due to unfavorable anatomy: very large defects in both cases (occluder size 36 mm and 40 mm), very thin postero-superior 6 mm rim on one of them and aortic rim absence on the other one. Stretched diameters were 34 mm and 38 mm on patients with 36 mm and 40 mm devices, respectively. Both of them were sent to surgery. We conclude that percutaneus closure of atrial septal defect with the Amplatzer device is a save and have good results.

Atresia tricuspídea asociada a tronco común: reporte de un caso / Tricuspid atresia associated with common trunk: a case report

The tricuspid atresia associated with persistent truncus arteriosus is a rare anomaly. A case is presented of one male patient of three months age in which was detected a cardiac murmur. The diagnosis was made by echocardiography and confirmed by cardiac catheterization. The first step of the palliation was done with disconnection of the trunk of the pulmonary artery combined with a systemic- to- pulmonary shunt of 4 mm. The patient died 24 hours later for persistent metabolic acidosis.

[Tricuspid atresia associated with common trunk. A case report]. / Atresia tricuspídea asociada a tronco común. Reporte de un caso.

The tricuspid atresia associated with persistent truncus arteriosus is a rare anomaly. A case is presented of one male patient of three months age in which was detected a cardiac murmur. The diagnosis was made by echocardiography and confirmed by cardiac catheterization. The first step of the palliation was done with disconnection of the trunk of the pulmonary artery combined with a systemic- to- pulmonary shunt of 4 mm. The patient died 24 hours later for persistent metabolic acidosis.