[Cor triatriatum. Diagnostic and surgical experience]. / Cor triatriatum. Experiencia diagnóstica y quirúrgica.

Five cases with cor triatriatum were diagnosed in less than a two years period. There were 4 females and one male. The mean age was 3.6 years. Three patients were operated on successfully. One patient died shortly after cardiac catheterization in acute pulmonary edema, another case is waiting for surgery with mild obstruction. We do not have a complete explanation for this high incidence of cor triatriatum. The utility of Echo Doppler color in diagnosis is highlighted. A literature review is made.

[Transcatheter closure of patent ductus arteriosus with Rashkind's occluder. Experience during 3.7 years]. / Cierre transcateterismo del conducto arterioso (CTCA) con oclusor de Rashkind. Experiencia de 3.7 años.

Thirty eight transcatheter umbrella closure (TUC) of a persistently patent ductus arteriosus using the Rashkind umbrella occluder (USCI), were attempted in thirty four patients. Mean age 8.5 +/- 9.0 years (range 1.5 to 31). Internal diameter of ductus arteriosus (DA) average 4.0 +/- 1.5 mm (range 2 to 9 mm). Successful implantation was achieved in 36 procedures (94.7%). Complete closure immediately postimplantation was achieved in 15 (45.4%), 12 (36.3%) had trivial and 6 (18.1%) severe residual shunt. In four cases we implanted successfully a second device. At the follow-up (average 24 months) in 31 patients, 87.0% (n = 27) had complete closure and 96.7% (n = 30) did not need another intervention. Device embolization to distal left pulmonary artery occurred in two cases (5.2%), one was retrieved by surgery and in the other case it was allowed to remain. No mortality was observed. This results confirm the efficacy, with low morbidity and no mortality of TUC, especially in those with smaller PDA (< 4 mm).

[Percutaneous mitral commissurotomy with an Inoue catheter in congenital mitral stenosis]. / Comisurotomía mitral percutánea con catéter de Inoue en estenosis mitral congénita.

We describe a 3-years-old boy, with congenital mitral stenosis, who underwent percutaneous transvenous mitral commissurotomy (PTMC) with Inoue balloon. The mitral gradient decreased from 24 to 4 mmHg, the mitral valvular area (MVA) increased from 1.2 to 1.6 cm2 without modification in mitral regurgitation. One year later the recatheterization showed decreased pulmonary pressures, and a 7.5 mmHg mitral valvular gradient without mitral insufficiency. MVA by echo is 1.8 cm2 with mild regurgitation. As far as we know there is no experience with Inoue balloon in children. We conclude that PTMC with Inoue balloon could be an attractive alternative in some patients with congenital mitral stenosis.

[Residual shunts after application of the Rushkind occlusion system in closure of persistent ductus arteriosus. Insertion of a second device]. / Fuga residual postcolocación de oclusor de Rashkind para cierre del conducto arterioso persistente via percutánea. Colocación de un segundo dispositivo.

From May 1991 to August 1994, we performed transcatheter closure of patent ductus arteriosus with Rashkind umbrella system in 25 patients. In one, the device had embolism, to the right pulmonary artery and was operated 24 hs afterwards without complications. Seven had residual shunts, two had subsequent surgery, two are being followed (one for mild and one for moderate residual shunt). In the other three cases we inserted a second device. We used a 12 mm device in two cases and a 17 mm device in the other. Two cases had total occlusion 24 hrs after and in one had mild residual shunt without clinical repercussion. There were no complications. All had electrocardiographic and clinical improvement, take no medication, and their cardiomegaly had decreased (Cardiac index pre 61 vs post 54%). In conclusion the insertion of a second device is safe and effective alternative for residual shunt after first Rashkind occluder.

[Kawasaki disease: the echocardiographic diagnosis of coronary aneurysms. A report of 2 cases]. / Enfermedad de Kawasaki: diagnóstico ecocardiográfico de los aneurismas coronarios. Informe de dos casos.

We report two infants with Kawasaki disease and coronary aneurysms diagnosed by echocardiography. First case, a one year old male with abnormalities of left coronary artery, developed a myocardial infarction and died three weeks later. Second case a two months old male with aneurysm in the right coronary artery who doing well three months after the diagnosis was made. Echocardiography is the primary tool for evaluation and follow up of coronary abnormalities.