[Pericarditis secondary to the rupture of a hydatid cyst]. / Pericarditis secundaria a rotura de un quiste hidatídico.

Cardiac hydatic cysts are rare and represent 0.5 to 2% of all hydatic cysts in humans, but usually associated with fatal complications. We report a case of a male 27 years old with a hydatid cyst located in left ventricle asymptomatic until rupture. It was diagnosed by two-dimensional echocardiogram in a control.

[Myocardial revascularization in the female sex: increased surgical risk or referral bias?]. / Revascularización miocárdica en el sexo femenino: mayor riesgo quirúrgico o sesgo de referencia?

During the last fifteen years the increased morbimortality of coronary surgery in women has been widely documented. Traditionally, the increased risk has been attributed to the smaller size of the coronary arteries of female patients. However, there are data in our series and in various others that lead to suspicion that there might exist a referral bias, which causes women to be referred to a surgeon at a more advanced age and in a worse clinical condition than men. This bias, if it is present, could contribute to the worse results obtained in coronary artery bypass surgery in women. The only way to determine if this is valid is by applying similar criteria of management to both sexes. Only in this way will it be possible to ascertain if the high morbimortality of myocardial revascularization surgery in women is due to factors that are related to the gender itself or to referral bias stated above.

[Aortic intramural hematoma. An atypical pattern equivalent to aortic dissection]. / Hematoma intramural aórtico. Un patrón atípico equivalente a la disección aórtica.

A case is presented of a hypertensive woman who had suffered a stabbing back pain for some three hours, with mild irradiation to precordium and accompanied by vegetative signs. A sinusal rhythm and negative T waves of little depth were seen on the ECG. A transthoracic bidimensional echocardiogram (TTE) showed a normal left ventricle with a somewhat dilated aortic root and the existence of a double echo running parallel to the anterior wall of the aorta but non-ondulating and without a visible intimal flap. Because of suspected aortic dissection an urgent contrasted CAT and a transesophageal echocardiogram were performed. These were informed as an aneurysm of the aortic root with mural thrombus from the ascending to descending aorta, but with no existing intimal flap suggesting dissection. A cardiac catheterization showed a mildly some dilated aortic root without dissection signs and normal left ventricle and coronary arteries. The patient was presented for surgical evaluation but, since no dissection was present, was not considered urgent surgery; she was admitted to the coronary unit and died 48 hours later in a situation of acute pericardial tamponade, documented by TTE, surely due to rupture of the aortic root to pericardial sack. This way of presenting threatened aorta rupture that has been only recently recognized is discussed, as well as some misconceptions which must be avoided.

[Experimental cardiogenic shock (author's transl)]. / Shock cardiogénico experimental.

An experimental model fo cardiogenic shock has been developed in anesthetized dogs. The shock was produced by injecting mercury into the second diagonal branch of the descending anterior coronary artery. Arterial and venous pressure E.C.G., aortic, renal and circumflex flow were directly measured. Other parameters such as O2 consumption and arterio-venous difference were also studied. The present model seems very useful to make therapeutic studies. Open chest surgery has been used for simplicity and economic reasons.

[Osmolar and free water clearance as renal function test during extracorporeal circulation with parcial and total hemodilution (author's transl)]. / Aclaramiento osmolar y de agua libre como prueba de función renal durante la circulación extracorpórea con hemodilución parcial y total

Four groups of dogs are subjected to extracorporeal circulation. Total hemodilution is used in groups I and II, either in normothermia or moderate hypothermia at 30 degrees C. Partial hemodilution is used in groups III and IV with identical temperature variations. The animals are kept under extracorporeal circulation for 120 min. Osmolar and free water clearance are measured at basal conditions after 40, 80 and 120 min. The present results show that total hemodilution should be used in those patients subjected to extracorporeal circulation where renal function has been previously disturbed.