Selective bundle reconstruction in partial ACL tears leads to excellent long-term functional outcomes and a low percentage of failures.

BACKGROUND: The optimal treatment of partial anterior cruciate ligament (ACL) tears continues to be debatable. Short-term results of selective bundle reconstruction have already been widely shown. The purpose of this study was to assess functional outcomes, subjective satisfaction and the failure rate of selective bundle reconstructions for partial ACL tears over a five to nine year follow-up period. METHODS: Patients who underwent ACL selective bundle reconstruction between October 2008 and October 2012 were studied. Functional assessment was performed with the objective International Knee Documentation Committee (IKDC) ligament evaluation form, the Lysholm knee scale and the Tegner activity level scale. Cumulative failure and level of satisfaction have also been investigated. RESULTS: Seventy-six patients were included. The average follow-up period was 85 months (range 65-110). Thirty-four had AMB tear and 42 had PLB tears. An overall statistically significant improvement (p < 0.001) was obtained in terms of the subjective IKDC and the Lysholm questionnaire between preoperative and last follow-up. The same or no more than one level lower Tegner score was restored in 97.3% of the cases. Cumulative failure was observed in two patients (2.6%). Dissatisfied patient percentage was 15% (4/76). CONCLUSIONS: Selective bundle reconstruction in partial ACL tears leads to excellent long-term functional outcomes, a low percentage of failures and a high degree of subjective satisfaction in patients. LEVEL OF EVIDENCE: Therapeutic case series; level 4.

Biplane opening wedge high tibial osteotomy with a distal tuberosity osteotomy, radiological and clinical analysis with minimum follow-up of 2 years.

BACKGROUND: High tibial osteotomy is an established and helpful treatment for unicompatimental osteoarthritis associated with varus deformity. However, asupratubercle high tibial osteotomy leads to a decrease in patellar height making the technique not suitable in case of concomitant patella baja. Moreover, this kind of osteotomy can change in situ forces at patellofemoral joint and the lateral patellar tilt. With the aim to widen the indication of high tibial osteotomy was proposed a biplane opening wedge high tibial osteotomy with a distal tuberosity osteotomy (B-OWHTO). This technique provide that the tibial tuberosity remains joined to the tibial metaphysis so as not to theoretically alter the patellar height. However, some Authors claim that BOWHTO could lead to an increase in tibial slope. The purpose of the present study was to assess the tibial slope, patella-femoral changes and axial correction as well as functional outcomes following a B-OWHTO. METHODS: Patients operated on with a B-OWHTO and a minimum 24 months of follow-up were included. The mechanical alignment of the lower limb, patellar height, lateral patellar tilt and posterior tibial slope were calculated preoperatively, immediately after surgery and at the 24-month follow-up. The clinical results were evaluated using the Lysholm, Kujala and Hospital for Special Surgery knee scores. The possible postoperative development of patellofemoral pain or radiologic patellofemoral alteration was also evaluated. RESULTS: Twenty-three patients were included with a mean follow-up of 33 months (range 27-41). The mechanical alignment of the lower limb shifted from a mean 9.3º ± 2.5 varus preoperatively to a mean 0.2º ± 2.2 valgus postoperatively. No changes in patellar height, lateral patellar tilt or in the posterior tibial slope were observed. The mean Lysholm and HSS scores improved from 68.3 ± 9.1 and 64.2 ± 5.2 preoperatively to 93.2 ± 2.1 and 94.1 ± 3.6 at final follow-up (p < 0.01). The mean Kujala score improved from 67.3 ± 9.8 to 86.4 ± 7.6 at final follow up (p < 0.01). No patients developed both radiological or clinical symptoms at patellofemoral joint. CONCLUSIONS: Open wedge high tibial osteotomy with a dihedral L-cut distal and posterior to the tibial tubercle accurately corrected axial malalignment without any change at patella-femoral joint or any modification to the posterior tibial slope while providing improved knee function at short-term follow-up. The radiographic as well as the clinical results support the use of this technique to treat medial compartment knee osteoarthritis and varus malalignment in young and middle-aged patients with a normal-to-low patellar height. LEVEL OF EVIDENCE: Case series with no comparison group, Level IV.

Reconstruction of the Medial Patellofemoral Ligament.

Patellar instability has been shown to be associated with different major factors. However, studies have demonstrated that soft tissue reconstructions are adequate enough to reestablish patellar constraint. In recent years, the medial patellofemoral ligament has been recognized as the primary passive restraint for lateral translation of the patella. Their reconstruction has gain popularity as the procedure is quite simple and fast. Although several surgical techniques have been described for their reconstruction, no clear consensus has been reached as to which is best. We present an implant-free, medial patellofemoral ligament reconstruction technique that uses a gracilis tendon autograft, 2 bone convergent tunnels at the original patellar attachment, and looping the graft around the adductor magnus tendon that is used as a pulley for femoral fixation.

Open-Wedge Valgus High Tibial Osteotomy Technique With Inverted L-Shaped Configuration.

High tibial osteotomy (HTO) is a useful alternative in the treatment of symptomatic varus malalignment. However, among its drawbacks is the tendency to decrease patellar height and increase the posterior tibial slope. The increased tibial slope increases anterior cruciate ligament tension and may compromise its function. On the other hand, patella baja often causes anterior knee pain and, over time, may favor degeneration of the patellofemoral joint. The aim of this study is to describe a technical modification of the standard open-wedge HTO. It consists of a double inverted L-shaped cut, which includes the anterior tibial tuberosity in the proximal fragment, to avoid any alteration of patellar height and control the eventual increase of the posterior tibial slope.

Asistencia artroscópica en reconstrucción de luxacion acromioclavicular: descripción de técnica y reporte de resultados / Arthroscopic reconstruction in acromioclavicular dislocation: technical description and results

Introducción: La elección del tratamiento quirúrgico de la luxación acromioclavicular, es aún motivo de controversia. En este trabajo se describe una técnica combinada: realizamos un primer tiempo artroscópico, y un segundo tiempo con abordaje mini invasivo. Material y Métodos: Se intervinieron 41 pacientes con luxación acromioclavicular grados III, IV y V. Para el seguimiento Se incluyeron luxaciones agudas, crónicas y cirugías de revisión; se excluyeron pacientes con otras patologías de hombro asociadas, obteniendo un total de 24 pacientes en el seguimiento final. Con una edad promedio de 28,6 años, 20 siendo del sexo masculino. Los pacientes fueron evaluados con el Score de Ucla, el Score de Constant, la evaluación del dolor mediante la Escala Visual Analógica (VAS) preoperatorio, a los 6 y 12 meses Postoperatorio. Resultados: Obtuvimos un Score de Constant preoperatorio de 41,3;: 89.4 a los 6 meses; 92.3 al año. El Score de UCLA, respectivamente: 21.7; 29.1; 31.4 Preoperatorio, a los 6 y 12 meses respectivamente. VAS: 8,4; 2,3; 1,2. Hubo 2 casos de reruptura por trauma y un caso de insatisfacción estética de la cicatriz. Conclusión: Esta técnica brinda una reconstrucción anatómica sólida, estable en plano coronal y axial, combinando dos métodos de reducción, uno sintético y otro biológico, donde el primero aporta la resistencia adecuada hasta la revascularización e integración del aloinjerto, con muy buenos resultados a mediano plazo. Tipo de estudio: Serie de casos. Nivel de evidencia: IV.

Introduction: The optimal surgical technique of AC jont dislocations is still controversial. This paper describes a combined reconstructive technique wich involves a first arthroscopic step, and a second one with minimally invasive approach. Meterials and methods: We performed 41 interventions in patients with acromioclavicular dislocation grade III, IV and V. Acute and chronic dislocations and revision surgeries were included. We excluded patients with other associated pathologies that may cause shoulder pain or function limitation, leaving 24 cases for the final sample. The average age was 28.6 years. 20 patients were male. We use UCLA, VAS and Constant scores before the procedure, and in the postoperative period at 6 and 12 months. Results: The scores achieved the following results: Constant preoperative 41.3; 6 months: 89.4; and 12 months: 92.3. UCLA, respectively: 21.7; 29.1; 31.4. VAS: 8,4; 2,3; 1,2. A case of an esthetic dissatisfaction and two traumatic ruptures were reported. Conclusions: This technique provides a solid, stable and anatomical reconstruction in both axial and coronal planes. It involves two reduction methods, synthetic and biological, where the first one provides adequate strength until allograft revascularization and integration occurs, with goods results in the medium term. Type of Study: Case series. Level of evidence: IV.

Avulsión proximal de tendones isquiotibiales: tratamiento quirúrgico en deportistas de alto rendimiento. Reporte de caso / Proximal hamstring injuries. Surgical treatment in high-performance athletes. Case report

Las lesiones proximales de los tendones isquiotibiales son un gran desafío para la traumatología del deporte. A pesar de que el tratamiento conservador muchas veces presenta resultados aceptables, el mismo tiene una alta incidencia de complicaciones neurológicas por atrapamiento del nervio ciática. Existe evidencia que la reparación quirúrgica primaria presenta mejores resultados teniendo en cuenta el retorno al deporte, la recuperación de la fuerza de flexión de rodilla y con un menor índice de complicaciones neurológicas. Caso: Jugador de rugby de alto rendimiento, 18 años que en marzo de 2014 presenta avulsión proximal completa de los tendones isquiotibiales izquierdo. El mecanismo de lesión fue por una flexión abrupta de cadera con extensión completa de rodilla. Se intervino quirúrgicamente, mediante abordaje posterior longitudinal, realizando una reparación con tres arpones de titanio 5,0 mm. Durante el postoperatorio inmediato se inmovilizó la rodilla en 70º de flexión, sin descarga hasta la sexta semana. El paciente realizó un protocolo de movilidad y recuperación de la fuerza progresiva. Resultados: A las 9 semanas del postoperatorio el paciente realizaba actividades de vida diaria sin dificultad. El retorno a la práctica de rugby fue a los 9 meses. Dieciocho meses post operatorios el paciente realizaba sus actividades deportivas previas a la lesión, no presenta complicaciones neurológicas, cuenta con una debilidad de flexión de rodilla del 10% comparada con la pierna contra lateral y no refiere dolores en la región de la cicatriz. Discusión: Existe evidencia que los resultados del tratamiento quirúrgico son superiores a los del conservador y que los mismos tienen una menor incidencia de complicaciones neurológicas...

Tenodesis del biceps: comparación de técnica supra-pectoral artroscópica versus sub-pectoral abierta / Biceps tenodesis. Arthroscopic supra-pectoral versus mini-open sub-pectoral technique

Introducción: La biotenodesis es la técnica preferida para el manejo de la patología del tendón de la porción larga del bíceps en personas jóvenes, deportistas, trabajadores, y aquellos que desean evitar alguna deformidad estética. El objetivo de nuestro trabajo es evaluar los resultados clínico funcionales, la satisfacción personal del paciente, y las posibles complicaciones de dos técnicas diferentes de tenodesis: Supra-pectoral Artroscopica y Sub-pectoral Abierta Materiales y Métodos: De enero de 2009 a enero de 2012 evaluamos en forma retrospectiva 81 pacientes con patología del tendón largo del biceps tratados con dos técnicas de tenodesis diferentes. Grupo A: 61 pacientes con técnica de biotenodesis artroscópica suprapectoral y Grupo B: 20 pacientes con técnica mini abierta subpectoral utilizando tornillo interferencial. Utilizamos los escores de ASES, Rowe, Simple Shoulder Test, Constant Murley y VAS, y el grado de satisfacción personal en cuanto a estética y dolor local en la cicatriz se evaluo mediante entrevistas personales y telefónicas. El tiempo promedio de seguimiento fue de 12 meses. Resultados: Grupo A: Rowe de 86 puntos, ASES de 81 puntos, el SST de 9 puntos, y Constant Murley de 87 puntos. VAS: escaso dolor post quirúrgico (2/10). El grado de satisfacción fue muy bueno. Grupo B: Rowe de 85 puntos, ASES de 82 puntos, el SST de 8,5 puntos, y el Constant Murley de 85 puntos. VAS: 3/10, mayor en el sitio del abordaje subpectoral. Molestias estéticas sobre la cicatriz en 4 casos, todos estos de sexo femenino. Conclusión: Una tenodesis íntegramente artroscópica es técnicamente mas desafiante y requiere inicialmente una curva de aprendizaje de mayor duración para realizar con éxito este procedimiento. La tenodesis subpectoral es un procedimiento más rápido, sencillo pero su elección estaría únicamente ligada a una cuestión de ahorro de tiempo quirúrgico...(AU)

Introduction: The biotenodesis is the preferred technique for handling the pathology of the long head of the biceps tendon in younger people, athletes, workers, and those wishing to avoid any cosmetic deformity. The aim of our study was to evaluate the functional clinical outcomes, patient satisfaction, staff, and possible complications of two different tenodesis techniques: Supra pectoral pectoral Sub Arthroscopic and Open. Materials and methods: From January 2009 to January 2012 retrospectively evaluated 81 patients with pathology of the long biceps tendon treated with two different tenodesis techniques. Group A: 61 patients with arthroscopic technique suprapectoral biotenodesis and Group B: 20 patients with mini open technique using subpectoral interference screw. We used the scores of ASES , Rowe, Simple Shoulder Test , Constant Murley and VAS , and the degree of personal satisfaction in terms of aesthetics and local pain at the scar was assessed through personal and telephone interviews. The average follow-up time was 12 months. Results: Group A: 86 points Rowe, ASES 81 points, 9 points SST , Constant and Murley 87 puntos.VAS : poor postsurgical pain (2/10). The degree of satisfaction was very good...(AU)

Tenodesis del biceps: comparación de técnica supra-pectoral artroscópica versus sub-pectoral abierta / Biceps tenodesis. Arthroscopic supra-pectoral versus mini-open sub-pectoral technique

Introducción: La biotenodesis es la técnica preferida para el manejo de la patología del tendón de la porción larga del bíceps en personas jóvenes, deportistas, trabajadores, y aquellos que desean evitar alguna deformidad estética. El objetivo de nuestro trabajo es evaluar los resultados clínico funcionales, la satisfacción personal del paciente, y las posibles complicaciones de dos técnicas diferentes de tenodesis: Supra-pectoral Artroscopica y Sub-pectoral Abierta Materiales y Métodos: De enero de 2009 a enero de 2012 evaluamos en forma retrospectiva 81 pacientes con patología del tendón largo del biceps tratados con dos técnicas de tenodesis diferentes. Grupo A: 61 pacientes con técnica de biotenodesis artroscópica suprapectoral y Grupo B: 20 pacientes con técnica mini abierta subpectoral utilizando tornillo interferencial. Utilizamos los escores de ASES, Rowe, Simple Shoulder Test, Constant Murley y VAS, y el grado de satisfacción personal en cuanto a estética y dolor local en la cicatriz se evaluo mediante entrevistas personales y telefónicas. El tiempo promedio de seguimiento fue de 12 meses. Resultados: Grupo A: Rowe de 86 puntos, ASES de 81 puntos, el SST de 9 puntos, y Constant Murley de 87 puntos. VAS: escaso dolor post quirúrgico (2/10). El grado de satisfacción fue muy bueno. Grupo B: Rowe de 85 puntos, ASES de 82 puntos, el SST de 8,5 puntos, y el Constant Murley de 85 puntos. VAS: 3/10, mayor en el sitio del abordaje subpectoral. Molestias estéticas sobre la cicatriz en 4 casos, todos estos de sexo femenino. Conclusión: Una tenodesis íntegramente artroscópica es técnicamente mas desafiante y requiere inicialmente una curva de aprendizaje de mayor duración para realizar con éxito este procedimiento. La tenodesis subpectoral es un procedimiento más rápido, sencillo pero su elección estaría únicamente ligada a una cuestión de ahorro de tiempo quirúrgico...

Introduction: The biotenodesis is the preferred technique for handling the pathology of the long head of the biceps tendon in younger people, athletes, workers, and those wishing to avoid any cosmetic deformity. The aim of our study was to evaluate the functional clinical outcomes, patient satisfaction, staff, and possible complications of two different tenodesis techniques: Supra pectoral pectoral Sub Arthroscopic and Open. Materials and methods: From January 2009 to January 2012 retrospectively evaluated 81 patients with pathology of the long biceps tendon treated with two different tenodesis techniques. Group A: 61 patients with arthroscopic technique suprapectoral biotenodesis and Group B: 20 patients with mini open technique using subpectoral interference screw. We used the scores of ASES , Rowe, Simple Shoulder Test , Constant Murley and VAS , and the degree of personal satisfaction in terms of aesthetics and local pain at the scar was assessed through personal and telephone interviews. The average follow-up time was 12 months. Results: Group A: 86 points Rowe, ASES 81 points, 9 points SST , Constant and Murley 87 puntos.VAS : poor postsurgical pain (2/10). The degree of satisfaction was very good...

A new classification of complications in neurosurgery.

OBJECTIVE: To define and grade neurosurgical and spinal postoperative complications based on their need for treatment. METHODS: Complications were defined as any deviation from the normal postoperative course occurring within 30 days of surgery. A four-grade scale was proposed based on the therapy used to treat the complications: grade I, any non-life-threatening complications treated without invasive procedures; grade II, complications requiring invasive management such as surgical, endoscopic, and endovascular procedures; grade III, life-threatening adverse events requiring treatment in an intensive care unit (ICU); and grade IV, deaths as a result of complications. Each grade was classified as a surgical or medical complication. An observational test of this system was conducted between January 2008 and December 2009 in a cohort of 1190 patients at the Hospital Italiano de Buenos Aires. RESULTS: Of 167 complications, 129 (10.84%) were classified as surgical, and 38 (3.19%) were classified as medical complications. Grade I (mild) complications accounted for 31.73%, grade II (moderate) complications accounted for 25.74%, and grade III (severe) complications accounted for 34.13%. The overall mortality rate was 1.17%; 0.84% of deaths were directly related to surgical procedures. CONCLUSIONS: The authors present a simple, practical, and easy to reproduce way to report negative outcomes based on the therapy administered to treat a complication. The main advantages of this classification are the ability to compare surgical results among different centers and times, the ability to compare medical and surgical complications, and the ability to perform future meta-analyses.

Resistance and biomass in Arabidopsis: a new model for salicylic acid perception.

Salicylic acid (SA) is an essential hormone for plant defence and development. SA perception is usually measured by counting the number of pathogens that grow in planta upon an exogenous application of the hormone. A biological SA perception model based on plant fresh weight reduction caused by disease resistance in Arabidopsis thaliana is proposed. This effect is more noticeable when a chemical analogue of SA is used, like Benzothiadiazole (BTH). By spraying BTH several times, a substantial difference in plant biomass is observed when compared with the mock treatment. Such difference is dose-dependent and does not require pathogen inoculation. The model is robust and allows for the comparison of different Arabidopsis ecotypes, recombinant inbreed lines, and mutants. Our results show that two mutants, non-expresser of pathogenesis-related genes 1 (npr1) and auxin resistant 3 (axr3), fail to lose biomass when BTH is applied to them. Further experiments show that axr3 responds to SA and BTH in terms of defence induction. NPR1-related genotypes also confirm the pivotal role of NPR1 in SA perception, and suggest an active program of depletion of resources in the infected tissues.

Echocardiometric evaluation of cardiovascular abnormalities in Marfan syndrome.

UNLABELLED: Marfan syndrome is an inherited disorder of connective tissue with manifestations in various organ-systems including cardiovascular system. The aim of this study was to characterize and determine the frequency of cardiovascular alterations by echocardiography in 2 age cohorts of Mexican patients with Marfan syndrome and their comparisons with control groups. MATERIAL AND METHODS: Sixty six with Marfan syndrome and 33 control patients were evaluated by echocardiography. Segments of the aorta and pulmonary artery were measured at different levels, cardiac valves were examined for prolapse and the interatrial septum was assessed for septal aneurysm. Numeric values were corrected for the body surface area and compared with the control group. RESULTS: Mean significant values between group I (children) and Group II (adults) were as follows: aortic annulus 16.62 +/- 4.57 mm/m2 vs 12.81 +/- 1.95 (p < 0.001), aortic root 23.30 +/- 7.49 mm/m2 vs 18.36 +/- 2.97 (p < 0.001), sinuses of Valsalva 24.14 +/- 7.29 mm/m2 vs 19.84 +/- 3.59 (p < 0.001), ascending aorta 18.43 +/- 5.90 mm/m2 vs 17.02 +/- 4.79 (p < 0.001), aortic arch 16.12 +/- 4.73 mm/m2 vs 14.20 +/- 2.68 (p < 0.001). Pulmonary valve prolapse was seen in 10/22 (45.5%) vs 7/44 (15.9%), p < or = 0.03. Interatrial septal aneurysm was found in 3/22 (13.6%) vs 20/44 (45.5%), p < or = 0.03. There was a significative diference in the presence of atrial septal aneurysm between the adult group and control group (p < 0.001). CONCLUSIONS: The incidence of cardiovascular abnormalities in our series is similar to that in the literature with the exception of the very high incidence of pulmonary valve prolapse vs control groups, then it suggests that the clinical manifestations of MFS are strikingly severe in the Mexican population. Also a high incidence of interatrial septal aneurysm (34.9%) in comparison to control groups (18.2%) was found.

Echocardiometric evaluation of cardiovascular abnormalities in Marfan syndrome / Valoración ecocardiométrica de las anomalías cardiovasculares en el síndrome de marfán

Marfan syndrome is an inherited disorder of connective tissue with manifestations in various organ-systems including cardiovascular system. The aim of this study was to characterize and determine the frequency of cardiovascular alterations by echocardiography in 2 age cohorts of Mexican patients with Marfan syndrome and their comparisons with control groups. Material and methods: Sixty six with Marfan syndrome and 33 control patients were evaluated by echocardiography. Segments of the aorta and pulmonary artery were measured at different levels, cardiac valves were examined for prolapse and the interatrial septum was assessed for septal aneurysm. Numeric values were corrected forthe body surface area and compared with the control group. Results: Mean significant values between group I (children) and Group II (adults) were as follows: aortic annulus 16.62 ± 4.57 mm/m² vs 12.81 ± 1.95 (p< 0.001), aortic root 23.30 ±7.49 mm/m²vs 18.36 ± 2.97 (p < 0.001), sinuses of Valsalva 24.14 ± 7.29 mm/m² vs 19.84 ± 3.59 (p < 0.001), ascending aorta 18.43 ± 5.90 mm/m² vs 17.02 ± 4.79 (p < 0.001), aortic arch 16.12 ± 4.73 mm/m² vs 14.20 ± 2.68 (p < 0.001). Pulmonary valve prolapse was seen in 10/22 (45.5%) vs 7/44 (15.9%), p < 0.03. Interatrial septal aneurysm was found in 3/22 (13.6%) vs 20/44 (45.5%), p < 0.03. There was a significative diference in the presence of atrial septal aneurysm between the adult group and control group (p < 0.001). Conclusions: The incidence of cardiovascular abnormalities in our series is similar to that in the literature with the exception of the very high incidence of pulmonary valve prolapse vs control groups, then it suggests that the clinical manifestations of MFS are strikingly severe in the Mexican population. Also a high incidence of interatrial septal aneurysm (34.9%) in comparison to control groups (18.2%) was found.

El síndrome de Marfán es una enfermedad hereditaria del tejido conectivo con manifestaciones en varios órganos incluyendo el sistema cardiovascular. El objetivo del estudio fue caracterizar y determinar la frecuencia de las alteraciones cardiovasculares mediante ecocardiografía en 2 grupos de pacientes mexicanos con síndrome de Marfán en comparación con los grupos controles. Material y métodos: Se estudiaron mediante ecocardiografía a 66 pacientes con síndrome de Marfán y 33 pacientes del grupo control. Se midieron los segmentos de la aorta y de la arteria pulmonar a diferentes niveles, se valoró prolapso valvular y presencia de aneurisma del septum interatrial. Los valores numéricos fueron corregidos por área de superficie corporal y comparados con el grupo control. Resultados: Los variables con valor significativo entre el grupo I (niños) y el grupo II (adultos) fueron: Anillo aórtico: 16.62 ± 4.57 mm/m² vs 12.81 ± 1.95 (p< 0.001), raíz aórtica 23.30 ±7.49 mm/m²vs 18.36 ± 2.97 (p < 0.001), senos de Valsalva 24.14 ± 7.29 mm/m² vs 19.84 ± 3.59 (p < 0.001), aorta ascendente 18.43 ± 5.90 mm/m² vs 17.02 ± 4.79 (p < 0.001), arco aórtico 16.12 ± 4.73 mm/m² vs 14.20 ± 2.68 (p < 0.001). Se encontró prolapso valvular pulmonar en 10/22 (45.5%) vs 7/44 (15.9%), p < 0.03. Aneurisma del septum interatrial en 3/22 (13.6%) vs 20/44 (45.5%), p < 0.03. Hubo diferencia significativa para la presencia de aneurisma del septum interatrial entre el grupo de adultos y el grupo control (p < 0.001). Conclusiones: La incidencia de anormalidades cardiovasculares en nuestra serie es similar a la reportada en la literatura excepto la alta incidencia de prolapso valvular pulmonar en relación al grupo control, lo que sugiere que las manifestaciones clínicas cardiovasculares del síndrome de Marfán son más severas en la población mexicana. Se encontró también una alta incidencia de aneurisma del septum interatrial (34.9%) en comparación al grupo control (18.2%). (Arch Cardiol Mex 2005; 75: 133-140).