[Experience with 24-hour ambulatory blood pressure monitoring in follow-up of patients with aortic coartacion in a pediatric hospital]. / Experiencia con monitoreo ambulatorio de presión arterial de 24 horas en seguimiento de pacientes con coartación de aorta en un hospital pediátrico.

Introduction: Hypertension (HTA) is an important comorbidity in children with aortic coarctation (COAO) and 24-hour ambulatory blood pressure monitoring (ABPM) allows an accurate diagnosis. Objective: Describe the prevalence of HTA in the office and its recategorization with ABPM Material and methods: Descriptive, observational, retrospective study; It included children between 4 and 18 years with COAO who performed ABPM. PA was registered in the office and ABPM, echocardiogram and medication. Results: 33 patients, 26 men, age 10.2 ± 3.8 years, By PA in the office: 22 normotensive; 8 HTA controlled; 2 preHTA; 1 HTA not medicated. With 32 complete MAP records, they were categorized: normotensive 11, preHTA 7, nocturnal HTA 3, masked HTA 4; HTA controlled 3; Uncontrolled HTA 3 and 1 HTA. Conclusion: The prevalence of hypertension in this population in the office was low. The ABPM recategorized and detected nocturnal HTA and masked HTA.

Introducción: La hipertensión arterial (HTA) es una comorbilidad importante en niños con coartación de aorta (COAO) y el monitoreo ambulatorio de presión arterial de 24horas (MAPA) permite un diagnóstico preciso. Objetivo: Describir la prevalencia de HTA por presión arterial (PA) en consultorio y su recategorización con MAPA Material y Método: Estudio descriptivo, observacional, retrospectivo; incluyó niños entre 4y18 años con COAO que realizaron MAPA. Se registró PA en consultorio y MAPA, ecocardiograma y medicación. Resultados: 33 pacientes, 26 varones, edad 10,2 ± 3,8 años, Por PA en consultorio: 22 normotensos; 8 HTA controlada; 2 preHTA; 1 HTA no medicado. Con 32 registros completos de MAPA, se recategorizaron: normotensos 11, preHTA 7, HTA nocturna 3, HTA enmascarada 4; HTA controlada 3; HTA no controlada 3 y 1 HTA. Conclusión: La prevalencia de HTA en esta población en consultorio fue baja. El MAPA recategorizó y detectó HTA nocturna e HTA enmascarada.

The Kawashima Operation With Simultaneous Preparation for Transcatheter Fontan-Kreutzer Completion.

Patients with functionally single ventricle and interrupted inferior vena cava may develop progressive cyanosis soon after the Kawashima operation. Therefore, early redirection of the hepatic venous return to the pulmonary circulation is recommended. To avoid performing an early redo sternotomy, we propose to prepare these patients for the interventional Fontan-Kreutzer at the time of the Kawashima operation using a technical modification of the approach reported by Prabhu and coworkers in 2017. The technique described here uses an expanded polytetrafluoroethylene conduit interposed between the hepatic veins and the right pulmonary artery. This graft is everted and divided into two portions with a pericardial patch. The lower one is widely opened and anastomosed side-to-side to the atrium. A few months after the operation, percutaneous Fontan-Kreutzer completion can easily be performed using covered stents to open the patch and at the same time close the opening between the conduit and the atrium.

Modified In Situ Pericardial Rerouting Technique for Scimitar Syndrome Repair.

Scimitar syndrome repair represents a challenge due to the high incidence of postoperative pulmonary venous obstruction associated with classic surgical strategies. In situ pericardial rerouting technique has been considered a promising alternative approach due to its simplicity and excellent midterm results. Access to the left atrium can be difficult in young patients with severe dextrocardia and hypoplastic right lung. We describe a modification of the original rerouting technique in which the atrial septum is repositioned in order to create a wide opening in the lateral aspect of the left atrium and ensure an adequate size of the reconstructed pathway.