Variante técnica en la confección del bolsillo de marcapasos / Technical variant in the pacemaker pocket manufacture

Con la variante a la técnica de implante de marcapasos a la hora de confeccionar el bolsillo se reduce el tamaño de la incisión y se simplifica el cierre de la herida.Objetivo: mostrar variante de la técnica en la confección clásica del bolsillo del marcapasos. Método: se realizó un estudio descriptivo retrospectivo en un grupo básico de trabajo del servicio de cardiología del Hospital Universitario Manuel Ascunce Domenech de Camagüey, desde enero de 2003 hasta diciembre de 2010. El universo de estudio lo constituyeron 1540 pacientes a los que se les implantó marcapasos. La muestra no aleatoria la constituyeron 598 pacientes. Resultados: predominó el sexo masculino y las edades sobre los 60 años, con 80 implantes como promedio anual. Del total, predominó el implante primario y los generadores monocámaras. Las complicaciones se presentaron en el orden del 1.82 por ciento.Conclusiones: con esta variante técnica para la confección del bolsillo se disminuyó el tamaño de la herida

With the variant to the technique of pacemaker implant, when preparing the pacemaker pocket, the size of the incision is reduced and it is simplified the wound closure. Objective: to show the technical variant in the classical pacemaker pockets manufacture. Method: a retrospective descriptive study was conducted in a basic working group of the Cardiology service at the University Hospital Manuel Ascunce Domenech of Camaguey, from January 2003 to December 2010. The universe of study was constituted by 1540 patients who were implanted pacemakers. Non-random sampling was constituted by 598 patients. Results: male sex and the age group of 60 years predominated, with 80 implants as an annual average. From the total, primary implant and single chamber generators prevailed. The complications were presented in the order of the 1.82 percent. Conclusions: this technical vapercentiant for the pocket manufacturing was reduced the size of the wound

The emergency operation of total obstructive anomalous pulmonary venous connection in newborn / 中华胸心血管外科杂志

Objective Evaluate the outcome of total anomalous pulmonary venous connection (TAPVC) repair in newborn,controlling for anatomic subtypes and surgical technique.Methods Between 1999 and 2011,68 patients (median age 16 days) underwent repair for supracardiac (21),cardiac ( 8 ),infracardiac ( 36 ) or mixed ( 3 ) TAPVC.All patients were emergencies,due to obstructed drainage.Supracardiac and infracardiac TAPVC repair included the side-to-side anastomosis between the pulmonary venous (PV) confluence and the left atrium.Coronary sinus unroofing was preferred for cardiac TAPVC repair.Results Early mortality was 2.9％ (2/68).The echo showed no obstruction in the pulmonary vein anastomosis and flow rate was 1.1 m/s ～ 1.42 m/s in the follow-up of 3 years.Side-to-side anastomosis provides excellent results for TAPVC repair while left atrial enlargement procedures appear to be associated with higher risk of late arrhythmias.Although early and aggressive reintervention for recurrent PV obstruction is mandatory,intrinsic PV stenosis remains a predictor of adverse outcome.The incidence of pulmonary vena is gradually reduced to 6％ ～ 11％.This often occurred in the infracardiac or mixed TAPVC.Conclusion The nicety of preoperative diagnose,the improvement of protection of heart function,using of pulmonary vena tissue for anastomose and avoiding of distortion of pulmonary venues and delayed closure of stemum can reduce the mortality.The preoperative degree of pulmonary veno obstruction and the time of emergency operation and the infracardiac or mixed TAPVC can affect prognosis.Along with the surgical technique,the mortality of TAPVC is gradually reduced and the result is amazing,but it is important to attach importance to the patient with re-stenosis of pulmonary veno,the time and method for reoperation.