[Evaluation of pulmonary valve stenosis by means of phonomechanocardiography]. / Valoración de la estenosis pulmonar valvular por fonomecanocardiografía.

At the DIF Children's Hospital, 12 patients with pulmonary stenosis (PS) were studied. The values of the systolic pressure of right ventricle (SPRV) varied between 69 to 300 mmHg, showing a direct relationship with age. Weight and height were not related to the degree of PS. Five patients presented dyspnea and 3 of them also presented cyanosis, but seven were asymptomatic. Symptoms appeared in those patients with higher systolic and end diastolic pressure of RV, although the correlation was not significant. The phonocardiogram (PCG) showed a correlation between the duration of the systolic ejective murmur (SEM) and the degree of increase SPRV. The presence of an ejection click did not show a significant correlation with the severity of PS. Furuta's index, the IIA-IIP interval and the IIP/IIA index indicated a substantial corresponding between the SPRV and the transpulmonary gradient, both measured by catheterization. The "a" wave of phlebogram was giant in patients with high SPRV. The calculation of the SPRV by PCG showed a strong correlation with the determination made by catheterization. After surgery the duration of the SEM and Furuta's index decreased in all patients. The ejection click disappeared in 3 patients, becoming apparent in one. The IIA-IIP interval was shorter than before the operation and the phlebogram "a" wave of was reduced, except in one patient. The PCG is a reliable method of great utility for the evaluation of PS.

[Vascular rings]. / Anillos vasculares

Anomalies in the development of aortic arches may cause the formation of a vascular ring around trachea and esophagus, responsible for compression symptoms. The most frequently found vascular rings are the double aortic arch, the right arch with left ligament and the retroesophageal right subclavian artery. The diagnosis is established by means of contrast esophagogram. Surgery is usually done through a left posterolateral thoracotomy to dissect widely the retroesophageal area, after liberating the obstruction by section of a secondary vessel. Three cases are reported to illustrate the most frequent types of vascular rings and their management.