ABSTRACT
La decisión de colocación de un marcapasos endocavitario en presencia de una cardiopatía compleja con anomalía del retorno venoso sistémico y pulmonar reparada en presencia de una vena cava superior izquierda (VCSI) puede constituirse en un problema cuando se emplea esta vía para alcanzar el ventrículo derecho. Se presenta el caso de una paciente de 23 años en quien se realizó una cirugía correctora a la edad de 3 años, y se interna para el reemplazo del marcapasos epicárdico. La evaluación completa tanto anatómica como funcional de esta lesión a través del ecocardiograma Doppler color descartó la necesidad de un estudio hemodinámico y facilitó la decisión y el éxito, si bien dificultoso, del implante
Subject(s)
Humans , Adult , Female , Heart Defects, Congenital/surgery , Pacemaker, Artificial , Vena Cava, Superior , Echocardiography, Doppler, ColorABSTRACT
La decisión de colocación de un marcapasos endocavitario en presencia de una cardiopatía compleja con anomalía del retorno venoso sistémico y pulmonar reparada en presencia de una vena cava superior izquierda (VCSI) puede constituirse en un problema cuando se emplea esta vía para alcanzar el ventrículo derecho. Se presenta el caso de una paciente de 23 años en quien se realizó una cirugía correctora a la edad de 3 años, y se interna para el reemplazo del marcapasos epicárdico. La evaluación completa tanto anatómica como funcional de esta lesión a través del ecocardiograma Doppler color descartó la necesidad de un estudio hemodinámico y facilitó la decisión y el éxito, si bien dificultoso, del implante (AU)
Subject(s)
Humans , Adult , Female , Heart Defects, Congenital/surgery , Vena Cava, Superior/abnormalities , Pacemaker, Artificial , Echocardiography, Doppler, ColorABSTRACT
Percutaneous pulmonary valvuloplasty was performed successfully in two neonates with cyanotic tetralogy of Fallot. It seems that balloon valvotomy may represent a palliative therapeutic alternative of choice in the neonatal period.
Subject(s)
Catheterization , Tetralogy of Fallot/therapy , Female , Humans , Infant, Newborn , Male , Palliative Care , Pulmonary Valve , Pulmonary Valve Stenosis/congenitalABSTRACT
Three cases of renal dysfunction at birth were observed in premature babies exposed in utero to prostaglandin synthetase inhibitors (PSI) and corticosteroids. Transient water and sodium retention with uraemia occurred in one patient, and severe acute renal failure with marked hyperkalaemia in twins. These findings may be due to impairment of prostaglandin (PG)-mediated renal adaptation to stress conditions after transplacental passage of PSI. Corticosteroids may also have affected PG synthesis inhibition.
Subject(s)
Acute Kidney Injury/chemically induced , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Cyclooxygenase Inhibitors , Infant, Premature, Diseases/chemically induced , Kidney Function Tests , Obstetric Labor, Premature/prevention & control , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Betamethasone/adverse effects , Cesarean Section , Diseases in Twins , Drug Therapy, Combination , Female , Humans , Indomethacin/adverse effects , Infant, Newborn , Ketoprofen/adverse effects , Male , PregnancyABSTRACT
In spite of the prominent position reached by echocardiography in the anatomical and functional diagnosis of congenital heart disease, angiography remains the reference method for preoperative assessment of most cardiovascular malformations. Digitalization of angiographic images, recently applied to cardiology, is of particular interest in paediatrics: the versatility of the method, the smaller amount and dilution of the contrast medium, the diminution of catheter size and the shorter exposure to X-rays are factors that reduce the risk of this invasive investigation. The experience acquired by the exploration of 500 congenital heart disease shows that there is no technical obstacle to using this method in paediatric cardiology, especially since the images obtained clearly are of better quality. Digital angiocardiography already has superseded the conventional analogical exploration in paediatric patients.
