A 24-Year-Old Male Patient With an Ostium Secundum Complex Atrial Defect Secondary to a Perforated Aneurysm With Inferior Vena Cava Agenesis.

The article describes a successful clinical outcome in the case of a 24-year-old male with a diagnosis of an ostium secundum atrial defect secondary to a perforated aneurysm associated with vena cava agenesis. During hospitalization, an echocardiogram revealed the presence of ostium secundum inter-atrial communication with a left to right shunt, a left ventricular ejection fraction (LVEF) of 60%, and mild pulmonary hypertension, measured at 40 mmHg. CT imaging showed anomalous dilation of the azygos vein (16.8 mm), associated with interruption of the vena cava in the intrahepatic and adrenal portion, continuing through the azygos system and draining into the superior vena cava. Open-heart surgery was performed with pericardium patch placement on the defect. Postoperative transthoracic echocardiography revealed a tracking of the interatrial septum, with adequate placement of the surgical patch and no evidence of residual short circuits. The postoperative recovery was favorable, and the patient was discharged five days after surgery. Outpatient monitoring at the first and third months showed no complications during physical examination and echocardiogram imaging.

Placental Transmogrification of the Lung in a Patient Without Emphysematous Disease.

We present a 47-year-old male without a relevant history or past respiratory diseases. He debuted with an acute, non-complicated COVID-19 infection, and later he started with mMRC-2 dyspnea, accompanied by a non-expectorant cough of four months evolution. A CT thoracic scan showed a dilatation of the aerial homogenous space and a well-defined anterior left pericardiac level, and a pericardial left bulla was diagnosed. The patient was treated with surgical intervention by video-assisted thoracoscopic surgery and had an adequate post-surgical evolution. The PPT must be managed by a multidisciplinary team with the definitive treatment of surgical resection.

[Heart failure with preserved ejection fraction (HFPEF). Impact of change in the paradigm of isolated diastolic dysfunction]. / Insuficiencia cardiaca con fraccion de expulsion preservada (ICFEP). Impacto del cambio en el paradigma de la disfunción diastólica aislada.

Heart failure with preserved ejection fraction is a significant and growing public health problem, since it currently represents half of all patients with heart failure. Despite improvements in the understanding of the disease, there is no benefit form treatments tested at all. Advances in diagnostic imaging and invasive evaluation algorithms will allow a more accurate and early diagnosis so that treatment of earliest forms in the progression of the disease are applied since the potential for benefit may be higher. Although important progress has been made in our understanding of the pathophysiology, cardiac catheterization, and cellular of diastolic failure mechanisms and not diastolic mechanisms of disease, further research is required promptly to determine how best to address these anomalies to reduce the significant burden of morbidity and mortality in this form of heart failure, which is reaching pandemic proportions.

[Utility of a pneumatic system to transport erythrocyte concentrates: pilot study]. / Utilidad de un sistema neumático para trasladar concentrados eritrocitarios. Estudio piloto.

BACKGROUND: The transport systems of erythrocyte concentrates should be safe and modern. In this paper we analyzed the safety of one pneumatic system to transport erythrocyte concentrates from blood transfusion service to post-surgical therapy service. METHODS: We analyzed 50 erythrocyte concentrates; a sample of 1.5 mL of blood was drawn previously and after delivering the concentrated erythrocyte. The samples were placed in glass tubes to measure temperature, hemoglobin, hematocrit and extracellular potassium concentration. The average and range as univariate analysis and the Mann-Whitney U test as a bivariate analysis were done for statistical analysis. RESULTS: Statistical differences were not observed in the parameters measured. The temperature was not modified by the pneumatic delivery system. The data indicated no significant differences (p > 0.05) pre and post delivered samples in temperature, hemoglobin concentration, hematocrit level or extracellular potassium concentration. The estimated travel time for each sample was 22.88 seconds. CONCLUSIONS: The transport of erythrocyte concentrates through pneumatic delivery system did not change temperature conditions according to the current regulation. Indeed, the data did not show evidence that the cellular suspension underwent a spontaneous cellular lysis by sending erythrocyte concentrates through a pneumatic delivery system.

INTRODUCCIÓN: los sistemas de transporte de componentes eritrocitarios deben ser seguros y modernos. En este trabajo se analiza la seguridad de un sistema neumático como medio de transporte de concentrados eritrocitarios del servicio de transfusiones al servicio de la terapia posquirúrgica. MÉTODOS: se estudiaron las muestras piloto de 50 concentrados eritrocitarios, previa homogeneización del tubo con pinza rotatoria. Se obtuvieron 1.5 mL de la muestra antes de enviar el concentrado eritrocitario por el sistema neumático y 1.5 mL después de su llegada a su destino. Las muestras fueron colocadas en tubos de cristal para su análisis. También se analizaron la concentración de hemoglobina, el nivel de hematócrito y la concentración de potasio extracelular. RESULTADOS: la información obtenida indicó que no hubo diferencias estadísticamente significativas (p > 0.05) al comparar los valores pre o posentrega respecto a la temperatura, la concentración de hemoglobina, el nivel de hematócrito ni la concentración extracelular de potasio. La estimación del tiempo de transporte a través del sistema neumático fue de 22.88 segundos. CONCLUSIONES: el envío de concentrados eritrocitarios mediante el sistema neumático no produjo cambios en las condiciones óptimas de temperatura indicadas en la normatividad vigente. Tampoco existió evidencia de que la suspensión celular enviada sufriera lisis celular espontánea debido al traslado de los componentes sanguíneos.