Valvuloplastía Pulmonar: experiencia en el Instituto de Salud del Niño / lung valvuloplastia: experience in the Institute of Health of the Boy

Valvuloplastía con balón es el tratamiento de elección para la Estenosis Pulmonar Valvular del infante, niño y adolescente. El presente artículo muestra la experiencia con esta técnica en el Instituto de Salud del Niño.

[Experience of a single center in liver transplantation in adults and children]. / Experiencia de un centro en trasplante hepático en adultos y niños.

Orthotopic liver transplantation (THO) is the treatment of choice for a variety of liver diseases. The national experience before 1993 has been scarce. In November 1993 we started our experience in THO at Clínica Las Condes, as part of a multiorgan transplant program (liver, kidney, pancreas). Until January 1995 we have performed 14 THO in 13 recipients (one retransplantation), of which 5 were in pediatric cases. The recipients range of age fluctuated between 1 and 61 years. In two pediatric cases a liver allograft reduction was performed. Six recipients (46%) required treatment for acute cellular rejection. One recipient had an hepatic artery thrombosis and had to be retransplanted. There was no operative mortality up to 30 days in cases of primary liver transplants. The retransplanted adult recipient, and another pediatric recipient that died from a late recurrence of a hepatoblastoma, accounted for the mortality of this experience. After an average follow up of 10 months, the actual patient survival in 85%. Of the 11 surviving recipients, 9 are in excellent conditions with a very good quality of life. This experience shows that an active liver transplant program in our country can be successful in obtaining results comparable to those published by very experienced foreign transplant centers.

[Acute non-cardiogenic pulmonary edema secondary to upper airway obstruction. Clinical case]. / Edema pulmonar agudo no cardiogénico secundario a obstrucción de vía aérea alta. Caso clínico.

Noncardiogenic pulmonary edema is a well recognized complication of upper airway obstruction. We report the case of a previously healthy 18-year-old male who presented this complication following laryngospasm after anesthesia. He developed severe pulmonary edema with hypoxemia, high cardiac output and low pulmonary capillary pressures. He was managed with mechanical ventilation and PEEP. Pulmonary edema resolved within 24 hours. The clinical picture, etiology, differential diagnosis and prevention are also discussed.