Evolution and Current Circumstances of Heart Transplants: Global and Mexican Perspective.

A cardiac transplant is an irreplaceable alternative for patients with terminal chronic heart failure refractive to treatment. Heart failure results from an imbalance between cardiac output and organic demand, the prominent etiology is ischemic heart disease and arterial hypertension. In developed countries, it has a prevalence of 4.2%, reaching over 11.8% in adults over 65. It affects around 64.3 million people worldwide, with 9 cases for every 1000 people. This syndrome has a death rate of 56% in 5 years, making heart transplants relevant. The procedure has dramatically evolved from the beginning of animal experimentation in the early 20th century to now, where significant advances are still being made. The purpose of this review is to compile the central aspects of international and Mexico's local heart transplant history and current status, as well as a general view of what this procedure entails and possible prospective outcomes for this practice.

Descending necrotizing mediastinitis associated with spinal cord abscess.

A 58-year-old man with a history of Ludwig's angina was admitted with a spinal cord abscess at the level of C2-T1 and associated osteomyelitic destruction of vertebral bodies, spinal cord compression, and secondary quadriparesis, followed by descending mediastinitis. A right posterolateral thoracotomy and a cervicotomy drained purulent exudates. A tracheostomy was performed, and the patient was discharged after 84 days.

Descending necrotizing mediastinitis and thoracic cellulitis due to varicella.

A 22-year-old man with varicella had associated cervical enlargement, right upper thoracic anterior and suprascapular cellulitis, and mediastinitis. A tracheostomy, right posterolateral thoracotomy, cervicotomy, and upper thoracic fasciotomy were performed 14 h after admission, draining purulent exudates from all sites. The patient was discharged on postoperative day 22.

Thoracic necrotizing fasciitis due to snake ointment that progressed to a mediastinitis.

We report the case of a 42-year old diabetic male presenting with erythema of the neck and anterior right thoracic region secondary to the application of an ointment derived from rattlesnakes, progressing to a full-blown necrotizing fasciitis in a short period of time, with associated mediastinitis, thrombocytopaenia and sepsis. The patient died despite aggressive multidisciplinary medical and surgical treatment. We present this case due to the unusual aetiology and fulminating course.

[Papillary cardiac fibroelastoma. An unusual presentation]. / Fibroelastoma papilar cardiaco. Una inusual presentación.

BACKGROUND: Papillary fibroelastoma is a rare benign tumor characterized morphologically since first being described in 1976. Nevertheless, this tumor can be presented with a variety of clinical manifestations, making diagnosis challenging for the physician. There are no gender or age preferences but it is diagnosed by site of presentation along with macro- and microscopic characteristics. CASE REPORT: We report the case of a male patient with a history of type 2 diabetes mellitus and arterial hypertension who was admitted to the hospital with a diagnosis of ischemic heart disease accompanied by sustained ventricular tachycardia. Echocardiogram reported degree I diastolic dysfunction, apical ventricular aneurysm, and unusual apical tumor of the septum and left ventricle. DISCUSSION: Primary heart tumors have an incidence of 0.0017%. The most common symptoms are chest pain, syncope, dyspnea and arrhythmias. Diagnosis is accomplished incidentally by echocardiography, which is usually carried out for other reasons. Surgical procedure of choice is total tumor resection along with valve repair or replacement, if necessary, and in some cases cardiac endothelium resection and repair, with or without pericardium patch replacement. CONCLUSIONS: Papillary fibroelastoma is rare but is a recognized cause of embolic phenomena. Rapid identification followed by surgical resection is curative, precise and well tolerated by the patient.