[Therapeutic catheterization: the percutaneous closure of a persistent ductus arteriosus and of interatrial communication]. / Cateteristmo terapéutico: cierre percutáneo del ductus arteriosus persistente y comunicación interauricular.

Between february and december 1990, we attempted percutaneous closure of patent ductus arteriosus (PDA) in 26 patients and in one ostium secundum atrial septal defect (ASD). One of the PDA was right sided with right aortic arch and two were post surgical leaks. We used the "USCI-Rashkind PDA double disc occluder" and the newly designed "Lock Clamshell" occluder for the ASD. Twenty seven patients (20 females and 7 males), aged 1.3 to 16 years (M = 5.6) and weighing 9.5 to 56 kg (M = 21.3), were studied. Diagnosis was made clinically with the aid of Doppler colour flow echocardiography, with follow-up studies at 24 hours, 6 months and 1 year after the procedure. Diameter of the ductus varied from 1.6 to 8.2 mm (M = 2.6). Successful implant of the device was achieved in 25 cases (95%), of which 18 (72%) were totally occluded at 24 hours and 21 (84%) after 6 months, remaining small residual leaks in four (16%). In only one patient total occlusion was demonstrated 1 year after device implantation. We achieved 22 (88%) total occlusions. One case was not possible to occlude, due to its large size. Angiocardiography demonstrated adequate anatomy in 18, and difficult in 8 patients. Twelve and 17 mm devices were used in 16 and 9 patients, respectively. Successful second implant with subsequent total occlusion was achieved in one patient with a previous moderate residual leak. The ASD was central and single, with a diameter of 20 mm. Immediate total occlusion was achieved. We conclude that percutaneous PDA closure is a safe and effective procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

[The angiographic diagnosis of the connection of the persistent left vena cava superior to the left atrium by the absence of the roof of the coronary sinus in a child with a Holmes' heart]. / Diagnóstico angiográfico de la conexión de la vena cava superior izquierda persistente a la aurícula izquierda por ausencia de techo del seno coronario en un niño con corazón de Holmes.

We describe a patient with angiographic findings of a left superior persistent vena cava draining in the left atrium with absence of the coronary sinus' roof and coexisting with Holmes' heart. The diagnosis can be made by selective angiography in the left atrium, pulmonary vein or at the left superior vena cava. We want to emphasize the importance of knowing this sort of anomaly before surgical treatment.

[Systemic-pulmonary fistula. Percentage of children attaining corrective surgery]. / Fístula sistémico-pulmonar. Porcentaje de niños que alcanzan la cirugía correctora.

Because of the lack of information on definitive long term results of the systemic pulmonary fistulae (SPF) we decided to review our experience. From 1978/1980, SPF was carried out on 91 children with a minimal follow-up period of 53 months, 80 (88%) survive the immediate postoperative period, 65 (71%) the late period, although only 48 (53%) reached corrective surgery. 14 (50%) of the 28 newborn children died and only 9 (32%) had corrective surgery. 12 (19%) of the 63 children of two months or older died and 39 (62 por 100) had definitive surgery. 72% with Fallot syndrome, 58% with TGA and pulmonary stenosis and less than 40% of other pathologies also reached definitive corrective surgery. Frequently the SPF is the only alternative to achieve total correction although there may be a high mortality and morbidity rate. The age (newborn children) and the complex pathology are unfavourable in the end results.

[Oral-facial-digital syndrome in male (author's transl)]. / Síndrome oro-facio-digital I (O.F.D.I) en varón

One case of oral-facial-digital syndrome (Papillon-Léage and Psaume) is presented. This is the second one reported on a patient with normal male karyotipe. Clinical data and genetic aspects are commented in relation with this new case in a 46 XY male.