[Non-surgical extraction of intravascular foreign bodies in children. Experience with 8 cases]. / Extracción no quirúrgica de cuerpos extraños intravasculares en niños. Experiencia en 8 casos.

BACKGROUND AND OBJECTIVES: Foreign body retrieval in the catheter room is a useful procedure at any age, but, although its interest, few reports of such technique have been reported in children. METHODS: We review and present our experience in 8 children, aged 5 days to 11 years, five of them having congenital hearts defects. RESULTS: We retrieved 4 catheter fragments, 2 endocardial electrode catheter tips, 1 Rashkind 12 mm. PDA umbrella, and 1 detachable Jackson coil. All of them were placed in systemic veins, right heart chambers or pulmonary arteries. We used biplane fluoroscopy and percutaneous right femoral vein puncture in all cases. Goose-Neck (Microvena Corporation) snares were used in 5 patients, hand made snares in 2 and a Swan-Ganz catheter in one. In 4 cases, the snare was introduced trough a Mullins long sheath and the foreign body pulled into its distal end, in order to bring it out of the femoral vein. Six foreign bodies came off the femoral vein: 4 trough the puncture site and 2 needing a venous cut-down. The two remaining foreign bodies, stopped while pulling at the common iliac vein and a minor surgical procedure was needed for final extraction. CONCLUSIONS: Therapeutic catheterization is the technique of choice for intravascular foreign body retrieval in children.

[Fallot's tetralogy with severe symptomatology during the first year of life (author's transl)]. / Tetralogía de Fallot grave en el primer año de vida. Aspectos clínicos e implicaciones quirúrgicas

Seventeen cases of Fallot's Tetralogy with severe symptomatology during the first year of life are reviewed. In all of them, a cardiac catheterization and angiocardiography were performed. In 2 cases the pulmonary outflow tract was atretic. In general, the clinical, radiologic, electrocardiographic and hemodynamic findings were similar to those previously reported, although in 3 patients of the present series atypical electrocardiographic findings were found. Pronounced narrowing and horizontal orientation of the infundibular chamber, and accentuated hypoplasia of the pulmonary artery branches and of the left heart cavities and were all unfavourable findings for total correction frequently found in the present material. Minimal or non-existent aortic dextroposition was observed in association with cases of Fallot's Tetralogy with extreme severity. Surgery was indicated as an emergency measure in the majority of the cases. Palliatives procedures were performed in 10 patients, and corrective surgery in one. Surgical results agree with the extreme severity that this lesion has, when it gives rise to important symptomatology so early in the life.