Search

Rabbits rendered leucopenic by means of nitrogen mustard reject kidney xenografts more slowly than normal controls It is therefore probable that polymorphonuclear leucocytes play an important role in the acute rejection of xenografts. The previously reported complement requirement for xenograft rejection was also confirmed in this work, by depleting the graft recipients of C3 with cobra venom factor. [ABSTRACT FROM AUTHOR]

In this year, we commemorate half a century of the first open-heart surgery performed in Mexico at the Military Hospital on January 11, 1957. The surgery was performed in a child with interventricular communication by Dr. Raul Baz; in this surgery a De Wall and Lillehei bubble oxygenator was used. The perfusionist was Dr. Marcelo García Cornejo. The present historical review is aimed at covering the advances in cardiology from its beginnings to the present.

Partial and total maternal and child health care costs were estimated. The study was developed in a Primary Care Health Clinic (PCHC) and a General Hospital (GH) of a social security health care system. Maternal and child health care services, type of activity and frequency utilization during 1995, were defined; cost examination was done separately for the PCHC and the GH. Estimation of fixed cost included departmentalization, determination of inputs, costs, basic services disbursements, and weighing. These data were related to depreciation, labor period and productivity. Estimation of variable costs required the participation of field experts; costs corresponded to those registered in billing records. The fixed cost plus the variable cost determined the unit cost, which multiplied by the of frequency of utilization generated the prenatal care, labor and delivery care, and postnatal care cost. The sum of these three equaled the maternal and child health care cost. The prenatal care cost was $1,205.33, the labor and delivery care cost was $3,313.98, and the postnatal care was $559.91. The total cost of the maternal and child health care corresponded to $5,079.22. Cost information is valuable for the health care personnel for health care planning activities.

A case of congenital intrapericardial aneurysm of the left atrium associated with functional mitral insufficiency is described; it was resected successfully. Clinical, radiographic, vecto-electrocardiographic, ecocardiographic and angiocardiographic findings are shown. Those are compared with those of other nine similar cases. The finding of qR or QS complexes in L-I and a VL in the electrocardiogram as a sign of left atrial enlargement and eco-fre space posterior to the left ventricular endocardium in the ecocardiogram is mentioned as useful data in the diagnosis of left atrial aneurysmal dilatation not previously reported. Considering that the surgical result is always good, it is concluded that the congenital intrapericardial aneurysm of the left atrium is a rare malformation which needs to be resected irregardless of the presence or absence of arrhythmias, embolisms or heart failure.

We are reporting a case of Ebstein's anomaly of the tricuspid valve and another case of a congenital double tricuspid lesion, both associated with pulmonary valve stenosis and with similar hemodynamics and physiopathology. Given that there are few reported cases in the literature, we analyzed the clinical and electrocardiographic findings of both. The utility of the echocardiogram is discussed in the diagnosis of such abnormalities and the angiographic and hemodynamic data commented upon. It is emphasized that right ventricular hypertension (105 mm Hg, and 98 mmHg, respectively) modifies the cardiopathic hemodynamics and its natural history, that was favorably modified by isolated corrective surgery of the pulmonary obstruction. The postoperatory transvalvular gradients were measured at 27 and 11 mm Hg, respectively. After having revised the pertinent bibliographic literature, we commented upon the factors that give such a high mortality rate in Ebstein's surgery and the congenital abnormalities which are most frequently associated.

This report documents our experience with mitral valve replacement in children. Between 1978 and 1982, 30 replacements have been performed in patients under 15 years of age. Twenty seven patients (90%) with rheumatic heart disease and 3 (10%) had congenital disease. Their functional capacity prior to operation was as follows: Nine patients fell into class II, 18 into class III and 2 into class IV. Preoperative cardiac catheterization, was undertaken in 26 patients, the mean pulmonary arterial wedge pressure was 27.4 +/- 8 mmHg, the pulmonary artery mean pressure was 48 +/- 20 mmHg, the left ventricular end diastolic pressure was 11.7 +/- 5.6 mmHg. One child died in the operative period. Twenty six patients (90%) have been followed for a mean period of 22.7 months. Late mortality occurred in three patients (11%). Bacterial endocarditis, thromboembolism and valve maldisfunction were not present. The post operative NYHA functional class was as follows: twenty two children fell into class I, and one patient fell into class II. The actuarial survival rate 5 years after operation was 79%. We believe that the Björk-Shiley prosthesis offer excellent results in children when repair of the natural valve is not possible.

It is communicated an isolated mytral insufficiency case, secondary to thorax's penetrative wound by steel arm. There are commented the clinic discoveries, phonomechanocardiographic, echocardiographic, haemodynamic and operation results of a unique orifice in the mytral's septal valve with important overflow. When perforation was sutured it was necessary reoperate it in order to suture's dehiscence and valve's substitution by a Bjork-Shilley's prothesis. The patient persists asymptomatic 35 months after intervention.

It is presented a pulmonary artresia case with untouched interventricular partition wall surgically treated. It was established the continuity between right ventricle and pulmonary artery's trunk with duramater ceiling, for which it was made a pulmonary valve. Postoperation evolution was excelent and it was obteined a frank diminution of the right ventricle's systolic pression. It is discussed about therapeutic conducts in this kind of congenital badformation.

It is presented the experience in the first 60 patients with duramater's prothesis. It is exposed the methodology which was utilized for these patients, in the same manner, the valve's confection technic. There are signaled the advantages, over mechanic valves, that these prothesis have, specially the no utilization of anticoagulatings, a minor incidence of tromboembolic phenomena, insignificant transvalvular gradient, major resistance to infection, central flux, minor turbulence and lower cost. It is informed about the obtained results with electrocardiographic, radiologic, phonomechanocardiographic, echocardiographic and haemodynamic postoperation studies, evolution after two years has been very good, 90% of the patients shows substantial improvement and only 30% need to take anticoagulants. There were 5 hospital deaths and 1 late death by hepatitis.

The calculation of mitral valve orifice area in patients with mitral stenosis is important because it establish the surgical indication and the type of surgical procedure to be done (commisurotomy, valvuloplasty or valve replacement). Moreover, the postoperative measurement of the mitral orifice area may be useful to evaluate the surgical results and to differentiate between inadequate commisurotomy and restenosis. We studied 12 patients with measurement of mitral orifice area by two-dimensional echocardiography imaging and digital microproccesing. The measurements were compared with the surgeon's estimate. The correlation obtained was of r = 0.86 (p less than or equal to 0.05). The description of the surgeon corroborated the echocardiographic findings respecting mitral subvalvular apparatus in all except one patient. Concerning the thickening of the values, echocardiographic and surgical findings were concordant in 10 patients. The mitral orifice area showed inverse relationship with pulmonary artery wedge pressure measured by catheterization in 5 patients (r = -0.844). After commisurotomy, the mitral orifice area was analyzed in 9 patients, since one patient requerired valve replacement and in two we did not obtain echocardiographic studies. The postoperative increase of the mitral orifice area was significant; (before surgery X 0.6 cm2 +/- 0.16) and after surgery (X 2.7 cm2 +/- 0.22) p less than or equal to 0.001).