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J Esquivel Avila

Publications and source records attributed to J Esquivel Avila.

At least 19 recordsLinked to original sources
PubMedDate not supplied

[Phonomechanocardiography in the evaluation of the functional status of valvular prosthesis].

The FMCG in 22 patients with valvular prosthesis is analyzed and its clinical, hemodynamic and surgical correlation are established (11 from the I.N.C. and 11 from the Hospital Infantil I.M.A.N.). The average age of the patients was 15 years old, 18 had a mitral and six aortic valvulopathy, and they all required a valvular replacement. Of the mitral prosthesis, 14 were Starr-Edwards (13 of ball valve and one of disc), three Lillehei-Kaster and one Börck-Shiley. In 5 patients, the FMCG suspected disfunction that was later corroborated by catheterism in three patients and by surgery in all of them. The important differences of the FMCG between the group with good and the one with bad function were: the aparition of a rumble, a decrease in the amplitud of the closing snap, index of closing snap opering snap of less than one, lenghtening of fases PFVP and IVCP, and shortening of IVDRP. In the patients with auricular fibrilation, after long dyastoles; that would represent an adequate atrial emptying; the closing snap was more intense, the PFVP was lennthened the IVDRP was shortened when the prosthesis was not properly functioning. All the aortic prosthesis were ball valve Starr-Edwards type; in one the FMCG suspected disfunction and the patient had a sudden death outside of the Hospital. The significant differences of the FMCG were the decrease in the intensity of the opening snap, with a Hylen index of less than one, lengthening of the PFVP, IVCP and of the expulsive period (EP). The authors conclude that the FMCG is a good method for an early detection of the disfunctions of valvular prosthesis.

Adolescent↗
PubMedDate not supplied

[Evaluation of the electrocardiogram in tricuspid atresia].

Due to the broad behaviour variability of the tricuspid atresia by the defects to which it is associated, the authors propose another classification, based on the position of the great vessels and the characteristics of the pulmonary flow, in addition to the extent of the intracardiac septal defects (atrial septal defect and ventricular septal defect) and the presence of patent ductus arterious. Eleven patients with tricuspid atresia with situs solitus and heart normo-placed are studied for diagnosis confirmation by catheterism or autopsy. Electrocardiograms are studied and observed in two patients with transposition of the great vessels and pulmonary oligohemia, a more evident right auricular enlargement (P of greater voltage in DII and AP heading right in the front plane), the AQRS deviated to the right, up and backwards, with less evidence of the left ventricular power than in other varieties of tricuspid atresia. These characteristics gave a diagnosis useful for this variation. On those patients without transposition and pulmonary flow increase, it is observed that growing appearance of the left auricle is more evident and so is the power of the free wall of the right ventricle (high R in right precordial deviations), the AQRS heads left as in most of the cases, but forward and upwards also. This electrocardiographic information is considered to have great importance to establish a diagnosis of the variations of tricuspid atresia due to associated malformations. Common varieties have already been extensively described by other authors and are not subject to special study. Bibliography on this matter is reviewed.

Abnormalities, Multiple↗
PubMedDate not supplied

[Phonomechanocardiographic study of innocent murmurs in children].

At the National Institute of Pediatrics DIF (formerly IMAN), a comparative study was performed in 157 healthy children. Ninety four (59.8%), had an innocent cardiac murmur, and 63 children (40.1%) had no heart murmur detectable. The presence of innocent murmurs was more frequent in pre-school and school age; murmurs of basal location were predominant. The murmurs were brief midsystolic and of the ejective type. All of them had the characteristics of a vibratory murmur of sinusoidal type, with diagonal radiation and low frequency. One more dynamic of pharmacological tests were performed in 60 children. In 88.5% of the cases, the murmur showed left behavior during the Valsalva monouver. Only in 15.7% during the Azoulay maneuver suggested right origin of the murmur. In 70% the murmur decreased with orthostatism and in the children who inhaled amyl nitrite, the murmur showed a behavior suggestive of aortic ejective origin. The comparison between the groups with and without murmurs showed that the heart rate was lower for those children with murmurs (P less than 0.05), the left ventricle ejection time was shorter in children with murmurs (P less than 0.01), but instead the preejection period was longer in children with murmurs (P less than 0.05). These differences let us point out that in children with murmurs the blood flow during the early systole is higher than in those without murmurs. This conditions probably a determinant in the origin of the innocent murmur.

Adolescent↗
PubMedDate not supplied

[Echocardiographic signs of congenital absence of the pulmonary semilunar cusps].

Five patients with congenital absence of the pulmonary valve leaflets were studied with M-mode and two-dimensional echocardiography. In addition to previously reported findings in this heart malformation, we found the presence of a narrow valvular ring that obstructs the outflow tract of the right ventricle, and a to-and-fro movement of the contrast bubbles from the right ventricle to the pulmonary artery suggesting pulmonary regurgitation. These features along with the volume overload data of the right ventricle suggests the diagnosis of congenital absence of the pulmonary valve leaflets.

Adolescent↗
PubMedDate not supplied

[Echocardiographic study of congenital mitral valvulopathy].

M mode, two dimensional and Doppler echocardiographic findings of eleven patients with congenital abnormalities of mitral valve are described. Nine of them had mitral stenosis and two had predominant regurgitation. Six of our patients had other associated cardiovascular malformations (3 coarctation of the aorta, two tetralogy of Fallot and one patent ductus arteriosus). In none of them, there was demonstration of abnormal echoes in the left atrium. In patients with congenital mitral stenosis the M mode echocardiographic findings were indistinguishable of those present in rheumatic mitral stenosis. With two dimensional echocardiography the anatomy was determined from the subvalvular characteristics and the mitral valve diastolic area. The Doppler study showed increase of the peak velocity of the mitral flow in all cases. We conclude that the M mode and two dimensional-Doppler echocardiography are helpful in the recognition of the isolated congenital mitral pathology or when it is associated to other malformations.

Abnormalities, Multiple↗
PubMedDate not supplied

[Calculation of the arterial pulmonary pressure by using phonomechanocardiography. Correlation with the measurement by catheterization].

We are presenting a phonomechanographic study for the calculation of sytolic pressure of the pulmonary artery, following the method proposed by Burstin & Fishleder. Correlation is made of 287 patients with the pressure obtained from the registration of direct-catheterism in the pulmonary artery. We insist on the advantages of this method such as quicker accomplishment, easier calculation and harmless for the patient, and we are analyzing some of the physiologic mechanisms which participate in the calculation of the pulmonary systolic pressure. We concluded that it is a reliable method of a high degree of correlation uith the hemodynamic research, specially when both studies are contemporary.

Adolescent↗
PubMedDate not supplied

[Echocardiographic study of corrected transposition (author's transl)].

We studied patients with corrected transposition of the great arteries by M and bidimensional echocardiography. Three patients in situs solitus and one in atrial situs inversus. The characteristics of the atrio-ventricular valves, and it's relation with other heart structures was determined, as well as the ventriculo-arterial connections and the presence of associated defects. The approximations employed were parasternal and suprasternal. The cases of discordant ventriculo-arterial connection in atrial situs solitus showed mitro-pulmonary continuity. In these cases the pulmonary artery, located in a right posterior situation with respect to the aorta, became intensely opaque when contrast material was injected in a peripheral vein. In atrial situs inversus, the aorta had a right and anterior position. We conclude that it is possible to establish the diagnosis of atrioventricular discordance by an adequate systematization of the echocardiographic recordings.

Adolescent↗
PubMedDate not supplied

[Echocardiographic study of different forms of pulmonary atresia].

Echocardiographic recognition of pulmonary atresia with either ventricular septal defect or intact ventricular septum is of great value in the differential diagnosis with other forms of right ventricular outflow tract obstruction or hypoplasia of the right ventricle. We studied nine patients with pulmonary atresia seven with ventricular septal defect and two with intact ventricular septum. It was not possible in either group of these patients to register systolic opening and diastolic closure movements of the pulmonary valve. In the group with ventricular septal defect, aortic straddling was present in all cases. In one patient it was possible to register the echoes of an imperforated pulmonary valve. In the remaining patients, the differential diagnosis with persistent truncus arteriosus was not possible. M-mode and Two-dimensional echocardiographic features of pulmonary atresia with intact ventricular septum are specific of this malformation and can differentiate it from other forms of hypoplasia of the right ventricle.

Child↗
PubMedDate not supplied

[Echocardiographic study of chronic aortic insufficiency. Hemodynamic, angiographic and total clinical correlates. II. Evaluation of left ventricular function].

An important point in the evolution of chronic aortic insufficiency (CAI) is the degree of disturbance of left ventricular performance (LVP), from which the surgical risk and the prognosis depend. Is possible by M mode Echocardiography (M-Echo) to evaluate the different elements that regulate the LVP, with the known measurements and by ratios of integral appraisal that are described here. We studied 14 patients with pure CAI at the National Institute of Cardiology, all of them had left catherization, ventriculography aortography, M-Echo, Chest X ray and EKG. The end systolic diameter (ESD) of the left ventricle (LV) and the fractional shortening (FS) showed good correlation with the end diastolic pressure (EDP) of the LV (r = 0.86 and -0.74 respectively). The percentage of aortic regurgitation (%AR) did not show significative correlation with the parameters of LV function. The ratios of integral appraisal showed good correlation with the EDP of the LV, the left atrium diameter over ejection fraction ratio (LAD/EF) was r = 0.764; the E point-septum separation over the fractional shortening ratio (E-S/FE) was r = 0.776, and for the ESD over the normalized velocity of the posterior wall of the LV ratio (ESD/NVPW) was r = 0.85. The relationship of the ESD/NVPW ratio with the EF was good (r = 0.95), with the mean velocity of circunferential shortening (r = -0.94) and with the cardiothoracic index (r = 0.88). We did not find a relationship between the functional class (NYHA) and the LVP, evaluated hemodynamic and echocardiographic methods used here. The M-Echo is an useful procedure for the sequential study of CAI, that permits recognition of the initiation and severity of the LV dysfunction, and it is of great help to signal the right moment for the surgical treatment.

Aortic Valve Insufficiency↗
PubMedDate not supplied

[Segmental echocardiographic analysis of congenital cardiopathies].

The usefulness of M mode and two-dimensional echocardiography in the segmental localization of the cardiac chambers in congenital heart disease was studied. Nineteen patients with congenital heart disease and various possibilities of conexion of the different segments of the heart were diagnosed by angiocardiography and in some cases by surgical treatment. The echocardiographic diagnosis in these cases was based in the analysis of the spatial position of the heart chambers, atrio-ventricular, aortic and pulmonary valves. The results obtained are presented and the differential diagnosis is discussed. We conclude that in the majority of these patients with complex congenital heart disease, the diagnosis can be suggested by echocardiography, or at least, this procedure can guide us to program the angiocardiographic studies.

Adolescent↗
PubMedDate not supplied

[Chronodynocardiometry in healthy children. 1: Systolic times].

At the National Institute of Pediatry (IMAN) were studied the phonomechanocardiographic recorders obtained of 125 children, all were eutrophic and healthy. The measure of the systolic time intervals were the purpose of the study. Children's age varied from 2 months old to 18 years old; 82 boys and 43 girls. The duration of the R-R space increased according to age (P less than 0.001), the electroacoustic systole and the ejection time showed more duration in older children (r = 0.61 and 0.77 respectively). In opposite, the pre-ejection time as well as its phases, had a similar duration in all ages. Tables of values and ranges of the systolic time intervals according to age are presented. The systolic time intervals were correlated to the R-R space duration, and showed a direct proportion with the electroacoustic systole (r = 0.76) and ejection time (r = 0.83), but the pre-ejection time had not significant changes. The electroacoustic diastole duration was proportional to the R-R space (r = 0.96). The regression equations were calculated to evaluate the normal range of the systolic time intervals in children, obviously in accordance to cardiac frequency.

Adolescent↗
PubMedDate not supplied

[Chronocardiometry in healthy children. II. Diastolic time intervals].

At the National Institute of Pediatrics DIF (called before IMAN) a prospective study of diastole time intervals (DTI) was performed on 138 healthy children by phonomechanocardiography. The correlation of the DTI with age and heart rate (HR) was studied. Also the relationship of the DTI with systolic times intervals (STI) was studied. The age of children did not show significant correlation with the DTI. Isovolumic relaxation phase (IVRP), tachydiastolic phase (TDP) and presystolic phase (PSP) were slightly modified by HR and obviously, without significance. But instead, the bradidiastolic phase (BDP), effective diastole (ED) or the time on which the mitral valve is opened and total diastole (D) showed directly proportional relation with R-R interval of the ECG (P less than 0.001). The left ventricular ejection time (LVET) was longer according to the ED duration (r = 0.818). The ejection fraction (EF) showed proportional increase to the ED duration, but without statistics significance. The influence of the DTI that have upon STI is important.

Adolescent↗