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Biomedical subjects

Jesús Vargas Barrón

Publications and source records attributed to Jesús Vargas Barrón.

9 recordsLinked to original sources

[Aortic valve complications associated with subarterial infundibular ventricular septal defect. Echocardiograpic follow-up].

INTRODUCTION AND OBJECTIVES: Interventricular fibromuscular septal defects of the outlet tract are subarterial infundibular ventricular septal defects (VSDs). This anatomical situation predisposes to aortic cusp prolapse (AoP) and/or regurgitation (AoR). METHODS: In order to determinate the frequency of VSDs and the presence or development of aortic valve alterations detected by two-dimensional echocardiography, we studied 35 patients with VSDs. The defect area and presence, severity, and evolution of AoP and/or AoR were evaluated. Ten anatomic specimens were studied to verify the echocardiographic correlation. RESULTS: Subarterial infundibular defect was present in 6.9% of all ventricular septal defects. The average age at time of diagnosis was 5,8 years. VSDs diameter and gradient did not change during follow-up. At time of diagnosis, 30 patients (87%) did not have AoR, but during an average follow-up of 8 years, 11 (32%) developed it. By the end of the study, 46% had AoR. When the time to progression of AoR was compared in the group that developed it versus the group that did not, the median values were similar in both groups. There was a greater tendency to development and/or progression of regurgitation in small VSDs. The echo-anatomic correlation was precise. CONCLUSIONS: Aortic valve damage was a frequent finding in VSD. Most cases did not progress to more severe AoR. Small VSDs developed more severe regurgitation in less time. Surgery must be considered when AoR is detected. Regular evaluation by echocardiography is important in follow-up.

Adolescent↗

[Indications for and information of tridimensional echocardiography].

Three-dimensional echocardiography is becoming an important tool within the diagnostic arsenal in cardiovascular diseases. This study provides, in an easy way, a new dynamic and functional point of view of the anatomy of the heart and of the vascular tree. This review describes its principles, discusses its indications, and its place within clinical evaluations. Its capabilities. Advantages in relation with other imaging methods, its current situation and, of course, its own limitations are also commented.

Echocardiography, Three-Dimensional↗

[Echocardiography at the emergency room].

The potential utility of the echocardiography in the assessment and management of patients in the emergency room is wide-ranging and encompasses the spectrum of cardiac problems encountered in clinical cardiology. We describe the utility of the technique in the evaluation of patients with pericardial effusion; cardiac tamponade; and also in intracardiac thrombus.

Cardiac Tamponade↗

[Treatment of patent ductus arteriosus. Comparison of costs between surgical and trans-catheter closures in a public institution].

UNLABELLED: The costs of transcatheter closure of patent ductus arteriosus in relation to the surgical closure still a controvertial issue in our hospitals. The aim of the study was compared the costs of both treatments. METHODS: We included 57 patients treated with transcatheter occlusion and 26 underwent surgery. Information about laboratory tests, average in hospital days of stay, anesthesia type and duration, operating and hemodinamic room costs, was gather. A database containing the costs from the institution unitary costs system in force was designed. RESULTS: sociodemographyc characteristics were similar in both groups. Ductus size was larger in patients treated with surgery (p<0.05). In hospital stay, as well as, the number of complications after the procedure were less in the patients treated with transcatheter occlusion (p<0.05). The closure with Amplatzer device was more expensive than the surgical one, and both were more expensive than coil. With surgical treatment, 86.5% of the costs are due to in hospital stay, with the Amplatzer this issues represented a 36%, however, the cost of the devices by itself represents a 40% of the total treatment cost. CONCLUSIONS: Even though total charges of Amplatzer devices are more expensive than surgery, transcatheter occlusion represents advantages in relation to less in hospital stay, resources used and number of complications, which allows hospital resources optimization.

Cardiac Catheterization↗

[Left ventricular myxoma].

Primary tumors of the heart are rare entities. We report a unique case of a young woman presenting a left ventricular myxoma, which manifested itself as coronary artery disease and was diagnosed by echocardiography. Emergency surgical treatment was indicated, done through a transeptal approach with extensive resection of the tumor, its pedicle and the papilar muscle to which it was attached as well as the anterior mitral leaflet, which was thinned and deformed by the presence of the mass. Mitral valve replacement was mandatory. A complete retrospective review of the literature is presented.

Adult↗

[Echocardiographic diagnosis of obstructive intermittent dysfunction of a mitral disc prosthetic valve].

Echocardiographic findings in six patients with obstructive intermittent dysfunction of mechanical disc prosthetic mitral valve (OIPD) are described. All with a clinical picture of gradual installation and progressive dyspnea of several weeks of evolution. TTE with Bd recordings were performed in all of them with "oriented" M mode from apical 4/C view. The findings were compared with a control group of 14 patients with normal prosthetic valves. In the group of OIDP, all patients displayed a variable delay in the opening of the prosthetic disc, registered as a "protodiastolic step" in M mode. In three patients, the dysfunction was due to a thrombus. In two, due to pannus. Three were operated. One with thrombolysis. In two, the treatment consisted of heparin and increased oral anticoagulation. None die during the acute handling of the intermittent dysfunction. Two patients died: one seven months later due to cardiac failure and the other a year later due to prosthetic rethrombosis. In patients with mechanical prosthetic valve in mitral valve position and progressive dyspnea, the presence of a variable delay in the opening of the prosthesis is diagnostic of OIDP and requires urgent handling with thrombolysis or surgery.

Adult↗

[Ventricular pseudoaneurysm. Clinical and echocardiographic evolution].

The case of a patient with cardiac rupture following a myocardial infarction is presented. The rupture led to the formation of a ventricular pseudoaneurysm that was occupied by a thrombus that sealed the breakthrough point. The patient has survived without surgical treatment during the last 5 years.

Echocardiography, Transesophageal↗