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M Quero Jiménez

Publications and source records attributed to M Quero Jiménez.

At least 19 recordsLinked to original sources
PubMed2004

[Non-surgical treatment of aortic coarctation and recoarctation].

OBJECTIVES: To analyze the results of nonsurgical treatment of aortic coarctation and recoarctation by evaluating the results of each technique, and its complications and outcome. PATIENTS AND METHODS: The results were as follows: 51 children underwent balloon dilatation due to recoarctation (86.5 %); two underwent dilation of a native coarctation (3.3 %) and six underwent stent implantation for recoarctation (10 %). Age ranged from 2 to 236 months (109 +/- 63.45 months) with a follow-up of between 1 and 156 months (38.87 +/-32.96 months). RESULTS: The mean predilatation gradient in children with recoarctation was 34 +/- 11.62 mmHg, which decreased to 11 +/- 5.38 mm Hg (p < 0.0001). In 12 patients (20.3 %) effective dilatation was not achieved. The size of the stenosis was 6.7 +/- 2.35 mm predilatation, which increased to 9.3 +/- 3.10 mm (p < 0.0001) after dilatation with a percentage increase of 50.97. There were very few complications. Six children required subsequent redilatation. The experience with stent showed a mean gradient of 32.83 +/- 10.62 mm Hg, which decreased to 7.3 +/- 3.8 mm Hg (p < 0.0001) with a balloon/stenosis ratio of 1.94. CONCLUSIONS: We conclude that the interventionist technique is highly effective in both native coarctation and recoarctation in the short term, as well as subsequently, with very few complications. The stent technique produces equally good results in older children, which is promising for the future.

Adolescent↗
PubMed2002

[Balloon valvoplasty for critical aortic valve stenosis in neonates].

OBJECTIVES: To evaluate the immediate results obtained with balloon aortic valvuloplasty in neonates and long-term echocardiographic outcome as well as to identify variables predictive for outcome. To identify the degree of agreement between hemodynamic and echocardiographic study. PATIENTS AND METHODS: We analyzed the results obtained in 26 procedures performed in 18 boys and 8 girls (2.25:1), aged 2 to 49 days (16.1 12.9 days). All procedures were performed in the Pediatric Cardiology Unit of Ramón y Cajal Hospital in Madrid between June 1989 and June 2001. Follow-up was from 0 to 144 months (39.5 39.7 months). RESULTS: The immediate effects observed through echocardiographic study were a significant decrease in the maximum Doppler gradient (from 77.8 to 32.4 mm Hg; p < 0.0001) and in the medium Doppler gradient (from 41.7 to 18.5 mm Hg; p < 0.05). Hemodynamic studies showed a significant decrease in left ventricular systolic pressure (from 119.8 to 82.8 mm Hg; p < 0.0001) and an increase in aortic systolic pressure (from 56.8 to 66.6 mm Hg; p < 0.007). The hemodynamic peak gradient decreased from 63.1 to 17.7 mm Hg; p < 0.0001. In 23 % of the patients, aortic insufficiency significantly increased. Echocardiographic follow-up showed a significant increase in the telediastolic size of the left ventricle and a decrease in the maximum and medium Doppler gradient. The procedure showed initial success in 68.7 % and analysis of survival free of valvular surgery was 65.8 % at 45 months. Proportional risk analysis revealed that the post-valvuloplasty gradient was a predictive factor for future valvular surgery.

Aortic Valve Stenosis↗
PubMed1999

[Intravascular hemolysis following percutaneous occlusion of the ductus arteriosus].

Transcatheter occlusion of patent ductus arteriosus has become a safe and successful technique, but it's not free of complications. We present the case of a two-year-old boy who underwent routine transcatheter closure of his patent ductus arteriosus, using a "coil" device. Twenty hours later he developed severe persistent hemolysis in association with residual ductal flow. Patient's clinical situation became stable when the device was removed. Pulmonary embolization of the device and hemolysis are the main complications of percutaneous closure of the patent ductus arteriosus. Hemolysis occurs rarely (0.5%) and is always associated with the presence of residual ductal flow. Several approaches to this problem have been described. Mild cases may require no intervention; however, when severe hemolysis is present, removal of the device may be needed, proceeding with surgical repair of the patent ductus arteriosus.

Catheter Ablation↗
PubMed1996

[Heart growth in the normal human fetus. A two-dimensional echocardiographic study].

INTRODUCTION: Fetal cardiac growth was studied by two-dimensional echocardiography. The size of various cardiac structures were compared with gestational age. Normal values for each measurement were determined, with special attention being paid to the differences between the right and left chambers. PATIENTS AND METHODS: Ninety human fetuses with a gestational ages between 17 and 39 weeks were studied. Any structural abnormality was excluded at prenatal and postnatal examination. Aortic, pulmonary artery, tricuspid and mitral valve annulus diameters were measured with classical echocardiographic views. These variables were compared between them and plotted against gestational age. The correlations were determined by Student's T-test and regression analysis using 95% confidence limits. RESULTS: A good correlation (r > 0,7) between all the measurements and gestational age was obtained. In absolute values, tricuspid and pulmonary artery valve diameters were significantly greater (p < 0,01) than mitral and aortic valve diameters, respectively. Nevertheless, the diastolic diameter of the left ventricle (LV) was slightly greater than the diastolic diameter of the right ventricle (RV). Separating the data of the second trimester from of those of the third, the initial dominance of LV (RV/LV ratio = 0,93) tends to disappear and a slight dominance of RV (RV/LV ratio = 1,03) was observed at term. CONCLUSION: This study establishes normal values based on two-dimensional echocardiographic cardiac measurements throughout gestational stages. The data obtained will be very useful for the prenatal diagnosis and perinatal management of certain cardiopathies like the hypoplastic left heart syndrome. The relative dominance of RV in utero was also demonstrated. The different morphology of both ventricular outflow tracts and their volume changes throughout gestation, secondary to placental resistance variation, could justify the changes in the RV/LV ratio during the intrauterine period.

Confidence Intervals↗
PubMed1996

[Aortico-left ventricular tunnel associated with pulmonary valve stenosis].

Aortico-left ventricular tunnel is an unusual cardiac anomaly. The main clinical feature is early, severe aortic regurgitation, and surgical management is mandatory. Exceptionally this defect is associated with pulmonary valve stenosis. A case of a newborn with aortico-left ventricular tunnel plus pulmonary valve stenosis is reported. Initially she underwent percutaneous pulmonary valvuloplasty during diagnostic cardiac catheterization and with surgical closure of the tunnel later.

Aorta, Thoracic↗
PubMed1995

[Redundancy of the interatrial septum without associated congenital cardiopathy. Its prenatal echocardiographic diagnosis and follow-up].

INTRODUCTION AND OBJECTIVE: Aneurysm of the atrial septum at the level of the foramen ovale is reported commonly at the routine fetal echocardiographic examination. Cases with entire involvement of the atrial septum have been exceptionally reported. We described the data concerning the prenatal detection of a total redundancy of the atrial septum in 6 cases without congenital heart disease. METHODS: The gestational age was between 28 and 38 weeks, and none of the fetuses had evidence of heart defect. A routine fetal echocardiography was made in all the cases. Rhythm disturbances were studied by M mode. During the first three months of life, a cardiologic control was made in all the cases. RESULTS: The large displacement of the atrial septum towards the left atrium was clearly visualized in four-chambers view; by using Pulsed Doppler and Color flow mapping, the pulmonary venous return and mitral orifice flow were not impaired. Premature atrial beats were found in two fetuses and no hemodynamic disfunction was observed in all entire study group. Postnatal echocardiographic control was normal in all patients. The atrial septum becomes completely rectified with normal patency of the foramen ovale membrane in the newborn studies. The supraventricular extrasystoles were confirmed in the neonatal period. In both, the arrhythmia disappeared in a few days after delivery without treatment. CONCLUSIONS: Despite the benign follow-up in our cases, the unexpected presence of an extremely redundant atrial septum, leads to a close prenatal attention particularly in the presence of rhythm disturbance. The pathologic substrate of this anomaly might be an intrinsic alteration of the myocardial structure of the septum like seems demonstrated in the aneurysm circumscribed to area of the fossa ovalis [correction of fosa ovale]. The increase in the left atrial pressure after birth will produce a normal 2-D echo patterns in the newborn period.

Arrhythmias, Cardiac↗
PubMed1995

[Non-surgical extraction of intravascular foreign bodies in children. Experience with 8 cases].

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.

Catheterization↗
PubMed1993

[Aortic hypoplasia in a case of single ventricle with normally related vessels].

In cases with double inlet left ventricle when there exists a hypoplasia of one of the great arteries, the affected vessel arises from the accessory right ventricular chamber. This is due in general to the presence of a restrictive bulbo-ventricular foramen that results in hypoplasic vessel. The case we present in this paper has unusual anatomic morphology: the hypoplasic vessel (the aorta) arises from the main ventricular chamber. We analyse the electrocardiographic findings useful for the differential diagnosis from cases of isolated aortic coarctation of hypoplasia. We review also the intraventricular anatomic malformations that may cause the presence of a hypoplasic vessel. Even if, our patient died in the neonatal period, the adequate surgical procedure for this case is reviewed.

Abnormalities, Multiple↗
PubMed1993

[Value of two-dimensional Doppler color echocardiography in mitral-ventricular-aortic obstructive disease in the newborn].

Over the last years, the bidimensional echocardiography has assumed an increasingly impact in the management of heart disease in neonates. With the addition of Doppler technique and color flow mapping this non invasive method provide the most accurate definition of cardiac anatomy and physiology. It is particularly true in newborns with left inflow or outflow obstruction disease such as: pulmonary vein stenosis, divided left atrium, mitral and aortic stenosis or atresia, subvalvular narrowing, and hypoplastic left ventricle and aortic tract. The combination of these two methods contribute to recognize a specific left cardiac abnormalities and allow us to evaluate the therapeutical success in the follow up period.

Aortic Valve↗
PubMed1993

[Unilateral agenesis of the pulmonary artery. Experience with 4 cases].

We present our experience with four cases of unilateral pulmonary agenesis, 3 of the right artery and the other one of the left. Two of the patients had pulmonary hypertension and one of them died at two years of age. All cases were diagnosed by using pulmonary angiography. Aortography demonstrated the absence of circulatory supply to the lung and a contralateral aortic arch to the absent pulmonary artery. We have performed a review of the literature with an emphasis on the diagnostic aspects of this condition, and discuss the considerations for possible surgery in symptomatic patients.

Angiography↗
PubMed1993

[Congenital familial cardiopathies. Prenatal diagnosis].

The diagnosis of congenital heart disease by means of echocardiography is already a real fact. The use of this technique for diagnosis in utero currently allows the detection of these malformations during the early stages of pregnancy and to determine the prognosis of the fetal cardiopathies, as well as to establish a medical or surgical treatment of the neonate. The prenatal echocardiographic study of 126 pregnant women, previously having had children with heart disease, has allowed s to prove the greater incidence of cardiopathy in this population (6.4%), compared to the results obtained from a group of pregnant women previously having normal children and without a high risk pregnancy (0.8%). These findings support the theory that genetic factors are the primary cause of congenital cardiac malformations, although the existence of teratogen factors (rubella, diabetes, etc.) in some cases cannot be excluded.

Adult↗
PubMed1992

[Intracardiac mycetoma induced by central catheterization].

We report a case of an infective endocarditis presented as a right atrial mass which pathological study showed a big vegetation of candida albicans (mycetoma). We think its presence was related to a great central vein catheterization during the neonatal period. The clinical feature was completed with pulmonary fungal embolism and later tricuspid valve afectation. With this work we wish to remark the necessary careful management of patients with central vein catheters to avoid this severe complication. We review the pharmacological and surgical treatment of this uncommon entity.

Candidiasis↗
PubMed1992

[Therapeutic catheterization: the percutaneous closure of a persistent ductus arteriosus and of interatrial communication].

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)

Adolescent↗