Biomedical subjects
P Malo
Publications and source records attributed to P Malo.
[Cardiac transplant in single ventricle].
Univentricular heart is an uncommon congenital heart disease. A select group of these patients (those with severe pulmonary stenosis or atresia) can reach adult age with different degrees of heart failure and severe chronic hypoxemia. Patients with adequate pulmonary tree development are likely to undergo heart transplantation when usual palliative techniques are contraindicated. Three cases of univentricular heart with pulmonary stenosis in which heart transplantation was the optimal choice are reported. Different techniques used to assess pulmonary tree development are analysed.
More cases of paroxetine withdrawal syndrome.
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[The anatomical correction of transposition of the great arteries in the neonatal period].
INTRODUCTION AND OBJECTIVES: Anatomic correction of transposition of the great arteries in simple and complex form is theoretically the only procedure which offers the possibility of real cure to the problem. We report there our operative results and mid-term follow-up with this approach. METHODS: From June 1989 to February 1994, anatomical surgical correction was performed in 41 patients in the neonatal period, 31 with simple TGA and 9 patients with transposition associated with ventricular septal defect. We report our preoperative management, anatomic findings and surgical technique. RESULTS: Our initial experience with the arterial repair was associated with a high operative mortality. The actuarial survival rate was 74% at 56 months. Hospital mortality of the last 31 patients was 12.9%. Intermediate-term follow-up was 18 months. No late deaths. One patient underwent reoperation for supravalvular pulmonary stenosis. All survivors are in functional class I. The only significant risk factor of in-hospital mortality was the time of surgery (learning curve). CONCLUSION: The initial experience with arterial repair is associated with a difficult learning curve. Primary repair must be performed during the newborn period in simple and complex transpositions. Mid-term results are very encouraging. Longer follow-up is necessary to secure this technique and to render obsolete all other types of repair.
[The use of cryopreserved homografts in reconstructing the right ventricular outflow tract in congenital cardiopathies].
In recent years the use of cryopreserved allograft valves has become very popular. Homograft valves have been used for aortic valve replacement and for reconstruction of the outflow tract of the right ventricle for more than 30 years with very good results. Recently the method of cryopreservation has made possible the creation of valve banks. The use of this cryopreserved valves has obtained very good short and medium term results. We present our experience with the use of cryopreserved allograft valves in the reconstruction of the right ventricular outflow tract in the treatment of complex cardiac malformations. We have operated 15 children. Six were diagnosed of different types of transpositions of the great arteries with ventricular septal defect and pulmonary atresia or stenosis. There were 2 deaths not related to the use of the allograft valves. Nine other patients were diagnosed of different types of complex cardiac malformations. One patient with a univentricular heart and pulmonary stenosis and a neonate presenting with a truncus arteriosus communis died after the operation; again the deaths were not related to the use of the homograft conduits. Our technique of cryopreservation consists in the procurement of aortic and pulmonary valves from multiorgan donor patients. The valves are sterilized in antibiotics for 48 hours. Then the process of freezing is began with a period of progressive cooling down to -40 degrees C and second phase of storage in liquid nitrogen to a temperature of -178 degrees C. The short and medium term results are very satisfactory. We have not seen late important complications.
[Myocardial infarction and myocardial ischemia in newborn children and infants, not secondary to an abnormal coronary].
Three cases (one, newborn infant and two infants--one of them recently published--) who present electrocardiographic and enzymatic alterations comparative with diagnosis of ischemia and myocardial infarction are reported. Rarity of this entity in infants is stressed as most of published cases are secondary to ananomolous coronary artery. Etiology of the cases presented shows a myocardiac fibrosis with Schwachman's syndrome in one case, a coronary thrombosis secondary to a disseminated intravascular coagulation in a second case, and finally a generalized hypoplasia of coronary arteries. Hypoxia appears in these cases a factor acting in favour of myocardial ischemia. Diagnostic criteria of acute myocardial infarction are based on typical electrocardiogram and rise of isoenzymes of LDH and CPK-MB. Although rare, it is a diagnosis to be considered in cases of unknow cardiac insufficiency in newborns and infants.
[Tetralogy of Fallot with anastomosis of the Waterson-Cooley type. Evaluation of the development of vascular pulmonary disease].
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Single primitive ventricle with normally related great arteries and atresia of the left A-V valve.
A child aged 2 years and 9 months was angiocardiographically diagnosed to have a single ventricle with normally related great arteries and atresia of the left A-V valve. A Blalock-Hanlon procedure and division of a large patent ductus arteriosus were followed by reduction in pulmonary artery pressure, but after operation the patient showed signs of left ventricular failure unresponsive to medical treatment, necessitating pulmonary artery banding. We have found only three similar published cases, and this is the only one with full angiographic documentation.
Distribution of acetylcholinesterase along the dorso-ventral axis of the hippocampal formation in the rabbit.
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[Pneumopericardium in the newborn (author's transl)].
A case of pneumopericardium in a newborn affected of hyaline membrane disease, and undergoing assisted ventilación is presented. Literature is reviewed. Physiopatology, morbidity, mortality, and predispossing factors are described. Knowledge of the clinical simptomatology is essential in order to perform the prompt pericardiocentesis, should cardiac tamponade be present.
[Total abnormal pulmonary venous drainage: surgical treatment, results and postoperative follow-up].
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[Acute pulmonary stenosis in the infant].
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