Cateterismo cardiaco en cardiopatías congénitas. Qué realizamos y hacia donde nos dirigimos

La aplicación de las distintas técnicas de cateterismo cardiaco en el tratamiento de las cardiopatías congénitas has permitido que en muchas ocasiones, el tratamiento percutáneo mediante cateterismo se haya convertido en la primera opción terapéutica. Se analizan las técnicas de cierre y de apertura utilizadas, así como las nuevas lineas hacia donde se dirige el tratamiento percutáneo en el futuro

Hypertrophic Cardiomyopathy due to Mitochondrial Disease: Prenatal Diagnosis, Management, and Outcome

A case of prenatally diagnosed fetal hypertrophic cardiomyopathy is reported. The mother was referred to our department at 37 weeks’ gestation because of suspected congenital heart disease. Prenatal echocardiography showed biventricular hypertrophy and pericardial effusion, without additional abnormalities. Postnatal echocardiography conformed prenatal diagnosis. Neonatal EKG showed biventricular hypertrophy and Wolff-Parkinson-White syndrome. Skeletal muscle biopsy was consistent with mitochondrial oxidative phosphorylation defect involving a combined defect of respiratory complexes I and IV. Echocardiographic followup during the first year of life showed progressive regression of hypertrophy and evolution to left ventricular myocardial noncompactio

Prenatal Management and Outcome of Junctional Ectopic Tachycardia and Hydrops

Fetal dysrhythmias are reported in approximately 1-2% of all pregnancies and are a relatively common reason for referral to fetal medicine centers1-3. Fetal tachycardia is a serious condition in which the fetus is at risk of congestive heart failure and the subsequent development of hydrops1-4. This situation is associated with significant morbidity and mortality1-4. In general, the diagnosis and assessment of these dysrhythmias can be accurately made using high-resolution 2-D ultrasound using M mode and Doppler assessment of the relationship between the atrial and ventricular contractions5. Junctional ectopic tachycardia (JET) is a rare form of fetal tachyarrhythmia, which usually occurs in the setting of surgery for congenital heart disease6. In addition, a congenital variety of JET not related to surgery has also been described. While post-surgical JET has a mortality up to 14%, congenital JET has a mortality up to 34%6. The congenital form of JET has rarely been reported during the prenatal period7,8. We describe a case in which the diagnosis was suspected in utero in a patient referred to our Department because of the presence of important fetal ascitis. The diagnosis was based on the evidence of moderate tachyarrhythmia episodes without 1:1 AV relationship and intermittent absence of atrial contraction wave consistent with atrioventricular (AV) dissociation, together with ductus venosus reverse diastolic wave indicating mild cardiac failure. JET diagnosis was confirmed after birth