Primary cardiac malignancies are rare entities. Although sarcomas enclosed the main group of malignant heart neoplasms, primary cardiac leiomyosarcomas are extremely rare and constitutes less than 8% of cardiac tumors. Leiomyosarcoma usually originates from the pulmonary veins and have a worm-like shaped structure. In this article, we present a case of a 40-year-old Hispanic man diagnosed with a cardiac tumor who underwent surgical resection, during pathological examination the tissue samples were consistent with a malignancy of mesenchymal origin that contained irregular bundles of spindle cells. Subsequent immunohistochemical study categorized the mass as a primary heart leiomyosarcoma with positive smooth muscle actin and muscle specific actin. As usual in this type of malignancy, patient’s clinical status declined overtime, recurrence was diagnosed two months after surgery, and four months after the procedure the patient was discharge for palliative care.

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En los países industrializados, los altos costos del tratamiento de la diabetes mellitus derivan de las fallas en el proceso de respuesta a la enfermedad, sin embargo, en naciones emergentes, los elevados costos se asocian principalmente a la atención tardía de los pacientes. Los montos del tratamiento del pie diabético en México corroboran que existe una deficiencia en el sistema de salud. Por ello, los esfuerzos deben enfocarse a la prevención, pues el costo de un paciente con diabetes con buen control y sin complicaciones es de 8,000 pesos mexicanos anuales. Esta suma representa «poco» comparado con el costo del manejo anual de un solo paciente con complicaciones, que puede sobrepasar los 300.000 pesos, o incluso multiplicarse si se realiza una amputación mayor. Se debe fomentar una consciencia profunda de las catastróficas secuelas del pie diabético y, con ello, limitar la progresión de esta enfermedad. Es de extrema importancia modificar las imperfecciones en la atención médica e implementar estrategias preventivas eficaces a nivel local y nacional para minimizar la realización de amputaciones mayores y abatir sus consecuentes costos. La pérdida de una extremidad afecta al paciente y a la familia del enfermo. En estos casos, todos participamos de manera directa o indirecta en la reinserción de los enfermos a la vida productiva o normal, lo cual es imposible de lograr una vez que la extremidad se compromete seriamente, pues se afecta irreversiblemente el entorno del enfermo y a la sociedad en la que se desarrolla.

High‐risk patients that are not candidates for conventional coronary artery bypass grafting surgery can undergo coronary artery revascularization through less invasive procedures. Hybrid approaches have emerged to address coronary artery disease in this subset of patients. This case report highlights the successful application of a multidisciplinary heart team approach for hybrid coronary revascularization in a very high‐risk patient with complex coronary anatomy, who would not otherwise be a candidate for conventional modalities of revascularization. The optimal workup, selection criteria based on anatomy, anticoagulation strategies, and timing of intervention of hybrid coronary revascularization are outlined in this case report.

Background: The left atrial appendage (LAAp) resection is an effective treatment approach to reduce the risk of thromboembolism in patients with atrial fibrillation. Objective: To study was to study the impact of removing atrial appendages in the production of natriuretic peptides (NPs) in conditions of volume overload and to develop an experimental model of LAAp resection. Materials and Methods: In a swine model of ischemic heart failure (HF), serum NP levels were measured before (Basal-1A) and after (Basal-1B) a fluid overload. Animals were grouped as follows: (0) preserved appendages, (1) resected LAAp, and (2) both atrial appendages resected. Levels of NP were measured before (2A) and after a fluid overload (2B). Results: Furin levels were higher in Group 0-2A than in Group 2-2A, and a significant increase was found in Group 0-2B compared to Groups 1-2B and 2-2B. Corin levels increased in Basal-1B versus Basal-1A. Atrial NP (ANP) decreased in Basal-1B compared to Basal-1A. After HF induction, ANP increased in Groups 2-2A and 2-2B. Conclusions: Resection of atrial appendages drastically modifies the natriuretic mechanisms of cardiac homeostasis, especially after a fluid overload challenge. Herein, we describe the face and predictive validation of an animal model of atrial appendage resection useful to investigations in translational medicine.