Birth of a New Program in Mexico City: The Kardias Experience

Palacios-Macedo, Alexis

doi:10.1053/j.pcsu.2007.12.002

Cited by 9 publications

(13 citation statements)

References 4 publications

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“…A previous case series reporting five successful FAV reported no postnatal survival, in spite of three patients requiring only aortic valvuloplasties, which reflects that progress in prenatal therapy requires progress in postnatal management . To our knowledge, there have been four successful cases of the Norwood procedure performed by the same pediatric cardiac surgery group in our country, both in the private and public setting, which are currently waiting the second (n = 1) and third (n = 3) stages of surgical palliation . Of these, only one belonged to our present cohort of prenatally diagnosed HLHS.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of hypoplastic left heart syndrome and fetal aortic valvuloplasty in a country with suboptimal postnatal management

et al. 2019

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Background: Fetal aortic stenosis (AoS) may progress to hypoplastic left heart syndrome (HLHS) in utero. There are currently no data, prenatal or postnatal, describing survival of fetuses or neonates with AoS or HLHS in a country with suboptimal postnatal management. Study design: Prospective cohort study performed in Mexico, including cases diagnosed with AoS and HLHS within a 6-year period. AoS patients fulfilling previously published criteria for evolving HLHS (eHLHS) were offered fetal aortic valvuloplasty. Outcome variables were perinatal mortality, postnatal management, type of postnatal circulation, and overall survival. Results: Fifty-four patients were included: 16 AoS and 38 HLHS. Eighteen patients had associated anomalies and/or an abnormal karyotype. Seventy-four percent of HLHS received comfort measures, with only three cases reporting an attempt at surgical palliation, and one survivor of the first stage. Fetal aortic valvuloplasty was performed successfully in nine cases of eHLHS. Overall postnatal survival was 44%in AoS with fetal aortic valvuloplasty, and one case (ongoing) in the HLHS group.Conclusions: HLHS in Mexico carries more than a 95% risk of postnatal death, with little or no experience at surgical palliation in most centers. Fetal aortic valvuloplasty in AoS may prevent progression to HLHS and in this small cohort was associated with ≈50% survival.

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Section: Discussionmentioning

confidence: 99%

Outcomes of hypoplastic left heart syndrome and fetal aortic valvuloplasty in a country with suboptimal postnatal management

et al. 2019

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“…Poor population everywhere heavily relies on government or public programmes for healthcare. In Mexico, public and social insurance provide health coverage for the majority of salaried and non-salaried workers and their families 14 20. In Guatemala, nearly 60% of the population lives below the poverty line.…”

Section: Persistent Barriers To Cardiac Services In Lmicsmentioning

confidence: 99%

“…The literature from the ICPs provides a wealth of information on local ingenuity to meet the needs within their borders given constraints on infrastructures, finance and personnel shortage 13 14 21 22 26–41. The ICPs are knowledgeable about local disease burden and natural history, patient characteristics, resources, constraints and sociopolitical milieu.…”

Section: Persistent Barriers To Cardiac Services In Lmicsmentioning

confidence: 99%

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Paediatric cardiac surgery in low-income and middle-income countries: a continuing challenge

et al. 2015

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Despite advances in surgical and catheter-based treatment for congenital heart disease (CHD), there remain wide disparities across the globe. Ongoing international humanitarian and in-country programmes are working to address these issues with the ultimate goal to increase the quality and quantity of paediatric cardiac care, particularly in under-served regions of the world. This review aims to illustrate the reasons for these inequalities and suggests novel ways of improving access and sustainability of CHD programmes in low-income and middle-income countries.

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“…The success of these centers depends on their sustainability and appropriateness to local needs (28). The creation of sustainable local centers of excellence, with maximal staff retention and mortality rates approaching those of the developed world, requires time, individual enthusiasm money, and the support of dedicated non‐government organizations in the absence of government funding.…”

mentioning

confidence: 99%

Pediatric cardiac anesthesia in the developing world

Doherty

Holtby

2010

Pediatric Anesthesia

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More children die of congenital heart disease (CHD) in low-income countries and acquired cardiac disease is more frequent. Advances in diagnosis, surgery, perfusion and anesthesia in the developed world have had dramatic results on children's lives, and many forms of CHD can now be safely corrected or palliated. However, in developing countries, for the children who receive cardiac surgery, perioperative mortality and morbidity remain high. Pediatric cardiac anesthesia is a specialty in its infancy worldwide, and in developing countries, it is often nonexistent. Visiting 'specialists' as part of medical mission teams often provides anesthesia, but the hope for the future is that local staff will be trained in pediatric cardiac anesthesia and collaborative regional cardiac centers will be the mainstay of care, offering safer surgery to more children.

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Birth of a New Program in Mexico City: The Kardias Experience

Cited by 9 publications

References 4 publications

Outcomes of hypoplastic left heart syndrome and fetal aortic valvuloplasty in a country with suboptimal postnatal management

Outcomes of hypoplastic left heart syndrome and fetal aortic valvuloplasty in a country with suboptimal postnatal management

Paediatric cardiac surgery in low-income and middle-income countries: a continuing challenge

Pediatric cardiac anesthesia in the developing world

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