Isomorfismo cardiaco: Una perspectiva multidisciplinaria

Ortega-Zhindón, Diego B; Flores-Sarria, Iris P.; Minakata-Quiroga, María A.; Angulo-Cruzado, Stephanie T.; Romero-Montalvo, Luis A.; Cervantes-Salazar, Jorge

doi:10.24875/acm.20000567

Cited by 5 publications

(5 citation statements)

References 40 publications

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“…In addition to the surgical procedure, cardiac catheterization, the rate of which reached 21.1% in our center, is an important complementary method, especially for a description of the vascular anatomy; furthermore, catheterization improves the physiological response of the pulmonary vasculature in older individuals with a structural heart disease, and in cases of suspected obstruction related to the pulmonary venous systems [19].…”

Section: Discussionmentioning

confidence: 99%

“…It is important to take into account three scenarios at the time of diagnosis: first, the predominance of RAI in patients with AI; second, despite an all-in-one diagnostic approach, a precise diagnosis is sometimes challenging, even with a direct visualization of the atrial morphology during the surgical event; and third, patients with AI, mainly RAI, show an association with other extracardiac alterations, so complementary diagnostic approaches such as abdominal ultrasonography and contrast-enhanced imaging studies at the gastrointestinal level should be considered based on the findings during the initial evaluation, in addition to the multidisciplinary work in the care of these patients [19].…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of RAI was determined through the assessment of morphological features, considering a morphologically right atrium when the appendage was pyramidal, the crista terminalis was evident and the pectineal muscles were extending towards the vestibule of the tricuspid valve in its entire parietal extension. Additionally, the bronchopulmonary morphology was assessed, where the right bronchus was more horizontal and shorter than the left bronchus, with three lobes, and the right pulmonary branch was crossing anterior and slightly inferior to it [19]. The diagnosis of RAI was supported with echocardiography, computed tomography, magnetic resonance imaging and cardiac catheterization studies.…”

Section: Study Populationmentioning

confidence: 99%

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Cardiac Laterality: Surgical Results of Right Atrial Isomerism

Ortega-Zhindón,

Pérez-Hernández,

Rodríguez-Pérez

et al. 2023

Diseases

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Right atrial isomerism (RAI) is a complex entity with varying diagnostic and treatment outcomes due to its rarity. Treatment options range from palliative to corrective surgeries, resulting in heterogeneous outcomes. The aim of this study was to analyze the results obtained after cardiac surgery in patients with RAI. A retrospective study was conducted, including patients diagnosed with RAI who underwent cardiac surgery. Their follow-up was from 1 January 2010 to 31 March 2020. Demographic characteristics and perioperative conditions were described. Thirty-eight patients were included, the median age was 4 years (IQR 2–9.2) and 57.9% were men. The main diagnoses were atrioventricular canal (63.2%) and pulmonary stenosis (55.3%). The most common surgical procedures were modified Blalock–Taussig shunt (65.8%) and total cavopulmonary connection with an extracardiac conduit fenestrated without cardiopulmonary bypass (15.9%). We did not find any factors associated with negative outcomes in these patients. The overall survival was 86.8%, with a better outcome in those who did not require reintubation (log rank, p < 0.01). The survival of RAI was similar to other centers. Individuals with RAI should be evaluated rigorously to determine an adequate repair strategy, considering high morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

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Cardiac Laterality: Surgical Results of Right Atrial Isomerism

Ortega-Zhindón,

Pérez-Hernández,

Rodríguez-Pérez

et al. 2023

Diseases

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“…Se asocian a la codificación de la vía del factor de crecimiento transformante beta. Al verse alterada dicha vía, se determina una de las dos entidades: dextromorfismo o levomorfismo 7,8 .…”

Section: Introductionunclassified

“…Dada la complejidad del SH, su diagnóstico representa un gran reto para el ginecoobstetra y el médico materno fetal, pero una vez identificado, se debe derivar oportunamente al servicio de cardiología pediátrica 12 . Las patologías cardiacas requieren un manejo posnatal especializado, en su gran mayoría quirúrgico, lo cual tiene un impacto en el pronóstico a largo plazo de esta entidad 7 . Aun aquellos defectos aislados se deben protocolizar, debido a que pueden verse implicadas algunas morbilidades como malrotación intestinal, atresia biliar, desórdenes respiratorios e inmunitarios 2 .…”

Section: Introductionunclassified

Evaluación prenatal del síndrome de heterotaxia por ecografía fetal

Santiago-Sanabria,

Morales-Martínez,

Alonso-León

et al. 2023

PER

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El síndrome de heterotaxia es una entidad de baja prevalencia, que tiene su origen durante el desarrollo embrionario, que afecta a diversos órganos y sistemas. Es por ello que su diagnóstico representa un reto durante la gestación. El pronóstico dependerá principalmente de las malformaciones cardiacas asociadas. Se presenta el caso de un paciente con diagnóstico de síndrome de heterotaxia durante el primer trimestre. Se detallan los patrones ecográficos obtenidos durante el tamizaje del primer trimestre que auxiliaron a integrar el diagnóstico de esta entidad, así como las anomalías cardiacas asociadas. El manejo debe contemplar a un equipo multidisciplinario, el cual brinde un manejo oportuno, que será principalmente quirúrgico, enfocado en las malformaciones cardiacas.

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Cardiac Laterality: Surgical Results of Right Atrial Isomerism

Ortega-Zhindón,

Pérez-Hernández,

Rodríguez-Pérez

et al. 2023

Preprint

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Right atrial isomerism (RAI) is a complex entity whose treatment and outcome are heterogeneous. The aim of this study was to analyze the results obtained after cardiac surgery in patients with RAI. A retrospective study was conducted; it included patients diagnosed with RAI who underwent cardiac surgery; their follow-up was from January 1, 2010 to March 31, 2020. Demographic characteristics and perioperative conditions were described. Thirty-eight patients with RAI were included, the median age was 4 years (IQR 2-9.2), and 57.9% were men. The main diagnoses were atrioventricular canal (63.2%) and pulmonary stenosis (55.3%). The most common surgical procedures were modified Blalock‐Taussig shunt (65.8%) and total cavopulmonary connection with an extracardiac conduit fenestrated without cardiopulmonary bypass (15.9%). The use of inhaled nitric oxide was a marker of postoperative mortality in critically ill patients (OR: 10.33; 95% CI: 1.04 - 102.08; p = 0.02). The overall survival was 86.8%, with a better outcome in those who did not require reintubation (Log Rank, p < 0.01). The survival of RAI was similar to other centers of reference. Individuals with RAI should be evaluated rigorously to determine an adequate repair strategy, considering high morbidity and mortality.

show abstract

Isomorfismo cardiaco: Una perspectiva multidisciplinaria

Cited by 5 publications

References 40 publications

Cardiac Laterality: Surgical Results of Right Atrial Isomerism

Cardiac Laterality: Surgical Results of Right Atrial Isomerism

Evaluación prenatal del síndrome de heterotaxia por ecografía fetal

Cardiac Laterality: Surgical Results of Right Atrial Isomerism

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