Experience acquired after 34 years of the first heart transplantation in Mexico.

On July 21, 1988, a successful heart transplant was carried out for the first time in Mexico; 34 years later, several hospitals in the country have performed this procedure. We present information and comments on the results obtained within this period at Mexican Social Security Institute La Raza National Medical Center "Dr. Gaudencio González Garza" General Hospital, where 234 transplants have been performed (one out of every three carried out throughout the country), with a short- and mid-term survival comparable to that reported in the rest of the world.

The hemodynamic effects of diazepam versus dexmedetomidine in the treatment of alcohol withdrawal syndrome: A randomized clinical trial.

Background: Dexmedetomidine (DEX) is an alpha-2 adrenergic drug used for short sedation and as an alternative to diazepam (DZP) in the treatment of alcohol withdrawal syndrome (AWS).

Purpose: This study aims to compare the hemodynamic effect of DZP versus DEX on heart rate (HR) and blood pressure in patients with AWS.

Methods: Prospective randomized clinical trial that includes 40 patients with AWS from Mérida, Yucatán, México.

Dispositivos de asistencia ventricular como tratamiento de destino. A propósito de un caso.

The treatment of refractory terminal heart failure has been heart transplantation. However, there are limitations with regard to clinical conditions of the recipient and availability of donors, and ventricular support has therefore been alternatively used as destination therapy. We describe the case is of a female patient with ischemic cardiomyopathy-associated heart failure who had a left ventricular assist device successfully implanted and at eight months of the procedure was at functional class I, with no complications.

STEMI and NSTEMI: Real-world Study in Mexico (RENASCA).

Introduction: Mexico is the country with the highest mortality due to acute myocardial infarction in adults older than 45 years old according to the OECD (28 vs. 7.5% of the average).

[Retrasplante cardiaco electivo. Primer caso en México].

Orthotopic cardiac retransplantation is used to treat transplanted cardiac graft end-stage failure. We present the first case of successful elective cardiac retransplantation in Mexico. It was a 25-year old male with heart transplantation who developed graft-resistant chronic vasculopathy.

[Transcatheter aortic valve implantation for aortic stenosis. Initial experience].

Background: Aortic stenosis is a frequent disease in the elderly, and is associated with other systemic pathologies that may contraindicate the surgical procedure. Another option for these patients is percutaneous aortic valve implantation, which is less invasive. We present our initial experience with this procedure.

[Combined heart-kidney transplantation in Mexic].

Background: In our country, heart and kidney transplantation is a novel option for treatment of combined terminal heart and kidney failure. This program began in 2012 for selected patients with documented terminal heart failure and structural kidney damage with renal failure. Description of cases: Between January 1, 2012 and April 30, 2016, we made 92 orthotopic heart transplantations.

[Heart transplantation for the treatment of isolated left ventricular myocardial noncompaction. First case in Mexico].

Background: Myocardial noncompaction of the left ventricle is a congenital cardiomyopathy characterised by left ventricular hypertrabeculation and prominent intertrabecular recesses. The incidence ranges from 0.15% to 2.

[Primary cardiac hemangioendothelioma: early diagnosis and surgical resection].

Background: The term hemangioendothelioma encompasses all tumors that derive from the endothelium of blood vessels. It has an uncertain prognosis, and it is always considered as a low-grade malignancy.

Clinical Case: Male, 23, who was admitted to the emergency room with chest pain, intermittent paroxysmal nocturnal dyspnea and malaise.

[Routine hormonal therapy in the heart transplant donor].

Background: Successful heart transplantation depends largely on donor heart function. During brain death many hormonal changes occur. These events lead to the deterioration of the donor hearts.

Clinical outcome in patients with acute coronary syndrome and outward remodeling is associated with a predominant inflammatory response.

Background: Pro-inflammatory molecules and low-density lipoproteins play essential roles in the atherosclerosis. The aim of our study was to establish an association among the cytokines secreted by peripheral blood mononuclear cells and the serum concentration in patients with unstable angina and coronary outward remodeling before and after percutaneous coronary intervention. The clinical and coronary responses were evaluated 6 months after the procedure.

[Mucha-Habermann disease and orthotopic heart transplant. Case report].

Background: Mucha-Habermann disease is a cutaneous clinical manifestation of unknown etiology that frequently appears in young patients. The aim was to present Mucha-Habermann disease that occurred in an old man who had a heart transplant.

Clinical Case: a 62 year-old male, heart transplant recipient, who four years after that transplantation procedure presented with papular lesions in neck, thoracic members of which extended to all body surfaces and that evolved vesicles and pustular lesions.

[Distant heart procurement for transplantation].

Background: The low availability of organ donors is a serious hindrance to heart transplantation. Long-distance organ procurement has been accepted as an option despite longer ischemic time for the heart.

Methods: Long-distance procurement from outside Mexico City in adult patients with terminal heart failure submitted to orthotopic heart transplantation between February 1st 2011, and January 31st 2012, was assessed.

[Brain death, physiopathology, optimal care and hormonal therapy for cardiac donation].

Heart transplantation goes on leading the standard therapy for the terminal heart failure. The success of this procedure and the post-transplantation survival, meaning during the perioperative time, is variable because of the good performance of the donor graft, due to this situation, the pre-harvesting evaluation is very important. The brain death brought many changes: 1) first of all the "adrenergic storm" with its hemodynamic and cardiac dangerous events; 2) Thyroidal hormones, cortisol, vasopressin, and seric insulin depletion with its metabolic consequences respectively.

[Combined coronary artery bypass-graft surgery and valve surgery. Cardiothoracic surgery department of a high specialty medical unit experience].

Background: the combined heart valve surgery and coronary artery bypass graft surgery has increased in frequency. The combined procedures have an increased risk of perioperative complications and mortality and usually is realized in older patients. We present our experience with this combined procedure.

[Heart transplant program at the UMAE, General Hospital Dr. Gaudencio González Garza, of the La Raza National Medical Center].

Background: The heart transplantation has modified the life expectancy of patients with terminal heart failure.

Objective: To present our experience in heart transplantation.

Material And Methods: A retrospective cohort study was realized for heart transplant recipients between July 21, 1988 and May 30, 2011.

Intracardiac malignant fibrous histiocytoma. A case report.

Background: Primary cardiac tumors are rare forms of cardiac disease. The reported incidence varies between 0.002 and 0.

[Gated single photon emission computed tomography (SPECT) and radionuclide ventriculography for evaluate the left ventricle ejection fraction in heart transplant recipients. Comparative study].

Objective: To evaluate which is the best method to determine the left ventricular ejection fraction in heart transplant recipients: radionuclide ventriculography or gated SPECT, compared with echocardiography as the gold standard method.

Material And Methods: A prospective, transversal, observational, and open study including all orthotopic heart transplant recipients between January 1, 1993 and December 31, 2010 was realized after signed Informed Consent, and we performed echocardiography, radionuclide ventriculography and gated SPECT in 14 patients. Normal value for left ventricle ejection fraction was considered 50% in all the methods.

Cardiothoracic surgery in perspective. An analysis required by other specialties?

Cardiothoracic surgery is one of the younger surgical specialties. We present a review of current and future needs for assistance derived of life expectancy and the main causes of mortality. We also analyze the profile of the cardiothoracic surgeon, duration of professional life, and how knowledge is transmitted.

Coronary artery bypass grafting surgery with minimal extracorporeal circulation system.

Background: For coronary artery bypass graft (CABG) surgery, cardiopulmonary bypass (CPB) is required for many patients. However, this procedure has several risks. Our objective was to test the hypothesis that the minimal extracorporeal circulation circuit (MECC) is more advantageous than CPB for CABG surgery.

Prognostic value of serum levels of interleukin-6 in patients with ST-segment elevation acute myocardial infarction.

Background: Interleukin-6 (IL6) plays a role in atherogenesis as well as in most atherothrombotic phenomenon such as ST-segment elevation acute myocardial infarction (STEAMI). Our objective was to evaluate serum levels of IL6 as prognostic value for major clinical in-hospital events in patients with STEAMI.

Methods: We studied consecutive patients with diagnosis of STEAMI according to ACC/AHA/ESC criteria.

[Thoracic aortic aneurysm associated with aortic coarctation without previous surgery: report of two cases].

The aorta usually becomes aneurysmatic as a result of hemodynamic effects. It is uncommon in children and less frequently associated with aortic coarctation. Aneurysmatic formation is rare without previous endovascular or surgical procedures.

[Surgical treatment of an innominate artery aneurysm: case report of incidental finding during myocardial revascularization].

Innominate artery aneurysms are an uncommon pathology. There are several pathogenic mechanisms involved in their formation, and patients are usually asymptomatic. However, different clinical presentations are possible.

[Outcomes of off-pump coronary artery bypass grafting in females].

Background: Women have more risk factors for coronary bypass graft surgery such as diabetes, high blood pressure, obesity, heart failure and shorter height (less body surface), compared with men. However, off-pump coronary artery bypass grafting demonstrates more benefits in females because of lower mortality, fewer postoperative respiratory complications, shorter hospital stay and improved outcome index.

Methods: We designed a retrospective study from the clinical files of females who underwent off-pump coronary artery bypass graft surgery in our hospital.