Well-Being and Agency in Parents of Children With Congenital Heart Disease: A Survey in Chile.

Background: Parents of children having congenital heart diseases (CHDs) develop symptoms of depression, distress, anxiety, and hopelessness more frequently than parents of healthy children. Associated with the described symptoms, parents may experience a lack of control and disempowerment, which decreases the parent's agency, a construct from development studies, and which may have negative consequences on adherence to treatment. The primary aim of this study was to assess the effect of medical treatment on well-being and agency in parents of children having CHDs, in Chile, and to compare it with reference values.

[Hypoplastic left heart syndrome: 10 year experience with staged surgical management].

Unlabelled: Hypoplastic left heart syndrome (HLHS) is a lethal congenital heart disease in 95% of non-treated patients. Surgical staging is the main form of treatment, consisting of a 3-stage approach, beginning with the Norwood operation. Long term survival of treated patients is unknown in our country.

[Electrical storm in Brugada syndrome successfully treated with isoproterenol. Report of a case].

We report a 22-year-old male who experienced several episodes of syncope within a timeframe of few hours. In the emergency room, multiple ventricular fibrillation episodes where documented along with a type 1 Brugada ECG pattern. Isoproterenol in continuous infusion was started, normalizing the ECG and avoiding further arrhythmia recurrences.

[Cardiac resynchronization therapy in patients with heart failure: a 10-year experience].

Background: Multiple randomized trials support the clinical benefits of cardiac resynchronization therapy (CRT) in patients with heart failure (HF) and ventricular dyssynchrony. Since the year 2000 this therapy has been increasingly used in Chile.

Aim: To describe the clinical characteristics and follow-up of HF patients undergoing CRT in a single Chilean university hospital during the last 10 years.

[Placement of a biventricular resynchronization device in a patient with a persistent left superior vena cava: report of one case].

Persistent left superior vena cava is the most common venous congenital malformation and is usually asymptomatic. Its presence could increase the difficulty for transvenous lead implantation. We report a 71-year-old woman with an idiopathic dilated cardiomyopathy, atrial fibrillation and heart failure that required biventricular resynchronization therapy.

[Twiddler syndrome: report of one case].

We report a 26 year old patient who had a single chamber pacemaker implantation one year before. During a routine pre-operative evaluation, pacemaker dysfunction was demonstrated due to sensing and pacing failure, associated to left pectoral muscle rhythmic contraction. Chest X-ray confirmed Twiddler syndrome, in which twisting or rotation of the device inside the pocket results in lead dislodgement and device malfunction.

Cardiac resynchronization therapy (and multisite pacing) in pediatrics and congenital heart disease: five years experience in a single institution.

Introduction: Clinical evidence supports the use of cardiac resynchronization therapy (CRT) in adults with heart failure, but experience in pediatrics and congenital heart disease (CHD) is limited in terms of patient numbers and follow-up. We sought to determine the functional assessment and clinical outcomes in pediatric and CHD CRT patients followed uniformly at one institution.

Methods: Retrospective review of 60 consecutive patients who underwent CRT between 2002 and 2007.

How revealing are insertable loop recorders in pediatrics?

Introduction: An insertable loop recorder (ILR) in patients with infrequent syncope or palpitations may be useful to decide management strategies, including clinical observation, medical therapy, pacemaker, or implantable cardioverter defibrillator (ICD). We sought to determine the diagnostic utility of the Reveal ILR (Medtronic, Inc., Minneapolis, MN, USA) in pediatric patients.

[Permanent pacemaker implantation in patients with persistent left superior vena cava and absent right superior vena cava. Report of three cases].

Persistent left superior vena cava and absent right superior vena cava is an uncommon anatomical association. This is a challenging situation for permanent pacemaker implantation. We report three patients with this anomaly and a permanent pacemaker successfully implanted through the left superior vena cava and coronary sinus, without acute or chronic complications.

[Experience in the use of a new endocardial stimulation electrode].

Background: Since February 2002, Flextend electrode catheters are used at the Cardiovascular Unit of the Catholic University Clinical Hospital. These transvenous catheters have an IS-1 connector, silicone coating, active fixation and retractile helix with dexamethasone acetate.

Aim: To report early and one year results using Flextend catheters.

[Treatment of beneficiaries of the Chilean public health system with arrhythmias in a University Clinical Hospital].

Background: The costs of medical care increase along with technological advances. Therefore, highly complex and expensive procedures should be performed in a limited number of institutions.

Aim: To report the initial experience on electrophysiological studies performed to beneficiaries of a public health insurance system in Chile (FONASA).

[Radiofrequency ablation of ventricular tachycardia in a patient after surgery for Tetralogy of Fallot: case report].

Ventricular tachycardia is one of the most feared complications after surgical repair of Tetralogy of Fallot and it is associated with sudden death. We report a 26 years old female with a history of surgical repair of Tetralogy of Fallot at age of 4 year-old, who developed sustained ventricular tachycardia despite antiarrhythmic drugs. She was successfully treated with radiofrequency catheter ablation.

[Chest pain and ST segment abnormalities in patients with accessory atrioventricular pathways. Report of three cases].

We report three patients with pre-excitation syndrome that resembled an acute coronary syndrome. A 65 years old woman, consulting in the emergency room for palpitations and retrosternal pain. EKG showed regular tachycardia and ST depression that reverted spontaneously after an episode of vomiting.

[Results of radiofrequency ablation of the inferior vena cava-tricuspid valve isthmus for atrial flutter].

Background: Radiofrequency ablation of the inferior vena cava-tricuspid valve isthmus relieves atrial flutter in 95% of cases.

Aim: To evaluate the long term results of radiofrequency ablation of the inferior vena cava-tricuspid valve isthmus in atrial flutter.

Material And Methods: Retrospective review of 86 patients with common atrial flutter, treated with radiofrequency ablation of the isthmus, while in sinus rhythm or flutter.

[New surgical approach to device closure of multiple apical ventricular septal defects].

We present an alternative technique for closing multiple ventricular septal defects difficult to access during surgery. A guidewire is advanced through the right ventricular free wall and through the main apical defect to the left ventricle, and this approach is used to place an Amplatzer device to occlude the ventricular septal defects. The procedure is performed in the beating heart, under intraoperative transesophageal echocardiographic guidance, and without extracorporeal circulation.

[Immediate results of palliative surgery for different forms of univentricular heart using the Norwood procedure].

Background: Norwood procedure is used as the first stage in the palliative treatment of the hypoplastic heart syndrome and can be used, with some technical modifications, in other forms of univentricular heart with aortic stenosis or hypoplasia. These patients have a high mortality (50%), derived from the procedure itself and from their abnormal physiological status.

Aim: To report our experience with the Norwood procedure.

[Fontan procedure: early and mid-term results with total cavopulmonary anastomosis].

Background: During the last five years, 65 patients with univentricular heart have been treated surgically in our institution, according to a protocol of staged operations that have been previously reported.

Aim: To evaluate the early and mid-term outcome of those patients that have completed their staging protocol by means of a Fontan procedure.

Patients And Methods: Between April 1996 and June 2001, 23 patients (age 16 to 223 months) underwent a Fontan procedure, 15 with an intracardiac lateral tunnel technique and 8 with an extracardiac conduit.