[Vena cava thrombectomy in kidney cancer. Report of 32 nephrectomies].

Background: Vena cava (VC) involvement in kidney tumors occurs in 4 to 10% of cases, and is associated with a higher mortality. Nephrectomy with thrombectomy of the VC, performed by a multidisciplinary team, improves survival.

Aim: To report a series of consecutive nephrectomies with caval thrombectomy performed in an academic center.

Case report: Multi-site perfusion strategy for type A acute aortic dissection complicated with cerebral malperfusion.

Acute type A dissection presenting with cerebral malperfusion has high morbidity and mortality. Given the complexity of underlying vascular involvement, it is a challenging clinical scenario. Many of these patients are not deemed surgical candidates.

Initial Experience in Chile with Stent Implantation in the Right Ventricle Outflow Tract in High-Risk Patients with Tetralogy of Fallot.

Tetralogy of Fallot (ToF) treatment is difficult in patients with surgical risk factors or unfavorable anatomy. Stent implantation in the right ventricular outflow tract (RVOT) is an option for these patients. We report our initial experience in Chile with RVOT stenting in patients with ToF.

Epithelioid pituicytoma: An unusual case report.

Background: Pituicytomas are considered World Health Organization Grade I malignancies. Until September 2017, a total of 81 cases of pituicytomas were diagnosed and described in literature. We present such a case in which histopathology shows an epithelioid pattern, a rare variant of pituicytoma.

[Results of a national program of pediatric heart transplantation: strengths and weakness].

Unlabelled: Pediatric heart transplantation is an effective therapy to treat advanced heart failure in children.

Objectives: To analyze the immediate and mid-term results of pediatric patients listed for heart transplantation.

Patients And Methods: Registration of patients admitted to our transplant protocol between October 2001 and July 2016 were reviewed, analyzing demographic data, diagnosis, status at the time of listing, waiting time until transplantation, donor data, use of ventricular assist device, hemodynamic data, complications and global mortality.

[Surgical site infections in children undergoing cardiac surgery with delayed sternal closure: Case-control study].

Introduction: Surgical site infections (SSI) are an important cause of morbidity in pediatric cardiac surgery. Risk factors in patients requiring delayed sternal closure (DSC) are unknown.

Aim: To report the rate of SSI in children undergoing cardiac surgery with DSC and determine the risk factors.

[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.

[Influence of the referring health care systems and other factors on the results of mitral valve replacement].

Background: There is no consensus regarding which risk factors influence the outcome of mitral valve replacement.

Aim: To study the effects of the referring health care system and other factors on the results of mitral replacement.

Patients And Methods: We included 632 patients operated between 1990 and 2010 receiving the St Jude prosthesis.

Survival of newborn infants with severe respiratory failure before and after establishing an extracorporeal membrane oxygenation program.

Background: Severe hypoxic respiratory failure is a leading cause of neonatal mortality in Chile. Extracorporeal membrane oxygenation improves survival in neonates with hypoxic respiratory failure.

Objective: To determine the impact of the establishment of a Neonatal Extracorporeal Membrane Oxygenation Program on the outcome of newborns with severe hypoxic respiratory failure in a developing country.

[Aortic valve replacement with bioprosthesis in patients 70 years old or older with aortic stenosis].

Background: Aortic valve stenosis is the most prevalent valvulopathy in the elderly, but it is frequently undertreated.

Aim: To assess early and long term results of valve replacement with bioprostheses in patients 70 years old or older with aortic stenosis.

Patients And Methods: A review of the database of the Cardiovascular Surgery Service of our hospital, for the period 1990-2007, identified 156 patients with aortic valve stenosis, aged 76.

Improvement of survival in infants with congenital diaphragmatic hernia in recent years: effect of ECMO availability and associated factors.

Background/purpose: Survival of patients with congenital diaphragmatic hernia (CDH) depends both on non-modifiable congenital conditions and on modifiable pre and postnatal management. ECMO improves survival up to 80% in neonates with CDH in the best ECMO centers worldwide. The first Neonatal ECMO Program in Chile was started in our University in 2003.

[Early and late morbidity and mortality of aortic valve replacement with mechanical or biological prostheses during the last decade: the gold standard].

Background: There is a growing interest in alternative techniques for aortic valve replacement (AVR). Therefore it is important to have updated results of conventional AYR as a valid comparative standard.

Aim: To evaluate both perioperative and late morbidity and mortality in patients undergoing conventional AVR, with either mechanical (RVAm) or biological (RVAb) prostheses.

[Ventricular assist device as a bridge to transplant in patients with cardiogenic shock. Preliminary experience in Chile with ABIOMED BVS 5000].

Hospitalization and death due to heart failure and cardiogenic shock is frequent and currently is increasing among the adult population. Although cardiac transplantation is the most effective treatment in patients with end-stage heart failure, its availability is limited. While waiting for transplantation, some patients become refractory to treatment and deteriorate progressively.

Renal function and cardiopulmonary bypass in pediatric cardiac surgical patients.

We studied prospectively the perioperative changes of renal function in nine children undergoing cardiac surgery with cardiopulmonary bypass (CPB). Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured with inulin and (131)I-hippuran clearances before CPB, during hypo and normothermic CPB, following sternal closure and 1 h postoperatively. Urinary alpha glutathione S-transferase (alpha GS-T) was measured pre- and postoperatively as a marker for tubular cellular damage.

[Long-term results of repair versus replacement for degenerative mitral valve regurgitation].

Background: Mitral valve repair is considered better than mitral valve replacement for degenerative mitral regurgitation.

Aim: To evaluate late clinical results of mitral valve repair as compared to mitral valve replacement in patients with degenerative mitral regurgitation.

Patients And Methods: All patients subjected to open heart surgery for degenerative mitral regurgitation between 1990 and 2002 were assessed for surgical mortality, late cardiac and overall mortality, reoperation, readmission to hospital, functional capacity and anticoagulant therapy.

[Extracorporeal membrane oxygenation (ECMO): consolidation of a neonatal-pediatric program in Chile and report of three cases].

Extracorporeal membrane oxygenation (ECMO) improves survival in neonatal and pediatric patients with reversible severe respiratory or cardiac failure, in whom intensive treatment fails. Since 1999, a multidisciplinary team is trained to form the first neonatal-pediatric ECMO center in Chile, according to the norms of the Extracorporeal Life Support Organization (ELSO). During 2003 the first three patients were admitted to the program: a male newborn with pulmonary hypertension, a 38 days old female operated for a total anomalous pulmonary venous connection and a 3 months old male with a severe pneumonia caused by respiratory syncytial virus.

Nitric oxide in pulmonary arteriovenous malformations and Fontan procedure.

Pulmonary arteriovenous malformations are a well documented complication of superior cavopulmonary (Glenn) connections. We report the successful management of a case of severe hypoxemia in the early postoperative period of a patient who underwent the Fontan operation. The patient had previously been diagnosed with pulmonary arteriovenous malformations; the use of inhaled nitric oxide was followed up with reversal of life-threatening hypoxemia.

[Valve repair surgery for incompetent bicuspid aortic valves].

Background: Surgical valve repair is a good alternative for correction of incompetent bicuspid aortic valve.

Aim: To report the early and late surgical, clinical and ecochardiographic results of surgical repair of incompetent bicuspid aortic valves.

Patients And Methods: Retrospective review of medical records of 18 patients aged 19 to 61 years, with incompetent bicuspid aortic valve in whom a valve repair was performed.

[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.

[Valve repair surgery in infectious endocarditis].

Background: Valve replacement has been the treatment of choice for patients with valvular complications of infectious endocarditis (IE). However, excellent results with valve repair allowed it to become a new therapeutic alternative for these patients.

Aim: To evaluate the results of valve repair in patients with valvular complications of IE.

[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.

[Long-term results of repair surgery of degenerative mitral insufficiency].

Background: Mitral valve repair is probably the procedure of choice for the surgical treatment of degenerative mitral insufficiency.

Aim: To evaluate the late results of mitral valve repair in degenerative mitral insufficiency.

Patients And Method: The records of 88 patients who underwent mitral valve repair for degenerative mitral insufficiency from December 1991 through June 2002 were reviewed.

[Axillary artery cannulation for extracorporeal circulation].

Background: When the ascending aorta and the femoral artery cannot be used for extracorporeal circulation, an emerging alternative is the use of axillary artery.

Aim: To report the experience using the axillary artery for extracorporeal circulation.

Patients And Methods: Between November 1998 and May 2002, 22 patients (14 male) were operated with extracorporeal circulation, cannulating the axillary artery.