Publications by authors named "Samuel Ramirez-Marroquin"

Background: Congenital heart disease (CHD) survival rate has improved dramatically due to advances in diagnostic and therapeutic techniques. However, concerning the unrepaired CHD population of moderate and severe complexity, the data regarding risk predictors and surgical outcomes are scarce. Our aim was to describe the surgical results and predictors of in-hospital outcomes in adult patients with moderate-to-severe complexity CHD that were not repaired in childhood.

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Introduction: Heart valve bioprostheses are the gold standard for aortic valve surgical replacement in selected patients.

Objective: To evaluate the safety and efficacy of the National Institute of Cardiology (INC) bioprosthetic heart valve in humans.

Methods: Single-center study that included 341 patients who underwent single surgical aortic valve replacement with INC heart valve.

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Treatment of ascending aorta disease is surgical; however, some series have evaluated the effectiveness of endovascular treatment. We report the case of a patient with a ruptured pseudoaneurysm who underwent endovascular repair via the left common carotid artery. The clinical and neurological evolution was satisfactory during the in-hospital follow-up.

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• Clinical signs are not useful for detecting DVT in critically ill COVID-19 patients. • DVT occurs despite full dose anticoagulation in critically ill COVID-19 patients. • Severe COVID-19 patients present a high prevalence of bilateral DVT.

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Purpose: It has been proposed that the cardiovascular effects of obesity are related to epicardial adipose tissue (EAT), which seems to play an active role on the development and calcification of atherosclerotic plaques, but the mechanisms are still unknown. Therefore, the aim of this study was to determine whether the EAT expresses the genes of calcifying factors and whether such expression is associated with the body mass index (BMI) and with the presence of coronary artery calcium (CAC) in patients with coronary artery disease (CAD).

Patients And Methods: Forty-three patients with CAD were enrolled specifically for this study, and their CAC score and EAT volume were determined by computed tomography.

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Article Synopsis
  • Delayed sternal closure (DSC) is often used in pediatric cardiac surgery for patients with severely impaired hearts, showing a higher risk profile compared to standard sternal closure (PSC).
  • During a 10-year study, outcomes were analyzed between 259 DSC cases and 2066 PSC cases, revealing that DSC patients had higher overall mortality rates (22% vs. 8.7%) and a significant risk of developing mediastinitis, particularly if closure occurs four days post-surgery.
  • The primary reasons for DSC were hemodynamic instability in younger patients and bleeding in older ones, indicating the need for careful management of post-surgery recovery.
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Background: The indications for pediatric coronary revascularization are diverse. There are a large proportion of patients with sequelae of severe inflammatory diseases such as Kawasaki disease, and other less common causes.

Methods: Retrospective review of ten pediatric patients undergoing coronary artery bypass surgery from January 2004 to December 2016.

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Background: Surgical repair of common arterial trunk (CAT) by means of a homograft conduit has become a standard practice. We report our experience in the correction of this heart disease with a handmade bovine pericardial-valved woven Dacron conduit as an alternative procedure to homografts, with a focus on early, mid-term, and long-term results.

Methods: We designed a retrospective study that included 15 patients with a mean age of 1.

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  • The Fontan operation is a crucial procedure for patients with univentricular hearts, but it can impact heart function and recovery when done with cardiopulmonary bypass (CPB).
  • A study compared patients who had the Fontan surgery with and without CPB from 2009 to 2012, noting key differences in recovery outcomes.
  • Results showed that while both groups had similar hospital stays, patients without CPB required less pharmacologic support and had no reported deaths, indicating that the surgery can be safely performed without it.
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  • Endovascular treatment is preferred over open surgery for patients with complicated acute thoracic aortic syndromes, particularly affecting the descending thoracic aorta, due to limited data on long-term outcomes.
  • The study analyzed 94 patients, with 63 receiving endovascular repair and 31 undergoing open surgery, focusing on those with complications like rupture and malperfusion.
  • Results showed a 5-year survival rate of 92% for endovascular treatment compared to 51.4% for surgical treatment, indicating that endovascular repair is both safe and effective for long-term outcomes in these cases.
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Introduction: Surgical treatment is accepted as conventional treatment of patients with acute aortic syndrome associated to ischemic complications. Promising results of thoracic endovascular aortic repair (TEVAR) has expanded its indication to a variety of thoracic aorta pathologies.

Objectives: The objective of this study was to evaluate the safety and efficacy of TEVAR during the in-hospital period and at mid-term follow-up, and compare with medical and surgical treatment in patients who presented with acute aortic syndrome (AAS) type B.

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Introduction: Current world tendency is the detection of health problems in order to offer solution alternatives by means of the development of computarized data bases.

Objective: To present the results of a computerized data base developed for the registry of pediatric cardiac surgery with the support of Asociación Mexicana de Especialistas en Cardiopatías Congénitas (AMECC, A.C.

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Background: Currently, there is a spreading worldwide tendency to characterize health issues and to propose alternative solutions via the creation of computerized databases. The aim of this study was to present the results in a computerized database of pediatric cardiac surgeries developed under the auspices of the Mexican Association of Specialists in Congenital Heart Diseases (Asociación Mexicana de Especialistas en Cardiopatías Congénitas A.C) and coordinated by the collegiate group of Pediatric Cardiology and Surgery as petitioned by the National Institutes of Health and High Specialty Hospitals Coordinating Commission.

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Article Synopsis
  • The Mexican Association of Specialists in Congenital Heart Disease (AMECC) was established in 2008 to enhance health care for children with congenital heart disease in alignment with the World Society for Pediatric and Congenital Heart Surgery's mission.
  • A national plan for regionalized care was developed alongside the National Health Secretary, which included a national survey to gather information on technological and human resources available for managing congenital heart disease.
  • A comprehensive national database was created using international nomenclature to track care advances and outcomes, with the goal of benefiting other countries facing similar challenges in congenital heart disease management.
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Heart development consists in a group of complex and specific morfogenetic interactions, that requires the proper activity of each factor implicated in this process. Congenital heart defects (CHD) are a group of multifactorial complex diseases with environmental and genetic factors playing important roles. There is not an exact relation between molecular mechanisms and morphological defects in CHD, because in most of the cases the proper development of an anatomical structure implies the adequate function of several pathways that may depend of the action of different genes.

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  • The study aimed to assess the outcomes and aortic remodeling in Marfan syndrome patients with type B dissection treated using endovascular repair (TEVAR).
  • A total of 10 patients who met the criteria for Marfan syndrome and had severe complications underwent TEVAR, with a notable 90% classified as high-risk for traditional surgery.
  • Results indicated a 20% cumulative mortality rate and high incidences of secondary complications like endoleaks, but survival rates at 8 years were comparable to those of traditional surgical interventions.
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  • The study examines 26 years of clinical management and treatment of scimitar syndrome in patients under 18 at the National Cardiology Institute.
  • The researchers analyzed 22 patients diagnosed with scimitar syndrome between 1984 and 2010, finding a higher prevalence of congestive heart failure and severe pulmonary hypertension in those under one year old.
  • The findings highlight the importance of early diagnosis and intervention in infants showing symptoms, as these conditions significantly impact mortality risk.
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The modified Fontan procedure represents the final stage of reconstructive surgery for most patients with functionally univentricular hearts. Although outcomes following Fontan procedures performed at sea level are widely reported, less has been documented and reported concerning outcomes in regions at high altitude. To clarify the main features involved, we present our institutional experience with Fontan operations performed in Mexico city (2,240 m above the sea level), with an emphasis on historical evolution of treatment.

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The morphopathology of tetralogy of Fallot with pulmonary atresia is detailed as a spectrum of variations which is the foundation to highlight the surgical anatomy of this cardiopathy and it is the embryological basis which determines its structure. Thirty five hearts were studied with the methodology of the segmental sequential system. The atrial situs, the connections between the cardiac chambers and between the right ventricle and the arterial pulmonary vasculature were determined.

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Article Synopsis
  • Congenital cardiopathies are the most common congenital malformations, with global prevalence ranging from 2.1 to 12.3 per 1000 newborns, potentially leading to high infant mortality rates.
  • A country-specific estimate suggests that between 10,000 to 12,000 infants may be affected by cardiac malformations, highlighting the need for data on the occurrence and types of these conditions.
  • Regionalizing medical resources and creating a reliable database could not only improve patient care but also aim to decrease infant mortality rates associated with congenital heart defects.
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Based on the sequentiality principle, this review proposes a practical method that allows the systematization of the anatomic diagnosis of congenital heart disease. We emphasize the need to use sequential connection between the different cardiac segments: atria, ventricles and great arteries. Five ordered steps are defined, which include determination of atrial situs and of the connection features between the ventricles and the great arteries.

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Surgical development of mitral valve repair techniques in pediatric patients has been slow because of the great variety in the presentation of congenital mitral valve malformations and the still unknown growing effect over the complex mitral valve apparatus. The aim of this study is to review our early an mid-term institutional outcomes in surgical repair of congenital mitral valve malformations. We studied retrospectively 14 patients with surgical repair of congenital mitral valve malformations in a 5 year period.

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