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Introduction: Congenital heart disease (CHD) has an incidence of 8-10 cases per 1000 live births. In Mexico, there are 18,000-20,000 new cases per year. Most tertiary care centers for CHD attend only pediatric population; the Mexican Institute of Social Security (IMSS) has a clinic that attends pediatric and adult population., Objective: To analyze the demographic aspects of the CHD clinic of IMSS., Methods: From 2011 to 2016 a cross-sectional study of the CC clinic of a third level hospital of the IMSS, including all patients with confirmed structural heart disease of recent diagnosis was carried out. The sex, age, reference entity, antecedent of pregnancy and treatment were registered. The population was divided into age ranges (<2 years, 2.1-6 years, 6.1-10 years, 10.1-17 years and >17.1 years). Descriptive statistics and χ 2 test were used in qualitative variables., Results: 3,483 patients with CHD (male:female ratio, 0.8:1.2) were included. Increased pulmonary flow acyanogenic cardiopathies were the most frequent CHD group (47.2%), with atrial septal defect being the most frequent diagnosis overall; 25.6% were adults and 35% of women with a history of pregnancy. Chiapas was Federal entity with greater proportion of patients diagnosed in the adult stage (33.82%); 7% were not candidates for any treatment for complications of the disease., Conclusions: CHD is a late diagnosis; it is necessary to create a national register to promote new health policies and a rational distribution of resources for these patients., (Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.)

Background: Left-sided cardiac obstructions represent 15% of congenital heart disease (CHD). The treatment in adults is surgical; however, balloon dilation by interventional catheterization can alleviate the symptoms in pediatric patients to allow them to reach the target height. The aim was to determine the survival and the factors associated with reintervention in patients with CHD with left-sided obstruction treated with balloon angioplasty., Methods: A cohort study was conducted in patients aged 4 to 17 years with left-sided heart obstruction (valvular stenosis [VS], supravalvular aortic stenosis [SAS], coarctation of the aorta [CA]) successfully treated with balloon angioplasty. The follow-up was of 10 years and the outcome variable was the restenosis with reintervention criteria. Pediatric stage at the time of the procedure, nutritional status, residual gradient, and presence of genetic syndromes were considered prognostic variables. For statistical analysis, measures of central tendency and dispersion were used. Chi squared was employed in qualitative variables and Kruskal-Wallis in quantitative variables., Results: We had a total of 110 patients: 40% had CA, 35% VS, and 25% SAS. 39% required reintervention: 80% in SAS, 35% in CA, and 14% in VS., Conclusion: The intervention balloon is a stopgap measure that allows patients with left-sided obstructions to reach the target height.

Background: The patent ductus arteriosus (PDA) represents one of the most prevalent diseases in hospitals which treat congenital heart diseases (CHD). Currently, in groups of more than 1 year of age percutaneous closure it is the standard therapy. The aim of this paper is to determine the frequency, characteristics and treatment of PCA in congenital heart disease service at the a Cardiology Hospital in Mexico., Methods: In clinical CHD our hospital, a descriptive study of 2010-2015 of patients who were treated with percutaneous closure PCA and surgery was performed. They were divided into the following ages: infant, preschool, children, adolescents and adults. The absolute frequencies were recorded., Results: 187 patients of preschool and school which accounted for 60% of the total sample were obtained. Percutaneous closure catheterization was performed in 90%; 2% of complications were recorded., Conclusions: In this clinic, the PCA is treated mostly by interventional catheterization in most stages of the human being with minimal complications.

Background: Myocarditis is the inflammation of the myocardial tissue, primarily caused by viral infection. Dilated cardiomyopathy (MD) is the most serious complication. Immunomodulatory therapy is not validated in these patients; however, it appears to offer benefits in the prognosis of this disease. The aim of this work was to determine the prognosis of immunomodulatory therapy in the development of MD in pediatric patients with viral myocarditis effect., Methods: A retrospective cohort of patients between 4 and 17 years diagnosed with viral myocarditis was integrated. It was considered as the main exposure treatment, which was divided into two types: normal (drugs targeted for heart failure and antiviral exclusively) and immunomodulatory (hyperimmune immunoglobulin, azathioprine and prednisone plus usual treatment). Time between diagnosis and treatment, history of asystole and positive for enterovirus and adenovirus antibodies: as measured confounders. The follow-up was 48 months. The outcome variable was the MD (LV diastolic diameter > + 2 Z-score and positive biopsy)., Results: 31 patients were obtained with a median of 5 (4-15) years; 6 received immunomodulatory therapy and regular rest. The MD was presented in 17% of patients exposed to immunomodulatory therapy vs. 35% traditional, with HR = 0.5 (0.1-0.7)., Conclusions: Inmunodulatory therapy is a protective factor for MD in patients with viral myocarditis.

Unlabelled: Congenital coronary artery fistulas are uncommon anomalies, however themselves may resemble the whole spectrum of cardiac manifestations. Clinical presentations vary considerably from adults to children., Material and Methods: patients with coronary artery fistula diagnosed by selective coronariography in the period from 2000 to 2007 were included., Results: 7 cases were found, 4 children, mean age 6.5 years, and 3 adults, mean age 25.6 years. The fistulae originate from the left coronary artery in 3 children, 2 connect to the pulmonary artery an one to the right atrium, in one child the fistula originated from the right coronary artery and terminated at the right ventricle. In the 3 adult patients, the fistula originated from the right ventricle, two connected to the right ventricle and one to the coronary sinus. Two children were operated on successfully and are asymptomatic 1 and 4 years later. In an adult patient with surgical ligation was performed, 4 weeks later developed an uncomplicated myocardial infarction. We reviewed the literature available and were compared with our cases., Conclusions: The clinical manifestations and hemodynamic features differ in childhood and adulthood. Coronary angiography is the primary diagnostic tool. Surgical treatment has low mortality and morbidity.

Ectopia cordis is an extremely rare cardiac anomaly. The heart is localized partially or totally outside the thorax cavity. This anomaly occurs as an isolated defect or combined with others midline defects. Cantrell and colleagues described, in 1958, a syndrome including defects of the abdominal wall, sternum, diaphragm, pericardium and heart. There are few successful surgical cases with this pentalogy. We describe a case with this Cantrell's pentalogy. The cardiac malformation was a univentricular heart with pulmonary stenosis. The patient underwent successful surgical palliation with a systemic-to-pulmonary anastomosis and uneventful recovering.

The primary cardiac tumors are inusual, the incidence varies in all the ages between 0.005 to 0.05%. In pediatrics patients the incidence is 0.27%. The more frequent tumors during the childhood are the cardiac rhabdomyomas. These tumors are considered benigns. The clinical expression is wide, in the most the cases, the patients are asymptomatic and are detected by murmurs. In the prenatal age are manifested by arrhythmias or hydrops fetalis. The neonates and children may be show cardiac arrhythmias, low cardiac index and sudden cardiac death. The association with tuberous sclerosis had been reported in 81%. We present a neonate with cardiac rhabdomyoma diagnosed in the newborn period when he was asymptomatic, however in the follow-up he developed cardiac failure by obstruction in the out flow tract of the right ventricle. He underwent open cardiac surgery to resect the obstruction. Five months after surgery, the patient remain asymptomatic.