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At the Hospital de Ginecobstetricia del Centro Médico "La Raza", were taken EKG to 30 healthy premature newborn during a six month period. The first EKG was recorded 3 hours after birth, the second in 8 hours, the third in 24 h, the fourth in 48 h, the fifth in 72 hours, the sixth at the end of the first week, the seventh at the fifteen days and the eighth at 30 days after birth. The mean heart rate was 135 +/- 10 beats/min in the first week. There were heart rate elevation for the first three days after birth. The QRS mean axis were + 130 +/- 25 degrees, without changes during the study time. The QTc interval in all cases was higher than 0.42 sec. The voltage of waves R and S at right and left precordial leads were similar. At this gestational age the ventricular masses are equals. The T waves changes reflected hemodynamic changes. It is concluded what the healthy premature newborn had a typical EKG as a reflex to the cardiocirculatory adaptations.

Thirteen clinical charts belonging to children with Kawasaki disease admitted to different hospitals were analyzed. The average age among the children was three years (from nine months to nine years), with a predominance of this disease in males with a ratio of 3.3:1. Echocardiograms were obtained from 10 of the patients; seven showed coronary aneurysms (70%). Other complications seen were myocarditis in six children, and one case in each of the following: arthritis, pericarditis, cardiac failure, coronary thrombosis, hydropic gall bladder and aseptic meningitis. All of the patients recovered successfully; only four of the patients with aneurysms were followed-up with an echocardiogram. The echocardiogram showed the aneurysms to have disappeared in three of the children one to five months later, and the other showed a persistent aneurysm plus dilated myocardiopathy 2.5 years later in the remaining patient. It is worth noting the high incidence of aneurysms (70%) compared to other series (20-65%) which may be due to the suspicion of this diagnosis in only typical cases.

The association of coarctation of the aorta (CoAo) and ventricular septal defect (VSD) reaches a high mortality rate of approximately 75% in the first year of life without surgical treatment. We present our experience in the study of twenty cases with this combination of congenital heart defects with ages varying from 5 days to 13 years; half of them were under 6 months of age: there was a slight female predominance. Congestive heart failure was the first clinical manifestation in 75% of the patients; all of them showed clinical evidence of VSD with pulmonary hypertension. Twelve patients were surgically treated; in five, a subclavia flap technic was used; in another five, a rhomboid patch was placed at the site of CoAo and in the remaining two, the repair was done by end to end anastomosis. Banding of the pulmonary artery was performed in two cases and both survived; in three cases, in which the CoAo and VSD repair was done simultaneously, only one survived. We have an overall surgical mortality of 25%. Due to the short follow-up we have been unable to determine which cases may require reoperation later in life.

We describe the clinical course of 120 children with tricuspid atresia (TA) attended in the Hospital de Cardiología y Neumología, "Dr. Luis Méndez", del Centro Médico Nacional. There were 61 males and 59 females. The age of presentation was in 79 newborn babies, seventeen between one and six months old, 20 between six and 24 months old, and four with two or more years old. The clinical picture was hypoxic spells in 89% and congestive heart failure in the others. The chest film showed cardiomegaly in 85%, with diminished pulmonary flow in 48%, increased flow in 27.5%, and normal in 9%. The electrocardiogram with superior left axis deviation in 94%, right atrial hypertrophy in 58%, left atrial hypertrophy in 47.5% and left ventricular hypertrophy in 96%. TA was classified as type I in 103 children, type Ic in 70, Ib in 27 and Ia in six, and type II in seventeen children, with eight IIc, six IIb and three IIa. In 44 the management was medical, 63 underwent systemic-pulmonary anastomosis, 37 of them with Blalock-Taussig shunt and Fontan procedure in thirteen children. There were 21 deaths. This survey is compared with the literature and from this point we make management recommendations.

We describe the results of surgical repair of atrial septal defects in 36 children who did not undergo pre-op cardiac catheterization. These cases were seen at the Hospital de Cardiologia y Neumología Dr. Luis Méndez del Centro Médico Nacional. There were 24 (67%) females and twelve (33%) males. The mean age was 6.4 +/- 2.4 years with a range from three to thirteen. All cases had auscultatory findings typical of atrial septal defect. Five patients with associated tricuspid murmur (chest film showed grade I cardiomegaly in 21 (58.3 per cent), grade II cardiomegaly in fifteen (41.7 percent). Pulmonary artery shadow was normal in 24 (66.6 percent) and increased in twelve (33.3%). Pulmonary blood flow was increased in all of them. Electrocardiogram showed sinus rhythm in 35 (97.2%). In one instance left atrial rhythm; all EKGs demonstrated right axis deviation, complete right bundle branch block and right ventricular hypertrophy with diastolic overload. Only three had right atrial hypertrophy. The M-mode echocardiogram showed right ventricular dilatation in all and paradoxically septal motion in 26 (72.2%). Two-dimensional echo with the subxiphoid view allowed direct visualization of the defect in all cases. We performed contrast echocardiogram in eight cases and Doppler echocardiogram in six of them. Cardiac surgery findings were ostium secundum atrial septal defect in 34 (94.4%). Two of them also had partial anomalous venous connection. All had uneventful recovery. We conclude that in typical atrial septal defects operative repair is feasible without prior cardiac catheterization.