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Background: Congenital heart disease is the most common birth defect and the leading cause of childhood mortality in high-income countries. In these countries, the prognosis for a child born with congenital heart disease is excellent, with over 90% achieving adulthood. However, in the low and lower-middle-income countries, as ours, the outlook is starkly different. In Chiapas, because of the progress of the hemodynamics program, more and more types of congenital heart diseases are susceptible to being treated by cardiac catheterization., Objective: To show the global experience of the interventionism in congenital heart diseases in Chiapas from its inception to recent days., Method: Through a retrospective study from April 2016 to June 2023, we reviewed the electronic files of the total of patients who underwent cardiac catheterism during the same period of time., Results: A total of 1000 procedures were performed, 581 in female patients, with a median age of 4 years (1 day to 77 years). Of the total procedures, 115 (11.5%) were diagnostic catheterizations and 885 (88.5%) were interventional., Conclusions: Cardiac catheterization in pediatrics in Chiapas has displaced cardiac surgery in a large percentage, and the results that have been obtained are undoubtedly encouraging, which already represents a decentralization in the care of congenital heart diseases in our country.

Complications related to pulmonary artery stenting are potentially life-threatening. We reported a novel technique of how to achieve the introduction of a partial dilated stent into a long sheath using a snare in the event of a iatrogenic perforation of a balloon catheter.There are no publications of similar techniques describing successful resolution of this type of complication.

Introduction: As a result of technological advances, more and more types of congenital heart diseases are susceptible to being treated in the hemodynamic laboratory. The sum of more advanced imaging techniques as well as the development of a diversity of devices specially manufactured for use in children has allowed a better selection of patients and therefore that many of them can be corrected through cardiac catheterization or some patients with more complex congenital heart diseases require fewer surgical procedures or, if they do require them, that these may be of less complexity and risk., Objective: We decided to show the global experience of the interventionism in congenital heart diseases in Chiapas from its inception to recent days., Methods: Through a retrospective study from April 2016 to August 2020, we reviewed the electronic files of the total of patients who underwent cardiac catheterism during the same period of time., Results: A total of 510 procedures were performed, 300 in female patients, with a median age of 4 years (8 days - 77 years). Of the total procedures, 67 (13.1%) were diagnostic catheterizations and 443 (86.9%) were interventional., Conclusions: Cardiac catheterization in congenital heart disease in Chiapas has become a very valuable option with encouraging results which represents a possible decentralization in the care of congenital heart diseases in our country.

Objectives: To demonstrate safety and efficacy of using different generations of softer Amplatzer™ devices for ventricular septal defect (VSD) closure to avoid serious complications at follow-up., Background: Transcatheter closure of perimembranous ventricular septal defects (PmVSD) is a well-established procedure; however, it is associated with unacceptable incidence of complete heart block. Great advantages have been achieved by using softer devices for VSD transcatheter closure. The first and second generation of Amplatzer™ occluders (AVP II, ADO, and ADO II) seem to offer a safe and attractive alternative for this procedure. These devices can be delivered using either an arterial (retrograde) or venous (prograde) approach., Methods and Results: Patients with congenital PmVSD who underwent transcatheter closure using ADO, ADO II, and AVP II devices were included. Primary end point was to determine efficacy and safety of these generations of devices and to determine the incidence of complications at follow-up (complete AV block and aortic/tricuspid/mitral regurgitation). One hundred and nineteen patients underwent VSD closure at a median age of 5 years (8 months-54 years). During the catheterization, there were only minor complications and at follow-up of 36 ± 25.7 months (up to 99 months), the closure rate was high of 98.3% and freedom from AV block was 100%., Conclusions: The use of softer Amplatzer™ devices is a good alternative to achieve PmVSD closure safely with no risk of AVB during the procedure or at midterm follow-up., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Roberto Mijangos-Vázquez et al.)

Objectives: The objective of this study was to demonstrate the safety and feasibility of using the new Cardia Ultrasept II™ device with interposed Goretex patch referring to the perforation of polyvinyl alcohol membrane., Background: Great advances have been made in the development of devices for closure of atrial septal defect. The Cardia Ultrasept II™ with interposed Goretex patch is the modified last generation of Cardia devices, having the advantage of a super-low profile within the atria and an integral locking delivery-retrieval mechanism that ensures safe deployment. In addition, with the interposition of the Goretex, it has been possible to abolish perforation of Ivalon's membrane as a complication.Methods and resultsPatients with ostium secundum atrial septal defect with surrounding rims with a minimum length of 5 mm and who underwent atrial septal defect closure with the new Ultrasept II™ with Goretex patch were included from two paediatric cardiac centres. Primary end point was to determine perforation of the Goretex membrane at follow-up; secondary end point included right ventricular diastolic diameter. In total, 30 patients underwent atrial septal defect closure at a median age of 6 (1-29) years. At follow-up for 6 (range, 1-15) months, freedom from perforations was 100%. A continuous decrease in right ventricular diastolic diameter was found with an initial median of 30 (25-49) mm and after catheterisation of 27.5 (18-33) mm, p=0.01, and Z-score of 2.6 (1.7-3.6) versus 1.9 (1-2.9) after procedure, p=0.01., Conclusions: The new modified generation of the Ultrasept II™ device with interposed Goretex patch is a good alternative to achieve atrial septal defect closure safely and feasibly with no membrane perforation at follow-up.

Objective: Kawasaki disease (KD) is a systemic vasculitis that affects young children. Coronary artery aneurisms, ectasia and stenosis are its main complications and may lead to ischemic heart disease or sudden death. Echocardiography evaluation it's mandatory in all patients with history of KD. Left ventricular longitudinal systolic strain (LVLSS) measured by speckle tracking it's an accurate tool to evaluate global and segmental left ventricle mechanics. Clinical utility of LVLSS in children with KD hasn't been established. The goal of this study was to analyse if the presence of coronary lesions alters segmental LVLSS and if there is a relationship with the affected coronary territory., Method: Case series. A complete transthoracic echocardiography with LVLSS was performed in children with history of KD with at least 6 months after the acute phase., Results: Nine patients where studied, with a median age of 6 years (minimum 2 and maximum 17). A percentage of 56 were male, and 77% had coronary aneurisms. An abnormal LVLSS was found in 56% of the population studied. All of the patients that had an abnormal LVLSS had coronary aneurisms with stenosis or complete occlusion confirmed by invasive coronary angiography and abnormal Nuclear Medicine perfusion scans., Conclusions: On the population studied, all patients with an abnormal LVLSS had obstructive coronary lesions and ischemic heart disease., (Copyright © 2015 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.)

Objectives: Congenital vascular malformations of the major arteries in the chest have been classified into 5 groups: 1) double aortic arch; 2) right aortic arch with left ligament or persistent ductus arteriosus; 3) aberrant subclavian artery; 4) aberrant left pulmonary artery, and 5) anomalous innominate artery. We reviewed the patients with aberrant right subclavian artery and their treatment., Methods: We studied retrospectively the records of 29 patients with aberrant right subclavian artery in childhood, from January 1992 to December 2012, analyzing the following variables: age at onset, clinical manifestations, associated cardiovascular defects, diagnosis and surgical approach method., Results: We found that most patients have an asymptomatic course, only 31% of them course with symptoms during the first year of life, with an incidental diagnosis of 35% during catheterization or other imaging studies. Patent ductus arteriosus was the most frequently associated congenital malformation, with 13%. Down's syndrome was found in 21%. The most common treatment was surgical section of the aberrant subclavian artery to release the esophagus., Conclusions: This vascular abnormality must be suspected in those patients with dysphagia, dyspnea, chest pain during feeding or breathing difficulties. A significant number of patients are not diagnosed in time, some reach adulthood without a diagnosis. This malformation is often found in imaging studies when evaluating the aorta or in a gastroesophageal reflux study, in which the barium bolus reveals the extrinsic compression of the esophagus., (Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.)