S1409-414220000002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422000000200001 Insuficiencia cardíaca en el 2000: tratamiento farmacológico actual Speranza Sánchez Mario ,Hospital Clínica Bíblica Instituto Centroamericano de Cardiología San José Costa Rica 08 2000 2000 2 2 4
S1409-414220000002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422000000200002 Anomalías congénitas del corazón: algunos comentarios Castañeda Aldo ,UNICAR Cuidad Guatemala Guatemala 08 2000 2000 2 5 6
S1409-414220000002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422000000200003 La estenosis pulmonar valvular en lactantes menores de 4 meses: la experiencia del Hospital Nacional de Niños de San José, Costa Rica Castro Abdón Gutiérrez Rafael O’Connell Mauricio ,CCSS Hospital de Niños San José Costa Rica ,CCSS Hospital de Niños ,Hospital Roosvelt Guatemala 08 2000 2000 2 7 10

La estenosis pulmonar valvular crítica en lactantes es una emergencia. El objetivo de este estudio es conocer nuestra casuística en dos centros ( Costa Rica y Guatemala). Método: se revisaron los expedientes de 24 lactantes menores de 4 meses, 12 de ellos menores de un mes, que se presentaron con estenosis pulmonar valvular crítica y que fueron sometidos a valvuloplastía. La edad varió de un día a tres meses y el peso de 2100 a 6000 gramos. La presiones ventriculares derechas variaron de 70 a 217 mmHg antes de la dilatación y de 20 a 90 mmHg postdilatación. El gradiente transvalvular varió de 35-203 mmHg pre dilatación y de 12 a 90 mmHg post dilatación. Hubo dos perforaciones cardíacas y una terminó en sala de operaciones. CONCLUSION: La valvuloplastía pulmonar es un procedimiento sencillo, barato para nuestro medio y con resultados muy alentadores hoy día.

Critically pulmonary valve stenosis in infants is an emergency. The objective of this study is to know our cases in two centers ( Costa Rica and Guatemala). Methods: we review the records of 24 infants less than four months of age, twelve of them less than one month of age and all with critically pulmonary stenosis that suffered balloon valvotomy. The range of age was from one day to three months and the weight range was 2100-6000 grams. The right ventricle pressures range from 70-217 mmHg before dilatation and decrease to 20-90 mmHg after dilatation. The transpulmonary gradient range from 35-203 mmHg and decrease to 12-90 mmHg. Perforation of the right ventricular outflow tract occur in two cases and one was brought to operation room for exploration.One patient shows complete right bundle branch block for a short period of time. Conclusion: the pulmonary valvuloplasty is a simple procedure, cheap for our area and with good results today.

 Estenosis valvular pulmonar crítica lactantes valvuloplastía Pulmonary valve stenosis criticaly infants balloon valvotomy Kovalcin JP Forbes TJ Nihill MR Geva T Echocardiographic determinants of clinical course in infants with critical and severe pulmonary stenosis J Am Coll Cardiol 1997 29 Ovaert C Qureshi SA Rosenthal E Baker EJ Tynan M Growth of the right ventricle after successful transcatheter valvotomy in neonates and infants with pulmonary atresia and intact ventricular septum J Thorac Cardiovasc Surg 1998 115 Guarnera S Piechaud JF Kachaner J Le Bidois J Cohen L Sidi D Villain E Treatment of critical pulmonary valvular stenoses in newborn infants using percutaneous valvuloplasty: Study of 28 cases Arch Fr Pediatr 1989 46 Trowitzsch E Colan SD Sanders SP Two dimensional echocardiographic evaluation of right ventricular size and function in newborns with severe right ventricular outflow tract obstruction J Am Coll. Cardiol 1985 6 Tabatabaei H Boutin C Nykanen DG Freedom RM Benson LN Morphologic and hemodynamic consequences after percutaneous balloon valvotomy for neonatal pulmonary stenosis: medium-term follow up J Am Coll Cardiol 1996 27 Gildein HP Kleinert S Goh TH Wilkinson JL Treatment of critical pulmonary valve stenosis by balloon dilatation in the neonate Am Heart J 1996 131 Zeevi B Keane JF Fellows KE Lock JE Balloon dilatation of critical pulmonary stenosis in the first week of life J Am Coll Cardiol 1988 11 Caspi J Coles JG Benson LN Freedom RM Burrows PE Smalhorn JF Trusler GA Williams WG Management of neonatal critical pulmonic stenosis in the balloon valvotomy era Ann Thorac Surg 1990 49 Awariefe SO Clarke DR Pappas G Surgical approach critical pulmonary valve stenosis in infants less than six months of age J Thorac Cardiovasc Surg 1983 85
S1409-414220000002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422000000200004 Corrección quirúrgica de la coartación de la aorta: experiencia quirúrgica durante 30 años en el Hospital México Induni Eduardo Pucci Juan Soto Longino Alvarado Manuel Mendez Edgar Salazar Carlos Robelo Bayardo ,CCSS Hospital México San José Costa Rica 08 2000 2000 2 11 14

Presentamos aquí la experiencia quirúrgica en el tratamiento de la coartación aórtica acumulada a lo largo de 30 años en el Hospital México. Se intervinieron un total de 81 pacientes, cuyo promedio de edad es de 20.3 años, dado que inicialmente nuestro Centro contaba con un Servicio de Pediatría, existen 8 niños en la serie. Clínicamente los menores de un año se presentaron con insuficiencia cardíaca y los demás con sintomatología secundaria a hipertensión arterial o claudicación intermi tente. Durante los primeros 10 años se realizaron 27 resecciones y posteriormente se emplearon otras técnicas, pero a partir de 1984, se ha utilizado casi exclusivamente la aortoplastia con parche de duramadre. Ochenta y cuatro por ciento del grupo se tornaron normotensos, 10% mejoraron y un 6% no cambiaron. Dieciseis por ciento tuvo morbilidad postoperatoria, presentando condiciones comunes a este tipo de intervención y que se resolvieron fácilmente. La aortoplastia con parche nos ha dado buenos resultados, es técnicamente sencilla puesto que se ejecuta en el plano frontal y se hace mejor hemostasia, permite el crecimiento de la aorta en los niños y al dejar un diámetro adecuado reduce sustancialmente el gradiente.

Eighty two patients with aortic coarctation have been operated upon at the Hospital Mexico during the last 30 years. The median age is 20.3 years and since at the beginning our center also cared for children, 8 of them are here included. The clinical presentation in those below 1 year was heart failure, and the rest manifested signs and symptoms related to arterial hypertension or distal ischemia such as intermittent claudication of the lower extremities. During the first 10 years 27 resections were performed and later on other techniques were adopted, but since 1984 dura mater patch aortoplasty has been exclusively employed. Eighty four percent of the patients became normotensives, 10% improved and 6% did not change. Sixteen percent had common complications to this type of interventions which resolved with appropriate management. Two patients died (2.4%), one a 4 months old baby with heart failure and bronchopneumonia and the other a 23 year old with recoarctation who was reoperated for recurrent postoperative bleeding and developed multisystemic organ failure. The patch aortoplasty technique has given us very good results, it is easy to perform since it is done right in front of the surgeon and better hemostasis can be achieved, the remaining aortic tissue can and it will grow and allows for a wider luminal diameter reducing or abolishing pressure gradients across the coarcted segment.

 Coartación de aorta aortoplastía parche de duramadre Aortic coarctation aortoplasty duramater patch Morris G Coarctation of the aorta with special emphasis upon improved techniques of surgical repair J. of Thorac and Cardiovasc. Surgery Dec 19 60 4 Williams S Pierce Late results of the subclavian flap: Procedure in infants with coarctation of the thoracic aorta Cardiovascular surgery 1977 sept 1 97 58 ^s1 Morris R Sade Aortoplasty compared with aortic resection in young children Ann of Thor ac. Surg oct 19 79 28 Gibbons Spencer Cirugia toracica Cirugia toracica 1981 Ed Salvat P Cowgill D Corction of the aorta Cardiac Surg Jun 19 87 13 Litwin S Surgical resection of aortic coarctation of the aorta in infancy Jour. Ped.Surg 1971 11 Tawes L Coarctation of the aorta in infants and children Circulation 1969 39 Waldhaussen J Repair of the coarctation of the aorta with subclavian flap J. Thorac.Cardiovasc. Surg 1966 51 Palatianos G Changing trends in the surgical teatment of aortic coarctation Annals of thoracic surgery jul 19 85 40 Morua E Coartacion de la Aorta Acta Med. Costarricense 1988 31 ^s2 Sabiston Textbook of surgery Sabiston Textbook of surgery 1996 16 WBSaunders Co Findlow D Congenital Heart disease in adults Br J Anaesth 1997 78 ^s4 Heineman NK Extraanatomic Thoracic aortic by pass grafs: Indications ,Technics and results Eur.J. Cardiothorac-Surg 1997 11 ^s1 Heger M Aortic coarctation Long term follow-up in adults Z Kardiol 1997 86 ^s1 Guenthard J Arm leg pressure gradients on late follow up after aortic coarctation repair: Possible causes and implications Eur.Heart J 1996 17 ^s10 Ross D comunicacion personal comunicacion personal Venturini A Primary repair of coarctation of the aorta by patch graft aortoplasty Eur J Cardiiothorac Surg 1996 10 ^s10 Mc Connell M Congenital diseases of the aorta Rev Esp Cardiol 1996 49 ^s4 Convens C Aortic coarctation: A rare and unexpected cause of secondary arterial arterial hypertension in the elderly CathetCardiovasc Diagn 1996 39 ^s1 Yamaguchi T Intercostal artery aneurism associated with coarctation of the aorta: specific finding on MRI Int J Card Imaging 1997 13 ^s4 Linsay J Diagnosis and treatment of diseases of the aorta Curr Probl Cardiol 1997 22 ^s10 Crafoord S Congenital coarctation of the aorta and its surgical management Jthorac Cardivasc Surg 1945 14 Vosschulte K Surgical correction of coarctation of the aorta by an isthmuplastic operation Thorax 1961 16 Descalzo-Sonorans A Ballon percutaneus angioplasty in postoperative aortic coarctation Rev Esp Cardiol 1994 47 ^s4 Hillis LD Manual of Clinical problems in Cardiology Manual of Clinical problems in Cardiology 1989 third Little Brown Hornberger L Antenatal diagnosis of coarctation of the aorta: a multicenter experience J Am Coll Cardiol 1994 23 ^s2 Janzen J The disease picture of atypical aortic coarctation Helv.Chir.Acta 1993 60 ^s1-2 Poliakova N Aortic coarctation and the bicuspid aortic valve Ter Arkh 1996 68 ^s4 Gire C Rupture of cerebral aneurysm associated with aortic coarctation Rev Neurol Paris 1997 153 ^s5 Tabandeh H Retinal vascular abnormalities in aortic coarctation Eye 1996 10 ^s4
S1409-414220000002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422000000200005 Características clínicas y perfil de lípidos, lipoproteínas y lipoproteína (a) en pacientes con dislipoproteinemias primarias Jiménez Montero José G Bolaños Arrieta Mario Vargas Picado Marco A ,Merck Sharp & Dome Sucursal Centroamericana San José Costa Rica 08 2000 2000 2 15 23

Las dislipoproteinemias se asocian a varias complicaciones médicas como la enfermedad cardiovascular y la pancreatitis aguda. En pacientes con enfermedad cardiovascular la concentración de las lipoproteínas aterogénicas LDL, VLDL, Lp (a) se encuentra elevada y la concentración del colesterol HDL generalmente reducida. Este estudio analiza las características clínicas, el perfil lipídico y la concentración de la lipoproteína (a) en pacientes con dislipidemias primarias y familiares no hiperlipidémicos. Veinte pacientes con hipercolesterolemia familiar heterocigota (Hombres 6, edad promedio 46 años; mujeres 14, edad promedio 50 años); 18 con hiperlipidemia familiar combinada (hombres 11, edad promedio 35 años; mujeres 7, edad promedio 49 años) y 9 casos de dislipidemia tipo III (hombres 7, edad 28 años; mujeres 2, edades 60 y 30 años) representan el grupo de estudio. Once pacientes presentaban xantomas (6 con hipercolesterolemia familiar y 4 con dislipidemia tipo III), cuatro pacientes tenían historia de enfermedad coronaria prematura. La concentración de colesterol, triglicéridos, colesterol LDL se encontró elevada en todos los pacientes siendo la relación colesterol total/colesterol HDL mayor en los pacientes con hipercolesterolemia familiar heterocigota y con dislipidemia tipo III comparada con aquellos con hiperlipidemia familiar combinada. La concentración promedio de la lipoproteína (a) fue similar en los grupos estudiados. Se encontró que aproximadamente el 25 por ciento de los afectados presentaba concentraciones de Lp (a) superiores a 20 mg/dl y su concentración fue similar en hiperlipémicos y familiares normolipémicos. Los resultados de este estudio mostraron un perfil muy aterogénico en los pacientes con hipercolesterolemia familiar y dislipidemia tipo III. La concentración de Lp (a) parece que es independiente de la funcionalidad de los receptores de LDL por cuanto fue similar en los diferentes tipos de dislipoproteinemias.

Dyslipoproteinemias are associated with a number of medical complications such as cardiovascular diseases and acute pancreatitis In patients with cardiovascular disease atherogenic lipoproteins LDL, VLDL, Lp (a) are usually elevated and cholesterol HDL reduced. This study presents pertinent clinical characteristics, lipid profile and the concentration of lipoprotein (a) in patients with primary dyslipoproteinemias and in normo lipidemic relatives. Twenty patients with familial heterozygous hypercholesterolemia (Males 6, mean age 46 years; females 14, mean age 50 years); 18 patients with familial combined hyperlipidemia (males 11, mean age 35 years; females 7, mean age 49 years) and 9 patients with type III dyslipidemia (males 7, mean age 28 years; females 2, 60 and 30 years) were studied. Eleven patients had tendinous xanthomas (6 with familiar hypercholesterolemia and 4 with type III dyslipidemia), four patients had premature coronary heart disease. Cholesterol, triglyceride, and LDL cholesterol levels were elevated in all patients; the cholesterol/HDL ratio was higher in patients with familiar hypercholesterolemia and with type III dyslipidemia than those with familial combined hyperlipidemia. Mean plasma lipoproteín (a) was similar in all the study groups. It was found that aproximately 25 per cent of the hyperlipidemic patients had Lp (a) concentrations higher than 20 mg/dl and were also similar in normo and hyperlipidemic subjects. This study showed an atherogenic lipid profile in familial hypercholesterolemic and type III dyslipidemic patients. Lp (a) concentration seems to be independent of the functional status of the LDL receptor due to the fact that it's concentrations were similar in all types for dyslipoproteinemias.

 Perfil de lípidos lipoproteínas lipoproteína(a) dislipoproteinemias, primarias Lipid profile lipoproteins lipoprotein (a) primary dislipoproteinemias Castelli W P Garrison R J Wilson P W Abbott R D Kalousdian S Kannel W B Incidence of coronary heart disease and lipoprotein cholesterol levels: The Framingham study JAMA 1986 256 Abbott RD Wilson PWF Kannel WB Castelli WP High density lipoprotein cholesterol, total cholesterol and myocardial infarction: The Framingham Study Arteriosclerosis 1988 8 Multiple risk factor intervention trial research group. Multiple risk factor intervention trial. Risk factor changes and mortality results JAMA 1982 248 Miller GJ Miller NE Plasma high-density-lipoprotein concentration and development of ischemic heart-disease Lancet 1975 1 Shepherd J Cobbe SM Ford for the West of Scotland Coronary Prevention Study Group N Engl J Med 1995 333 Blankenhorm D M Nessim S A Johnson R L Sanmarco M E Asen SP Cashin-Hemphill Beneficial effects of combined colestipol niacin: Therapy on coronary atherosclerosis and coronary venous bypass grafts JAMA 1987 257 Ramdomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S) Lancet 1994 344 Summary of the second report of the management cholesterol education program (NECP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment panel II) JAMA 1993 269 Utermann G The mysteries of lipoprotein (a) Science 1989 246 Hopkins PN Lipoprotein (a) interaction with lipid and non-lipid risk factors in patients with early onset coronary artery disease: results from the NHLBI Family Heart Study Atherosclerosis 1998 141 ^s2 Jiménez Montero JG Mora Morales E Vargas Picado MA Vinocour Velvet M Protective factors aganist ischemic heart disease in familial hypercholesterolemia Cardiología Intercontinetal 1999 8 Lipid and lipoprotein analysis: Lipid Research Clinics Program Manual of laboratory operations Lipid and lipoprotein analysis: Lipid Research Clinics Program Manual of laboratory operations 1974 1 Washington DC Government priting office. (DHEW publication no. NIH) Friedwald WT Levy RL Fridrikson DS Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifugation Clin Chem 1972 18 Albers JJ Marcovina SM Lodge MS The unique lipoprotein (a) properties and immunochemical measurement Clin Chem 1990 36 Goldstein JL Brown MS Scriver CR Beaudet AL Sly WS Valle D Familial hypercholesterolemia The Metabolic Basis of Inherited Disease The Metabolic Basis of Inherited Disease 1989 6 New York McGraw- Hill Book Co Jimenez JG Vargas MA Trejos R Arauz AG Jimenez Z Calzada LD Descripción de tres casos con hiperlipoproteinemia tipo III Rev Cost Cien Med 1987 8 ^s3 Pasternak R C Gundy S M Levy D Thompson Task Force 3: Spectrum of risk factors for coronary heart disease JACC 1996 27 Goldstein JL Schrott HG Hazzard WR Bierman EL Motulsky AG Hyperlipidemia in coronary heart disease, II: genetic analysis of lipid levels in 176 families and delineation of a new inherited disorder, combined hyperlipidemia J Clin Invest 1973 52 Jarvik GP Brunzell JD Austin MA RM Krauss AG Motulsky E Wijsman Genetic predictors of FCHL in four large pedigrees: Influence of Apo B level mayor locus predicted genotype and LDL subclase phenotye Arteriosclerosis Thromb 1994 14 Nielsen LB Atherogenecity of lipoprotein (a) and oxidezed low density lipoprotein insight from in vivo studies of arterial wall influx, degradation and efflux Atherosclerosis 1999 143 Seed M Hoppichler F Reaveley D McCarthy S Thompson GR Boewinke E Utermann G Relation of serum lipoprotein (a) concentration to coronary heart disease in patients with familial hypercholesterolemia N. Engl J Med 1990 322 Miller M Seidler A Kwiterovich PO Pearson TA Long-term predictors of subsequent cardiovascular events with coronary artery disease and "desirable" levels of plasma cholesterol Circulation 1992 86 Kremper F Kostner GM Roscher A Haslauer F Bolzano K Sandhofer F Studies on the role of specific cell surface receptors in the removal of lipoprotein (a) in man J Clin Invest 1983 71
S1409-414220000002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422000000200006 Balón de Contrapulsasión INTRA-AORTICO (B.C.I.A.), una alternativa en el manejo del paciente cardiológico críticamente enfermo Rodríguez Antonio Núñez Percy Calzada Norberto Motta Jorge Pichel Daniel Arrocha Alberto ,Centro Médico Paitilla Ciudad de Panamá Panamá 08 2000 2000 2 25 33

El Balón de Contrapulsación Intra-aórtico (B.C.I.A.) es un equipo auxiliar de soporte cardiocirculatorio, cuya correcta indicación y utilización le proporcionará al paciente cardiológico críticamente enfermo, el apoyo suficiente para lograr su estabilidad hemodinámica. Presentamos 16 pacientes, contrapulsados por diversas causas, 7 de ellos presentaban una clara inestabilidad cardiocirculatoria y el resto padecía isquemia extensa y severa en curso o potencial. La evolución de estos 16 pacientes fue satisfactoria, reafirmándose el beneficio incuestionable de una correcta y adecuada contrapulsación. Esta maniobra de soporte cardiocirculatorio fue acompañada de medidas terapéuticas orientadas a mejorar la isquemia miocárdica, tales como la Angioplastía Coronaria o la Cirugía de Revascularización miocárdica.

Intraaortic balloon Pump (IABP) is a device for cardiac circulatory support. The right setting and timing will provide to the severlly ill cardiac patient the way to get haemodinamic compensation. We present 16 patient who were on intraaortic ballon pump, seven of them with a severe cardiovascular failure. We were able to improve their outcome with a good cardiovascular support associated with adecuate myocardial revascularization by PTCA or coronary by-pass surgery.

 Balón contrapulsación intraaórtica revascularización miocárdica Balloon pump intraaortic myocardial resvascularization Harken DE Presentation at the International College of Cardiology Meeting Presentation at the International College of Cardiology Meeting 1958 Brussel Dormandy JA Goetz RH Dripke DC Hemodynamics and coronary blood flow with counterpulsation Surgery 1969 65 Moulopoulos SD Topaz S Kolff WJ Diastolic balloon pumping (with carbon dioxide) in the aorta a mechanical assist to the failing circulation Am Heart J 1961 63 Kantrowitz A Tjonneland S Freed PS Initial clinical experience with intra-aortic ballon pumping in cardiogenic shock JAMA 1968 203 Scheidt S Ascheim R Killip T Shock after acute myocardial infaction Am J. Cardiol 1970 26 Alderman EL Fisher LD Litwin P Kaiser GC Myers WO Maynard C Results of coronary artery surgery in patient with poor left ventricular function (CASS) Circulation 1983 68 Califf RM Harrell FE Lee Kl Rankin JS Mark DB Hlatky MA Changing efficacy of coronary revascularization Implication for patient selection Circulation 1988 78 ^s3 Bounous EP Mark DB Pollock BG Hlatky MA Harrell FE Lee KL Surgical survival benefits for coronary desease patients with left ventricular dysfunction Circulation 1988 78 ^s3 Killip T Passamani E Davis K Coronary artery surgery study (CASS): a randomized trial of coronary bypass surgery. Eight years follow-up and survival in patient with reduced ejection fraction Circulation 1985 72 ^s6 Comparison of medical and Surgical treatment for patient with unstable angina and poor left ventricular function Circulation 1987 IV ^s4 Kirklin JW Blackstone EH Roger WJ The plights of the invasive treatment of ischemic heart disease J Am Coll Cardiol 1985 5 Kaiser GC Davis KB Fisher LD Myers WO Foster ED Passamani ER Survival following coronary artery bypass grafting in patient with severe angina pectoris (CASS) An observational study J Thorac Cardiovasc Surg 1985 89 Pryor DB Harrell FE Rankin JS Lee KL Muhlbaier LH Oldham HN The changing survival benefit of coronary revascularization over time Circulation 1987 76 ^s5 Pt 2 Lawrie GM Morris GC Baron A Norton J Galeser DH Determinant of survival 10 to 14 years after coronary bypass: analysis of preoperative variables in 1448 patients Ann Thorac Surg 1987 44 Coronary artery surgery study (CASS): a randomized trial of coronary artery bypass surgery: Survival data Circulation 1983 68 Holmes DR David KB Mock MB Fisher LD Gersh BJ Killip T The effect of medical and surgical treatment on subsequent sudden cardiac death in patient with coronary artery disease: a report from the Coronary Artery Surgery Study Circulation 1986 73 Cosgrove DM Loop FD Lytle BW Baillot R Gill CC Golding LA Primary myocardial revascularization: Trends in surgical mortality J Thorac Cardiovas Surg 1984 88 ^s5Pt1 Hung J Kelly DT Baird DK Hendel PN Leckie BD Grant AF Aorta-coronary artery bypass grafting in patient with sever left ventricular dysfunction J Thorac Cardiovasc Surg 1980 79 Christakis GT Weisel RD Fremes SE Ivanav J David TE Goldman BS Coronary artery bypass grafting in patient with poor ventricular function. Cardiovascular Surgeon of the University of Toronto J Thorax Cardiovasc Surg 1992 103 Grambow DW Topol EJ Effect of maximal medical therapy on refractoriness of unstable angina pectoris Am J Cardiol 1992 70 Bengston JR Kaplan AJ Pieper KS Prognosis in cardiogenic shock after acute myocardial infarction in the interventional era J Am Coll Cardiol 1992 20 De Wood MA Notske RN Hensley GR Intraaortic ballon counterpulsation with and without reperfusion for myocardial infarction shock Circulation 1980 61 Yamamoto H Hayashi Y Oka Y Efficacy of percutaneus transmural coronary angioplasty in patient with acute myocardial infarction complicated by cardiogenic shock Jpn Circ J 1992 56 Seydoux C Goy JJ Beuret P Effectiveness of percutaneus transluminal coronary angioplasty in cardiogenic shock during acute myocardial infarction Am J Cardiol 1992 69 Laney PL Dell` Italia LJ Brooks SR Follow-up exercise function in patient presenting with cardiogenic shock and acute transmural myocardial infarction J Am Coll Cardiol 1993 21 21 Pierri MK Zema M Kligfield P Exercise tolerance in late survivors of ballon pumping and surgery for cardiogenic shock Circulation 62 ^sI Stomel RJ Rasak M Bates ER Treatment strategies for acute myocardial infarction complicated by cardiogenic shock in a community hospital Chest 1994 105
S1409-414220000002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422000000200007 La evaluación cardiovascular en jóvenes deportistas Boccardo Daniel Tibaldi Miguel Coll Marcelo ,Universidad Católica de Córdoba Escuela de Cardiología Instituto Modelo de Cardiología Privado Sagrada Familia Córdoba Argentina 08 2000 2000 2 35 45 Maron BJ Epstein SE Roberts WC Causes of sudden death in competitive athletes J Am Coll Cardiol 1986 7 Thompson PD Funk EJ Carleton RA Incidence of death during jogging in Rhode Island from 1975 through 1980 JAMA 1982 247 Waller BF Roberts WC Sudden death while running in conditioned runners aged 40 years or over Am J Cardiol 1980 45 Virmani R Robinowitz M McAllister HA Nontraumatic death in joggers: a series of 30 patients at autopsy Am J Med 1982 72 Maron BJ Shirani J Poliac LC Sudden death in young competitive athletes: clinical, demographic, and pathological profiles JAMA 1996 276 Lithberson R Sudden death from cardiac causes in children and adults N Engl Med 1996 334 Drory Y Turetz Y Hiss Y Sudden unexpected death in persons less than 40 years of age Am J Cardiol 1991 68 Van Camp SP Bloor CM Mueller FO Non-traumatic sports death in high school and college athletes Med Sci Sports Exerc 1995 27 Corrado D Thiene G Nava A Sudden death in young competitive athletes: clinicopathologic correlations in 22 cases Am J Med 1990 89 Cheitlin NO De Castro CM McAllister HA Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva: a not so minor congenital anomaly Circulation 1974 50 Epstein SE Maron BJ Sudden death and the competitive athlete: perspectives on preparticipation screening studies J Am Coll Cardiol 1986 7 Maron BJ Thompson PD Puffer JC Cardiac Defects Committee (cardiovascular disease in the young), American Heart Association Circulation 1996 94 Maron BJ Bonow RO Cannon RO Hypertrophic cardiomyopathy: interrelations of clinical manifestions, pathophysiology and therapy, 1 N Engl J. Med 1987 316 Maron BJ Bonow RO Cannon RO Hyperthophic cardiomyopathy: interrelations of clinical manifestations, pathophysiology and therapy, 2 N Engl J Med 1987 316 Louie EK Edwards LC Hypertrophic cardiomyopathy Prog Cardiovasc Dis 1994 36 Braden D Strong WB Preparticipation screening for sudden cardiac death in high school and college athletes Physician Sports-med 1988 16 Fahrenbach MC Thompson PD The preparticipation sports examination., Cardiovascular considerations for screening Cardiol Clin 1992 10 Strong WB Steed D Cardiovascular evaluation of the young athlete Pediatr Clin North Am 1982 29 Update on the 1987 Task Force on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program Pediatrics 1996 98 ^s1 Report of the Second Task Force on Blood Pressure Control in Children - 1987 Report of the Second Task Force on Blood Pressure Control in Children - 1987 Braunwald E ed. Heart Disease ed. Heart Disease 1992 38 4 Philadelphia WB Saunders Company Thiene G Nava A Corrado D Right ventricular cardiomyopathy and sudden death in young people N Engl J Med 1988 318 Maron BJ Structural features of the athletic heart as defined by echocardiography J Am Coll Cardiol 1986 7 Maron BJ Nichols PF Pickle LW Patterns of inheritance in hypertrophic cardiomyopathy. Assessment by M-mode and two-dimensional echocardiography Am J Cardiol 1984 53 Pellicia A Maron B Preparticipation cardiovascular evaluation of the competitive athlete: perspectives from of 30 year Italian experience Am J Cardiol 1995 75 Hansen HS Froberg K Hyldebrandt N Nielsen JR A controlled study of eight months of physical training and reduction of blood pressure in children: the Odense schoolchild study Br Med J 1991 303 Kaplan NM Deveraux RB Miller HS 26 th Bethesda Conference : recommendations for eligibility for competition in athletes with cardiovascular abnormalities. Task Force 4 : systemic hypertension J Am Coll Cardiol 1994 24 Zipes DP Garson A 26th Bethesda Conference : recommendations for eligibility for competition in athletes with cardiovascular abnormalities. Task force 6 : arrhythmia J Am Coll Cardiol 1994 24 Graham TP Bricker JT James FW Strong WB 26 th Bethesda Conference : recommendations for eligibility for competition in athletes with cardiovascular abnormalities. Task Force 1 : congenital heart disease J Am Coll Cardiol 1994 24 Maron BJ Isner JM Mckenna WJ 26 th Bethesda Conference : recommendations for eligibility for competition in atheletes with cardiovascular abnormalities. Task force 3 : hypertrophic cardiomyopathy, myocarditis and other myocardial diseases and mitral valve prolapse J Am Coll Cardiol 1994 24 Storino R Milei J Enfermedad de Chagas Enfermedad de Chagas 1994 Buenos Aires Doyma Argentina S.A., Times Mirror de España S.A., División Mosby
S1409-414220000002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422000000200008 Inactividad como factor de riesgo coronario Vargas Pérez Fernando E ,Hospital Clínica Biblica San José Costa Rica 08 2000 2000 2 47 52 Fletcher GF Blair SN Blumenthal J Statement on exercises, benefits, and recomendation for physical activity programs for all Americans: A Statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association Circulation 1992 86 Blair SN Kohn HW Paffenbarger RS Physical fitness and all-cause mortality: A prospective study of healthy young men and women JAMA 1989 262 Margherita A J Effects of exercise and training on cardiovascular function Physical Medicine and Rehabilitation Clinics of North America 1995 2 ^s6 Halar EM Physical Inactivity Physical Medicine and Rehabilitation Clinics of North America 1995 1 ^s6 Asmussen E Similarities and dissimilarities between static and dynamic exercise Circulation 1981 48 Myers J Froelicher VF Hemodynamic determinants of exercise capacity in chronic heart failure Ann Intern Med 1991 115 Myers J Froelicher VF Optimizing the exercise for pharmacological investigations Circulation 1990 82 Londeree BR Moeschberger ML Influence of age and other factors on maximal heart rate J Cardiac Rehabil 1984 4 Cohn JN, de Quantitive exercise testing for the cardiac patient: the value of monitoring gas exchange: introduction Circulation 1987 76 Fletcher GF Froelicher VF Hartley LH Exercise standards: a statement for health professionals from the American Heart Association Circulation 1990 82 Paffenbarger RS Hale WE Work activity and coronary heart mortality N Engl J Med 1975 292 Kilbom A Physical training in women Scand J Clin Lab Invest 1971 119 Dimsdale JE Hartley LH Guiney T Postexercise peril: Plasma catecholamines and exercise JAMA 1984 251
S1409-414220000002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422000000200009 Pseudoaneurisma de la aorta torácica de origen traumático Induni Eduardo Soto Longino Pucci Juan Mendez Edgar Alvarado Manuel Salazar Carlos Gutierrez Rodrigo ,CCSS Hospital México San José Costa Rica 08 2000 2000 2 55 56

Se presenta el caso de un paciente con ruptura traumática de aorta descendente y con la formación tardía de un pseudoaneurisma, el cual fue reparado mediante la utilización de un parche de duramadre.

We report a patient whit traumatic rupture of de descending aorta and late presentation of a pseudoaneurism, in whom we repaired it with a duramater patch.

 Trauma pseudoaneurisma circulación extracorpórea ruptura de aorta Trauma pseudoaneurism extracorporeal circulation aortic rupture Fraedrich G Surgical therapy of chronic traumatic aneurysm Zentralbl Chir 1996 121 ^s9 Kanasawa S Traumatic injuries of the thoracic aorta: Report of five cases Nippon Kyobu Geka 1996 44 ^s12 Berenfeld A Traumatic aortic rupture diagnosed by transesophageal echocardiography J Am Soc Ecocardiogr 1996 121 ^s9 Fettori R Delayed surgery of traumatic aortic rupture: Role of magnetic resonance imaging Circulation 1996 94 ^s11 Yuda A Rupture of thoracic aorta due to blunt trauma: Report of three cases Kyobu Geka 1996 49 ^s11 Erbel R The aorta ,Aortic aneurism, trauma and dissection Crit Care Clin 196 12 ^s3 Alvarado E Mortalidad por trauma torácico en Costa Rica Acta Med Cost 1998 40 ^s4 Morua E Coartación de la aorta Acta Médica Cost 1988 31 ^s2 Palatianos G Changing trends in the surgycal treatment of coarction of the aorta Ann Thor Surg 1985 40 ^s1 Owens W Late results of patch repair of coarctation of the aorta using autogenous artrial wall Ann Thorac Surg 1997 64 ^s4 Traumatismo torácico 1989 Clínicas Quirúrgicas de Norteamérica
S1409-414220000002 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422000000200010 , 08 2000 2000 2 60 61