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REFERENCES......e124

It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced in the detection, management,

/pdf/acc-aha-2006-guidelines-for-the-management-of-patients-with-27qfh9fc7i.pdf

ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons

Guidelines summarize and evaluate all currently available evidence on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient, suffering from a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines are no substitutes for textbooks, and their legal implications have been discussed previously. Guidelines and recommendations should help physicians to make decisions in their daily practice. However, the ultimate judgement regarding the care of an individual patient must be made by his/her responsible physician(s).

A large number of Guidelines have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organizations. Because of the impact on clinical practice, quality criteria for the development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines can be found on the ESC Web Site (http://www.escardio.org/guidelines/rules).

Members of this Task Force were selected by the ESC to represent all physicians involved with the medical care of patients in this pathology. In brief, experts in the field are selected and undertake a comprehensive review of the published evidence for management and/or prevention of a given condition. A critical evaluation of diagnostic and therapeutic procedures is performed, including assessment of the risk–benefit ratio. Estimates of expected health outcomes for larger populations are included, where data exist. The level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to pre-defined scales, as outlined in Tables 1 and 2 .

View this table:

Table 1 
Classes of recommendations



View this table:

Table 2 
Levels of evidence



The experts of the writing and reviewing panels have provided disclosure statements of all relationships they may have which …

/pdf/esc-guidelines-for-the-management-of-grown-up-congenital-542gk4n515.pdf

ESC Guidelines for the management of grown-up congenital heart disease (new version 2010).

It is important that the medical profession play a central role in critically evaluating the use of diagnostic procedures and therapies introduced and tested for detection, management, or prevention of disease. Rigorous, expert analysis of the available data documenting absolute and relative

/pdf/acc-aha-2008-guidelines-for-the-management-of-adults-with-4oqjti8ewr.pdf

ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: Executive summary - A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease)

https://cdr.lib.unc.edu/downloads/4m90dx441

ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease)

Surgical treatment for secundum atrial septal defects in patients >40 years old. A randomized clinical trial.

Objective: To compare results of dilatation of native coarctation of the aorta with and without stent implantation. Design: Open, observational, non-randomised study. Patients: 54 consecutive adult patients: 32 with balloon angioplasty alone (group 1) and 22 with stent placement (group 2). Interventions: Balloon dilatation from 1995 to 1997; dilatation with Palmaz stent placement from 1997 to 1999. Main outcome measures: The primary end point was a composite index of failure including heart related death, a residual gradient of > 20 mm Hg, the need of reintervention, and aneurysm formation. Results: Peak systolic gradient (mean (SD)) was reduced both in group 1 (from 63.3 (22.8) to 10.7 (10.8) mm Hg, p 10 mm Hg was shown to be the best cut off point to separate risk groups, representing a hazard ratio (HR) of 9.59 compared with a residual gradient of ≤ 10 mm Hg (95% confidence interval (CI) 1.92 to 47.8). From multivariate Cox regression analysis, the only risk marker was the residual gradient (HR 8.9, 95% CI 1.2 to 63.0). The type of the coarctation and the use of stent were the factors associated with a residual gradient of ≤ 10 mm Hg. Conclusions: Mid term outcome in adult patients with native aortic coarctation receiving percutaneous treatment is strongly related to the immediate residual gradient. When treating these cases, efforts should be made to obtain gradients under 10 mm Hg, either by angioplasty alone or by placing a stent. Patients with discrete aortic coarctation have similar mid term results when the immediate residual gradient is ≤ 10 mm Hg despite the implantation of a stent. To achieve these gradients, patients with hypoplastic isthmus or tubular coarctation should be treated with primary stenting. Further studies including exercise tests and non-invasive imaging are still needed before definitive conclusions can be drawn.

https://heart.bmj.com/content/heartjnl/89/1/77.full.pdf

The adult patient with native coarctation of the aorta: balloon angioplasty or primary stenting?

The adult patient with Ebstein anomaly. Outcome in 72 unoperated patients.

Proposito. Identificar la prevalencia de hipertension arterial en Mexico y su relacion con otros factores de riesgo cardiovascular tales como diabetes, proteinuria, tabaquismo y obesidad. Metodo. Durante el ano 2000 se realizo una encuesta nacional probabilistica en 45,300 personas de toda la Republica sobre aspectos de enfermedades cronicas tales como diabetes, hipertension arterial (HTA), obesidad, proteinuria, tabaquismo y alcoholismo. Con un intervalo de confianza al 95% para una z (alfa)= 1.96, una proporcion de prevalencia estimada minima de 6%, un defecto de diseno de 2.5 y, un error relativo maximo de 0.145, se calculo un tamano de muestra de 44,344 personas. El diagnostico de HTA fue basado por diagnostico medico previo con toma de antihipertensivos o bien presion arterial al momento de la encuesta con cifras ≥ 140 mmHg en presion sistolica y/o ≥ 90 mmHg en presion diastolica. Los datos fueron ponderados para la distribucion de poblacion y genero de acuerdo con la encuesta nacional de poblacion y vivienda 2000 (INEGI). Resultados. Un total de 38,377 (98.8%) personas con edades entre los 20 y 69 anos fueron incluidas para estimar la prevalencia de HTA, el resto fueron eliminadas por no tener la informacion adecuada. La prevalencia global para la republica mexicana fue de 30.05%. La prevalencia en hombres fue de 34.2% y en la mujer de 26.3%. La prevalencia fue directamente proporcional a la edad. Asi, despues de los 50 anos, la prevalencia de HTA supera el 50%. La mujer alcanza y supera en prevalencia al hombre a partir de los 50 anos. Los estados del norte de la republica tuvieron una prevalencia de HTA de ~34%, mientras que en el sur se obtuvo ~ 27% (p < 0.05). Los odds ratio para HTA (ajustados para edad) fueron: en diabetes de 1.54 (IC95%, 1.44 - 1.63); en obesidad 2.3 (IC95%, 2.22 - 2.43); en tabaquismo 1.26 (IC95%, 1.21 - 1.32)

http://www.scielo.org.mx/pdf/acm/v72n1/v72n1a12.pdf

Hipertensión arterial en México: Resultados de la Encuesta Nacional de Salud (ENSA) 2000

Resumen Proposito: Determinar la prevalencia e interre-lacion de enfermedades cronicas no transmisi-bles (ECNT), obesidad, tabaquismo y proteinu-ria en la poblacion adulta (entre 20 y 69 anos)de la republica mexicana, asi como su estratifi-cacion de acuerdo a grupos de edad, genero yarea geografica. Metodo: En el ano 2000 se rea-lizo una encuesta nacional probabilistica en45,300 personas. El tamano de la muestra fuecalculado para abordar ENCT con una prevalen-cia minima estimada de 6%. La encuesta corres-ponde al tipo III del metodo paso a paso descri-to por la OMS. Los datos fueron ponderados parala distribucion de poblacion y genero, de acuer-do con la encuesta nacional de poblacion y vi-vienda 2000 (INEGI). Resultados: Un total de38,377 (98.8%) sujetos fueron incluidos para elanalisis. El 69.4% fueron mujeres. La edad pro-medio para el genero masculino fue de 39.4 +12.9 y para el femenino de 38.6 ± 13.0 transmi-sibles con la encuesta nacional de salud. La pre-valencia nacional promedio para hipertension fuedel 30.05%, para diabetes del 10.7%, para obe-sidad del 24.4%, para glucosa capilar anormaldel 12.7% y para proteinuria del 9.2%. Las pre-valencias de hipertension y diabetes fueron di-rectamente relacionadas con la edad, indice demasa corporal y perimetro de la cintura. La dis-tribucion piramidal de la poblacion mexicanadetermino que la proporcion mayoritaria en lasprevalencias de las ECNT se ubicaran antes de

https://www.medigraphic.com/pdfs/archi/ac-2003/ac031i.pdf

Prevalencia e interrelación de enfermedades crónicas no transmisibles y factores de riesgo cardiovascular en México: resultados finales de la Encuesta Nacional de Salud (ENSA) 2000

Fause Attie

Papers

Surgical treatment for secundum atrial septal defects in patients >40 years old. A randomized clinical trial.

The adult patient with native coarctation of the aorta: balloon angioplasty or primary stenting?

The adult patient with Ebstein anomaly. Outcome in 72 unoperated patients.

Hipertensión arterial en México: Resultados de la Encuesta Nacional de Salud (ENSA) 2000

Prevalencia e interrelación de enfermedades crónicas no transmisibles y factores de riesgo cardiovascular en México: resultados finales de la Encuesta Nacional de Salud (ENSA) 2000