Nestor Sandoval

Fundación Cardioinfantil Instituto de Cardiologia · Department of Cardiac Surgery

The global burden of paediatric and congenital heart disease (PCHD) is substantial. We propose a novel public health framework with recommendations for developing effective and safe PCHD services in low-income and middle-income countries (LMICs). This framework was created by the Global Initiative for Children’s Surgery Cardiac Surgery working grou...

Background The lack of evidence on complications using mitral valve approaches leaves the choice of risk exposure to the surgeon’s preference, based on individual experience, speed, ease, and quality of exposure. Methods The present study analysed patients undergoing mitral valve surgery using a superior transseptal approach or a left-atrial appro...

Fabrication of scaffolds with hierarchical structures exhibiting the blood vessel topological and biochemical features of the native extracellular matrix that maintain long-term patency remains a major challenge. Within this context, scaffold assembly using biodegradable synthetic polymers (BSPs) via electrospinning had led to soft-tissue-resemblin...

Background: The lack of evidence on postoperative outcomes using mitral valve approaches leaves the choice to the surgeon’s preference, based on individual experience, speed, ease, and quality of exposure. Methods: The present study analysed patients undergoing mitral valve surgery using a superior transseptal approach or a left-atrial approach bet...

Background: The lack of evidence with respect to complications with mitral valve approaches leaves the choice of exposure to the surgeon’s preference, basing it on individual experience, speed, ease, and quality of exposure. Methods: Analysis of patients undergoing mitral valve surgery by either a superior transseptal approach or a left-atrial app...

Background Coronary artery aneurysms (CAAs) are uncommon, and giant aneurysms (>2 cm) are even more unusual. Coronary atherosclerosis and Kawasaki disease are the leading causes for this pathology. The treatment for this condition is controversial because the evidence is based on case report series. Case summary We describe the case of a 77-year-o...

The coronavirus disease 2019 (COVID-19) pandemic currently gripping the globe is impacting the entire health care system with rapidly escalating morbidities and mortality. Although the infectious risk to the pediatric population appears low, the effects on children with congenital heart disease (CHD) remain poorly understood. The closure of congeni...

Objective Many low-income and middle-income countries (LMICs) struggle to provide the health services investment required for life-saving congenital heart disease (CHD) surgery. We explored associations between risk-adjusted CHD surgical mortality from 17 LMICs and global development indices to identify patterns that might inform investment strateg...

Objective: Low-volume centers might be reluctant to perform minimally invasive mitral valve repair (Mini-MVr) due to the initial learning curve involved, rates of repair, and outcomes. The objective of this study was to assess the learning process and outcomes of Mini-MVr in a low-volume center and compare the results with the conventional techniqu...

Background: Undiagnosed congenital heart disease in the prenatal stage can occur in approximately 5 to 15 out of 1000 live births; more than a quarter of these will have critical congenital heart disease (CCHD). Late postnatal diagnosis is associated with a worse prognosis during childhood, and there is evidence that a standardized measurement of o...

Background: Critical congenital heart disease (CCHD) make up a group of heart diseases present in newborns since the prenatal period and requiring early intervention through surgery or percutaneous interventions in the first year of life. Little is known about the societal economic impact associated with their care in low to middle income countries...

Purpose: The use of open hybrid stent graft systems (E-VITA) has become an excellent option for the treatment of complex aortic aneurysm and aortic dissections. However, its use in Latin America is unpopular and the established practice is to perform just an ascending aorta limited repair. Methods: Since February 2018, we began to use the E-VITA...

Purpose : This study shows how low-volume centers can achieve results in mitral valve repair (MVr) surgery comparable to those reported by referral centers. It compares outcomes of MVr using resection versus noresection techniques, tendencies, and rates of repair. Methods: Between 2004 and 2017, 200 patients underwent MVr for degenerative mitral va...

Purpose Since minimally invasive mitral valve repair (Mini-MVr) technique was introduced, it has become a routine approach to mitral valve disease. However, surgeons from low-volume centers might be reluctant to adopt this technique due to the initial learning curve involved. Methods Between 2004 and 2017, 200 patients underwent a mitral valve rep...

Background: The approach to coarctation of the aorta with hypoplastic aortic arch is controversial. We evaluated the outcomes in patients with coarctation of the aorta with or without hypoplastic aortic arch operated through a posterior left lateral thoracotomy. Methods: A retrospective cohort of patients with aortic coarctation, who underwent repa...

Resumen Introducción El manejo endovascular para patologías de la aorta ha aumentado como opción para pacientes de alto riesgo quirúrgico de cirugía convencional abierta. Los resultados a corto plazo para mortalidad, libertad de enfermedad y reintervención, evidencian resultados favorables respecto a la cirugía abierta, pero a mediano (1-12 meses)...

The World Society for Pediatric and Congenital Heart Surgery (WSPCHS) is the largest professional organization in the world dedicated to pediatric and congenital heart surgery. The purpose of this article is to document the first decade of the history of WSPCHS from its formation in 2006, to summarize the current status of WSPCHS, and to consider t...

Background: Isolated reports from low- and middle-income countries (LMIC) for surgical results in Tetralogy of Fallot (TOF) are available. The International Quality Improvement Collaborative for Congenital Heart Disease (IQIC) seeks to improve surgical results promoting reductions in infection and mortality in low and middle income countries. Met...

Abstract for Presentation on Demand

Synthetic vascular access for hemodialysis exhibits biological and mechanical material properties mismatch with the native vessels. These limitations prevent infiltration of endothelial cells and decrease grafts long-term patency, particularly in small diameter vessels. We aimed to design a curved structural reinforced small intestinal submucosa (S...

BACKGROUND Ebstein Anomaly (EA) is a heterogeneous congenital heart defect (CHD), frequently accompanied by diverse cardiac and extra-cardiac comorbidities, resulting in a wide range of clinical outcomes. HYPOTHESIS Phenotypic characterization of EA patients has the potential to identify variables which influence prognosis and subgroups with disti...

Introduction Few reports in the world have shown a differential effect of hypothyroidism in relation to morbidity and mortality following cardiac surgery. Objective To determine the association between preoperative hypothyroidism, composite and disaggregated outcomes of mortality and complications in patients undergoing first-time isolated myocard...

Adipose tissue can affect the metabolic control of the cardiovascular system, and its anatomic location can affect the vascular function differently. In this study, biochemical and phenotypical characteristics of adipose tissue from periaortic fat were evaluated. Periaortic and subcutaneous adipose tissues were obtained from areas surrounding the a...

The World Society for Pediatric and Congenital Heart Surgery was founded with the mission to “promote the highest quality comprehensive cardiac care to all patients with congenital heart disease, from the fetus to the adult, regardless of the patient’s economic means, with an emphasis on excellence in teaching, research, and community service.” Ear...

Abstract Poster Presentation

Abstract Poster Presentation

Abstract Poster Presentation

Background: Little has been published regarding surgery for transposition of the great arteries (TGA) in the developing world. Objectives: This study sought to identify patient characteristics, surgical interventions, institutional characteristics, risk factors for mortality, and outcomes among patients undergoing surgery for TGA in this setting...

Departmental Operations Procedure Manual. Department of Adult Cardiovascular Surgery. 1st Edition.

En el contexto de un estudio de corte transversal sobre cardiopatías congénitas huérfanas, estudiamos la Anomalía de Ebstein (AE), que es una cardiopatía congénita compleja que puede estar acompañada por diferentes comorbilidades y resultar en un amplio espectro de desenlaces.

More evidence is needed that links the diagnosis of different congenital heart diseases (CHD) identified after birth, with intermediate altitudes above sea level in geographically and ethnically diverse populations. Our aim was to estimate relative frequencies of CHD diagnosis by altitude and gender in the pediatric population of 12 cities in Colom...

Objetivo: Estimar la frecuencia relativa de las cardiopatías congénitas detectadas en el periodo post-natal en población pediátrica de once Departamentos de Colombia, y comparar cuáles son más frecuentes por Departamentos y regiones del país. Métodos: Se llevó a cabo un estudio observacional de corte transversal, teniendo como fuente de informació...

Objetivos: Determinar qué antecedentes clínicos del paciente y factores del procedimiento quirúrgico se asocian con la aparición de insuficiencia renal postoperatoria en pacientes sometidos a cirugía de revascularización miocárdica. Métodos: estudio llevado a cabo entre enero de 2005 y diciembre de 2013, de casos y controles anidado en una cohorte,...

Small intestinal submucosa grafts for vascular regeneration have produced variable patency (0-100%) that has been concurrent with variability in fabrication techniques. We hypothesized that 1) preservation (P) or removal (R) of the stratum compactum layer of the intestine and 2) a dehydrated (D) or hydrated (H) state, affect early graft patency and...

Introducción: Los resultados del tratamiento quirúrgico de los aneurismas de aorta abdominal dependen de múltiples factores asociados al paciente y a la experiencia del grupo tratante. Objetivos: Describir los resultados obtenidos en el tratamiento quirúrgico de aneurismas de aorta abdominal por un grupo multidisciplinario y evaluar el impacto del...

Objectives: Surgical care for CHD in the developing world is rapidly evolving, allowing an opportunity for survival for children with previously lethal conditions. Little information is available about such patients and their outcomes. The objectives of this study were to identify (1) patient characteristics, (2) surgical interventions, (3) institu...

The considerable blood mixing in the bidirectional Glenn (BDG) physiology further limits the capacity of the single working ventricle to pump enough oxygenated blood to the circulatory system. This condition is exacerbated under severe conditions such as physical activity or high altitude. In this study, the effect of high altitude exposure on hemo...

Introduction Mediastinitis is a multifactorial entity which occurs in up to 4% of patients undergoing coronary artery bypass graft (CABG). It has a hospital mortality of 14% to 47%, which generates increased costs of care and deterioration of the quality of life and patient survival in the long term. Objective To determine which clinical anteceden...

Abstract Poster Presentation

Introducción: El reparo endovascular de la aorta torácica (REVAT) se ha incrementado en el mundo en los últimos años con relación al abierto.Objetivo: Comparar los resultados clínicos del REVAT frente al reparo abierto en la Fundación Cardio Infantil (Bogotá, Colombia) entre 2002 y 2011.Metodología: Análisis retrospectivo de la cohorte de pacientes...

In the last 70 years, congenital heart surgery has dramatically evolved, and Latin America has completed this journey with unique regional features. Since the first ligation of a patent arterial duct by Enrique Finochietto in 1941 in Buenos Aires, the development of congenital heart surgery was deeply influenced by funding restrictions and scarcity...

Very little information is available about the epidemiology of congenital heart disease in developing parts of the world, including South America. This article describes the incidence of congenital cardiac disease, the different treatment rates among countries, and future solutions for achieving improved coverage for the children with cardiac disea...

A two coronary system is preferred for correcting anomalous left coronary artery from the pulmonary artery (ALCAPA); however, translocation is not always possible. In countries where neonatal arterial switch operations have not been perfected coronary transfer can be difficult. The purpose of this report is to describe the intermediate results usin...

The diagnosis and treatment for paediatric and congenital cardiac disease has undergone remarkable progress over the last 60 years. Unfortunately, this progress has been largely limited to the developed world. Yet every year approximately 90% of the more than 1,000,000 children who are born with congenital cardiac disease across the world receive e...

IntroductionSupraventricular TachycardiasSvt Involving the Av NodeSvt Independent from Av Node Primary Atrial TachycardiasVentricular TachycardiaNonischemic Ventricular TachycardiasVentricular Tachycardia of Chagasic OriginOther Causes of Ventricular ArrhythmiaSurgical Treatment Supraventricular ArrhythmiasSurgical ResultsConclusions References

Introduction: the purpose of this study was to evaluate the efficacy of the modified Maze III surgery using a reusable cryoablation clamp compared with the classic cut and suture Maze III only in patients with permanent atrial fibrillation and mitral surgery. Methods: in the period between May 1993 and April 2005, 134 patients underwent Maze surger...

The modified Cox maze procedure is the gold standard for ablation of atrial fibrillation in patients undergoing mitral valve surgery, and new approaches to atrial fibrillation ablation must be compared with it. Therefore, we sought to determine the time-related prevalence of atrial fibrillation and its risk factors after combined Cox maze and mitra...

Objective: In Latin America is common to see young patients with large ventricular septal defect (VSD) and severe secondary pulmonary hypertension (PHT). Surgical treatment is associated with significant morbidity and mortality. Sophisticated medications and circulatory assist devices may not be available in our centers to take care of the post-ope...

Paediatric cardiovascular services are frequently absent or poorly developed in many countries around the world. Our foundation made 83 trips in support of cardiovascular services between April 1993 and March 2003 to help alleviate this problem. In this study, we present an analysis of our results over these period of 10 years. We performed a revie...

Objective: to describe the cardiac characteristics of patients submitted to aortic valvular change with ring widening for a bigger prosthesis implantation, through clinical and echocardiographic follow-up. Material and methods: 26 patients were chosen between 1997 and 2001. Follow-up was possible in 13 patients. Mean age was 57 years. A control ech...

Closure of a large ventricular septal defect (VSD) in children with elevated pulmonary vascular resistance (PVR) is associated with significant morbidity and mortality. Sophisticated medications and circulatory assist devices may not be available to assist in the care of children with elevated PVR undergoing VSD closure. We designed a fenestrated f...

With this foreign body, typical patient complaints are odynophagia and dysphagia. After reviewing the patient’s symptoms again, it was discovered that on the same day as the onset of symptoms he had eaten a fish meal and 3 h later went for a walk. The event occurred during Holy Week, in which Catholics can only eat fish. However, in the present pat...

There is a limited experience with catheter ablation for treatment of ventricular tachycardia (VT) in Chagasic cardiomyopathy. A 30-year-old woman experienced episodes of palpitations and syncope due to attacks of VT. A diagnosis of Chagas disease was established on a biological basis. Two-dimensional echo and contrast ventriculography showed an ap...

Atrial fibrillation (AF) is generally associated with rheumatic valve disease and atrial septal defects (ASD) in young adults. Surgical correction of both disorders fails to convert to sinus rhythm or prevent further episodes of paroxysmal or chronic AF in most patients. The role and efficacy of combining mitral valve surgery or ASD correction with...

Es el reimplante valvular mejor que el Bentall Biológico Modificado para tratar aneurismas de la raíz asociados a insuficiencia? Obando CE; Gutiérrez HF; Santamaría G, Bresciani R; Camacho J; Sandoval N; Umaña J. Departamento de Cirugía Cardiovascular, Fundación Cardio Infantil, Bogotá, Colombia. Objetivo: comparar resultados funcionales, morbilida...

Mecanografiado Tesis (Politologo)-- Universidad de Los Andes, Facultad de Ciencias Jurídicas y Políticas, Escuela de Ciencias Políticas, Mérida, [19--] Incluye bibliografía