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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">Las cardiopat&#237;as cong&#233;nitas &#40;CC&#41; engloban anomal&#237;as estructurales significativas del coraz&#243;n o de los grandes vasos del t&#243;rax&#44; presentes al nacer&#44; que pueden tener implicaciones funcionales<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a>&#46; Son el tipo m&#225;s prevalente de enfermedad cong&#233;nita&#44; y su incidencia es de aproximadamente 10-12 casos por cada 1&#46;000 nacidos vivos<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">2</span></a>&#46; Tambi&#233;n son la principal causa de mortalidad infantil entre las anomal&#237;as cong&#233;nitas<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a>&#46; No obstante&#44; el panorama del tratamiento de las CC ha evolucionado de manera radical&#46; Los avances del conocimiento en el campo cardiovascular y la b&#250;squeda asidua de nuevos m&#233;todos diagn&#243;sticos&#44; intervencionistas y quir&#250;rgicos han revolucionado la atenci&#243;n a estos pacientes<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a>&#46; Aun as&#237;&#44; la gravedad de la CC determina su pron&#243;stico&#44; y los pacientes afectados se enfrentan a complicaciones de grado variable<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">El amplio espectro de gravedad de las CC&#44; combinado con la heterogeneidad en su definici&#243;n en los distintos estudios publicados&#44; da lugar a una variaci&#243;n significativa en las estimaciones de su incidencia&#44; que oscila entre 4 y 50 por cada 1&#46;000 nacidos vivos<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">6</span></a>&#46; En cualquier caso&#44; el pron&#243;stico de los neonatos diagnosticados de CC ha mejorado notablemente&#46; En la actualidad&#44; se espera que el 96&#37; de los reci&#233;n nacidos con CC que sobreviven el primer a&#241;o de vida alcancen los 16 a&#241;os de edad<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">7</span></a>&#46; La edad mediana de los pacientes con CC grave ha aumentado de 11 a&#241;os en 1985 a 17 a&#241;os en 2000&#44; y la mediana de la esperanza de vida para las CC en conjunto ha aumentado de 37 a&#241;os en 2002 a 57 a&#241;os en 2007<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">8</span></a>&#46; Esta tendencia positiva se hace patente en el considerable descenso de la mortalidad entre los pacientes con CC en las 2 &#250;ltimas d&#233;cadas&#44; con reducciones que oscilan entre el 50 y el 70&#37; seg&#250;n el defecto&#46; Estos resultados demuestran un avance considerable en el manejo y en el tratamiento de las CC&#44; lo que refleja la eficacia de los avances en la atenci&#243;n sanitaria y las intervenciones terap&#233;uticas<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El cateterismo cardiaco se ha convertido en una herramienta fundamental en el diagn&#243;stico y tratamiento de los pacientes con CC&#46; Esta t&#233;cnica permite una evaluaci&#243;n exhaustiva de la anatom&#237;a y funci&#243;n cardiacas&#44; facilitando la detecci&#243;n de anomal&#237;as y proporcionando informaci&#243;n precisa para guiar las intervenciones terap&#233;uticas<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">10</span></a>&#46; Desempe&#241;a un papel crucial en el tratamiento de las enfermedades cardiacas en los pacientes pedi&#225;tricos al hacer posible la realizaci&#243;n de procedimientos m&#237;nimamente invasivos&#44; lo que puede mejorar la calidad de vida y la evoluci&#243;n a largo plazo del paciente&#46; Es especialmente &#250;til en los pacientes de mayor complejidad que requieren una evaluaci&#243;n y un manejo exhaustivos<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A pesar de los esfuerzos realizados para responder a las necesidades de estos pacientes&#44; es posible que sigan encontrando diversos obst&#225;culos en su vida cotidiana&#44; como dificultades en la escolarizaci&#243;n en el sistema de r&#233;gimen general&#44; movilidad restringida&#44; limitaciones en las actividades diarias&#44; cambios en las relaciones sociales tanto con sus padres como con ni&#241;os de su edad&#44; y dificultades en el afrontamiento de su situaci&#243;n&#44; incluyendo aspectos f&#237;sicos&#44; psicosociales&#44; cognitivos y emocionales<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a>&#46; Aparte de los retos inherentes a su enfermedad de base&#44; estos pacientes se enfrentan a desaf&#237;os adicionales por su impacto sobre la calidad de vida en m&#250;ltiples dimensiones como la social&#44; la educativa o la emocional&#46; En este contexto&#44; la integraci&#243;n de la evaluaci&#243;n de la calidad de vida emerge como un componente crucial en el manejo de estos pacientes<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">13</span></a>&#46; En las &#250;ltimas d&#233;cadas se han logrado avances significativos en el tratamiento de las CC&#44; y casi el 95&#37; de los ni&#241;os diagnosticados superan con &#233;xito la transici&#243;n a la adolescencia y a la edad adulta&#46; No obstante&#44; los adolescentes con CC sufren un deterioro en la calidad de vida relacionada con la salud &#40;CVRS&#41;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La CVRS es un constructo multidimensional y subjetivo que abarca diversos aspectos del bienestar&#44; incluyendo el funcionamiento f&#237;sico&#44; social y psicol&#243;gico&#46; En el &#225;mbito pedi&#225;trico&#44; la evaluaci&#243;n de la CVRS se erige como una necesidad absoluta que va m&#225;s all&#225; del &#225;mbito cl&#237;nico y ofrece una perspectiva integral del bienestar de los ni&#241;os y adolescentes desde el punto de vista del paciente o de los padres<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a>&#46; Se han desarrollado varios instrumentos con este objeto&#44; como el Child Health Questionnaire &#40;CHQ&#41;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">16</span></a>&#44; el KIDSCREEN<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">17</span></a>&#44; el Youth Quality of Life Instrument &#40;YQOL&#41;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">18</span></a>&#44; el Child Health and Illness Profile &#40;CHIP&#41;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a> y el Pediatric Quality of Life Inventory &#40;PedsQL&#41;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a>&#46; Entre ellos&#44; el PedsQL destaca por su uso generalizado y su validez transcultural&#44; se encuentra disponible en varios idiomas y se emplea con frecuencia en la investigaci&#243;n en salud pedi&#225;trica<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El PedsQL&#44; desarrollado por el profesor Varni et al&#46; en EE&#46; UU&#46; en 1987&#44; es una herramienta fundamental para evaluar la calidad de vida de los ni&#241;os de 2 a 18 a&#241;os de edad<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a>&#46; Su m&#243;dulo general &#40;PedsQL 4&#46;0&#41; incluye 23 &#237;tems distribuidos en cuatro dimensiones&#58; funcionamiento f&#237;sico&#44; funcionamiento emocional&#44; funcionamiento social y funcionamiento escolar<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a>&#46; En este contexto&#44; el objetivo principal del estudio fue evaluar la CVRS de los ni&#241;os con CC sometidos a cateterismo cardiaco en un solo centro de alta complejidad y analizar su asociaci&#243;n con factores cl&#237;nicos y sociodemogr&#225;ficos&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Material y m&#233;todos</span><p id="par0035" class="elsevierStylePara elsevierViewall">Estudio anal&#237;tico transversal en pacientes de 2 a 18 a&#241;os con CC sometidos a procedimientos hemodin&#225;micos pedi&#225;tricos en un hospital de alta complejidad&#44; que es un centro de referencia para las cardiopat&#237;as cong&#233;nitas&#44; en el a&#241;o 2023&#46; Se recogi&#243; informaci&#243;n de bases de datos desarrolladas en la plataforma REDCap como parte del proyecto de seguimiento institucional PID 366 y del proyecto del Departamento de Hemodin&#225;mica Pedi&#225;trica PID 520<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">22&#44;23</span></a>&#46; El proyecto institucional recoge datos sobre la calidad de vida durante la estancia hospitalaria del paciente&#44; obtenidos por el personal de enfermer&#237;a mediante entrevistas en persona o telef&#243;nicas&#46; Los datos para el proyecto de hemodin&#225;mica se obtienen mediante el registro directo por parte del especialista en hemodin&#225;mica pedi&#225;trica que realiza el procedimiento y el volcado autom&#225;tico desde el sistema de historias cl&#237;nicas electr&#243;nicas del hospital&#46; Se excluy&#243; a los pacientes con estancias inferiores a 24<span class="elsevierStyleHsp" style=""></span>h y a los pacientes de origen extranjero&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Las variables de estudio incluyeron factores sociodemogr&#225;ficos como el sexo y la edad&#44; y medidas antropom&#233;tricas como el peso&#44; la talla y la superficie corporal&#46; Tambi&#233;n se recogieron variables cl&#237;nicas como el diagn&#243;stico principal&#44; el tipo de diagn&#243;stico &#40;al nacer o postoperatorio&#41;&#44; la categor&#237;a de riesgo obtenida con la herramienta Catheterization for Congenital Heart Disease Adjustment for Risk Method &#40;CHARM&#41;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">24</span></a>&#44; la puntuaci&#243;n de vulnerabilidad hemodin&#225;mica&#44; el prop&#243;sito del cateterismo cardiaco &#40;intervencionista&#44; biopsia o diagn&#243;stico&#41;&#44; el n&#250;mero de procedimientos de cateterismo&#44; el &#233;xito del procedimiento &#40;definido como lograr el objetivo establecido de la intervenci&#243;n&#41;&#44; los eventos adversos&#44; las complicaciones durante el procedimiento y las siguientes 24<span class="elsevierStyleHsp" style=""></span>h&#44; la estancia hospitalaria y la calidad de vida durante el ingreso&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">La calidad de vida se evalu&#243; mediante la versi&#243;n en espa&#241;ol del PedsQL 4&#46;0 &#40;validada en el pa&#237;s de aplicaci&#243;n&#41;&#44; consistente en 23 &#237;tems que eval&#250;an 4 dimensiones&#58; funcionamiento f&#237;sico&#44; funcionamiento emocional&#44; funcionamiento social y funcionamiento escolar&#46; Cada dimensi&#243;n consta de 4 a 8 preguntas&#46; Las respuestas se dan en una escala Likert de 5 puntos &#40;de 0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#171;nunca es un problema&#187; a 4<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#171;casi siempre es un problema&#187; con respecto al &#250;ltimo mes&#41;&#46; Las respuestas se punt&#250;an de manera inversa con transformaci&#243;n lineal para dar lugar a una puntuaci&#243;n entre 0 y 100&#46; El ajuste de la puntuaci&#243;n se realiz&#243; de la siguiente manera&#58; &#171;nunca&#187; equival&#237;a a 100 puntos&#44; &#171;casi nunca&#187; a 75&#44; &#171;a veces&#187; a 50&#44; &#171;a menudo&#187; a 25 y &#171;casi siempre&#187; a 0&#59; donde puntuaciones m&#225;s altas indican una mejor calidad de vida en el ni&#241;o&#46; La escala est&#225; disponible en distintas versiones para grupos de edad espec&#237;ficos&#58; de 2 a 4 a&#241;os &#40;ni&#241;os peque&#241;os&#41;&#44; de 5 a 7 a&#241;os &#40;ni&#241;os&#41;&#44; de 8 a 12 a&#241;os &#40;ni&#241;os mayores&#41; y de 13 a 18 a&#241;os &#40;adolescentes&#41;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">25</span></a>&#46; Se obtuvo una licencia para el uso de la escala PedsQL 4&#46;0 con fines de investigaci&#243;n cient&#237;fica&#44; y se utiliz&#243; el cuestionario para padres en todos los grupos etarios&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">En el an&#225;lisis descriptivo se calcularon frecuencias y porcentajes para las variables categ&#243;ricas&#46; La normalidad se evalu&#243; mediante la prueba de Kolmogorov-Smirnov&#46; Para las variables que segu&#237;an una distribuci&#243;n normal se calcularon medias y desviaciones est&#225;ndar&#44; y para las que no&#44; medianas y rangos intercuart&#237;licos&#46; Se evaluaron las diferencias entre grupos de edad con la prueba de la &#967;<span class="elsevierStyleSup">2</span> o la prueba exacta de Fisher&#44; y se utiliz&#243; la prueba no param&#233;trica de Kruskal-Wallis para las variables continuas&#44; seg&#250;n la distribuci&#243;n&#46; A continuaci&#243;n&#44; se realiz&#243; un an&#225;lisis de regresi&#243;n lineal bivariante comparando cada dimensi&#243;n &#40;funcionamiento f&#237;sico&#44; emocional&#44; social y escolar&#41; con cada variable independiente para identificar las candidatas para el modelo final&#46; Por &#250;ltimo&#44; se ajustaron 4 modelos de regresi&#243;n lineal multivariante en los que la variable dependiente era la puntuaci&#243;n global en la dimensi&#243;n en cuesti&#243;n para identificar los factores asociados&#46; La significaci&#243;n estad&#237;stica se defini&#243; como p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; Todos los an&#225;lisis estad&#237;sticos se realizaron con el programa Stata 16&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><p id="par0055" class="elsevierStylePara elsevierViewall">El estudio incluy&#243; un total de 164 pacientes distribuidos en diferentes grupos de edad&#58; 20&#44;12&#37; de 2 a 4 a&#241;os&#44; 23&#44;17&#37; de 5 a 7 a&#241;os&#44; 29&#44;87&#37; de 8 a 12 a&#241;os y 26&#44;82&#37; de 13 a 18 a&#241;os&#46; La mayor proporci&#243;n de pacientes de sexo femenino se registr&#243; en el grupo de 2 a 4 a&#241;os &#40;63&#44;64&#37;&#41;&#46; En cuanto a los diagn&#243;sticos principales&#44; la atresia pulmonar fue m&#225;s frecuente en el grupo de 2 a 4 a&#241;os &#40;18&#44;75&#37;&#41; y en el de 8 a 12 a&#241;os &#40;13&#44;64&#37;&#41;&#46; El 15&#44;63&#37; de los pacientes de 2 a 4 a&#241;os ten&#237;an diagn&#243;stico de ductus arterioso persistente&#46; Con respecto al momento del diagn&#243;stico&#44; el diagn&#243;stico al nacer fue m&#225;s frecuente en todos los grupos de edad&#44; excepto en el grupo de 2 a 4 a&#241;os&#44; en el que predomin&#243; el diagn&#243;stico postoperatorio &#40;53&#44;13&#37;&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Las complicaciones durante el procedimiento fueron poco frecuentes &#40;0-2&#44;27&#37;&#41;&#44; sin diferencias significativas entre los grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;485&#41;&#46; Los eventos adversos tambi&#233;n fueron infrecuentes &#40;0-2&#44;94&#37;&#41;&#44; sin diferencias significativas entre los grupos de edad &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;58&#41;&#46; La incidencia de complicaciones en las primeras 24<span class="elsevierStyleHsp" style=""></span>h fue baja &#40;0-6&#44;06&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;511&#41;&#46; La duraci&#243;n de la estancia hospitalaria fue similar en todos los grupos de edad&#44; con una mediana de un d&#237;a y un rango de 0 a 87 d&#237;as&#44; sin diferencias significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;874&#41;&#46; Estos resultados se pueden consultar en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Al analizar cada una de las dimensiones&#44; se observ&#243; que el funcionamiento f&#237;sico era la m&#225;s afectada en estos pacientes&#44; con una puntuaci&#243;n mediana de 32&#44;14 &#40;RIC&#58; 17&#44;14-62&#44;87&#41;&#44; seguida del funcionamiento escolar&#44; con una mediana de 56 &#40;RIC&#58; 28-88&#41;&#46; Por otro lado&#44; los resultados fueron m&#225;s favorables para el funcionamiento emocional&#44; con una mediana de 62 &#40;RIC&#58; 32-74&#41;&#44; mientras que las puntuaciones en el funcionamiento social mostraron la mejor calidad de vida con una mediana de 68 &#40;RIC&#58; 44-100&#41;&#46; Al evaluar las puntuaciones por grupos de edad&#44; las puntuaciones m&#225;s altas de funcionamiento f&#237;sico se encontraron en los ni&#241;os de 8 a 12 a&#241;os&#44; con una mediana de 35&#44;71 puntos &#40;RIC&#58; 14&#44;25-64&#44;28&#41;&#44; seguidos del grupo de 13 a 18 a&#241;os con 34&#44;28 puntos &#40;RIC&#58; 21&#44;42-55&#44;71&#41;&#44; mientras que en el grupo de 2 a 4 a&#241;os fue de 30 puntos &#40;RIC&#58; 18&#44;57-52&#44;85&#41; y en el grupo de 5 a 7 a&#241;os de 29&#44;28 &#40;RIC&#58; 12&#44;85 a 62&#44;85&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;601&#41;&#46; De forma similar&#44; la puntuaci&#243;n mediana en la dimensi&#243;n de funcionamiento emocional fue mayor en el grupo de 5 a 7 a&#241;os&#44; con 69 puntos &#40;RIC&#58; 48-76&#41;&#44; seguido del grupo de 2 a 4 a&#241;os&#44; con 62 puntos &#40;RIC&#58; 42-70&#41;&#44; el grupo de 8 a 12 a&#241;os&#44; con 60 puntos &#40;RIC&#58; 34-76&#41; y&#44; con la puntuaci&#243;n m&#225;s baja&#44; el grupo de 13 a 18 a&#241;os&#44; con 52 puntos &#40;RIC&#58; 15-70&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;141&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">El an&#225;lisis de regresi&#243;n lineal bivariante revel&#243; una asociaci&#243;n significativa entre el diagn&#243;stico principal y el funcionamiento f&#237;sico&#46; As&#237;&#44; la atresia pulmonar &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y el ventr&#237;culo &#250;nico &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; se asociaban a un deterioro significativo en esta dimensi&#243;n&#46; Tambi&#233;n se identificaron diagn&#243;sticos que afectaban al funcionamiento emocional&#44; como el ventr&#237;culo &#250;nico &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; Asimismo&#44; se encontraron coeficientes negativos para la asociaci&#243;n con el diagn&#243;stico postoperatorio &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; El aumento de la superficie corporal tambi&#233;n se asociaba a un deterioro en el funcionamiento emocional &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">En el an&#225;lisis del funcionamiento social&#44; se observ&#243; que el peso del paciente ten&#237;a un impacto significativo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#44; mientras que otras variables no se asociaban con la calidad de vida en esta subescala&#46; El an&#225;lisis del funcionamiento escolar encontr&#243; una asociaci&#243;n significativa con el diagn&#243;stico de ventr&#237;culo &#250;nico &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46; De forma similar&#44; los pacientes con una clasificaci&#243;n de riesgo 2 &#40;CHARM&#41; tuvieron puntuaciones m&#225;s bajas en el funcionamiento escolar &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46; Por &#250;ltimo&#44; se observ&#243; una disminuci&#243;n considerable en la puntuaci&#243;n del funcionamiento escolar en los pacientes que presentaron eventos adversos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">El an&#225;lisis multivariante identific&#243; asociaciones entre distintas variables independientes y el funcionamiento f&#237;sico en ni&#241;os con CC&#46; Los pacientes con atresia pulmonar ten&#237;an puntuaciones m&#225;s bajas en esta dimensi&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;048&#41;&#46; En cuanto al funcionamiento emocional&#44; los pacientes con ventr&#237;culo &#250;nico mostraban puntuaciones m&#225;s bajas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;035&#41;&#44; indicativas de un deterioro significativo en esta dimensi&#243;n&#46; Por el contrario&#44; los pacientes que hab&#237;an sido sometidos a procedimientos cardiovasculares con anterioridad revelaron un deterioro mayor en el funcionamiento social &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;047&#41; y el escolar &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;048&#41;&#46; Por otra parte&#44; la edad se asoci&#243; con puntuaciones significativamente m&#225;s bajas en los grupos de 5 a 7 a&#241;os &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;016&#41; y de 8 a 12 a&#241;os &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;024&#41;&#46; Adem&#225;s&#44; una clasificaci&#243;n de riesgo 3 &#40;CHARM&#41; se asoci&#243; significativamente con puntuaciones m&#225;s bajas en el funcionamiento escolar &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#46; Por &#250;ltimo&#44; el desarrollo de eventos adversos tambi&#233;n se asoci&#243; con puntuaciones m&#225;s bajas en el funcionamiento escolar &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discusi&#243;n</span><p id="par0085" class="elsevierStylePara elsevierViewall">Las cardiopat&#237;as cong&#233;nitas constituyen un problema de salud importante a nivel mundial y afectan especialmente a la edad pedi&#225;trica&#46; Los avances en el conocimiento y las estrategias de tratamiento cardiovascular han mejorado de manera considerable el manejo y el pron&#243;stico de las cardiopat&#237;as cong&#233;nitas&#44; y las tasas de mortalidad han descendido dr&#225;sticamente en las &#250;ltimas d&#233;cadas&#46; Sin embargo&#44; el abordaje de las necesidades polifac&#233;ticas de los pacientes con CC sigue suponiendo un reto complejo&#44; especialmente en lo respectivo a su CVRS y bienestar psicosocial&#46; Los hallazgos de este estudio demuestran la compleja relaci&#243;n entre distintas dimensiones de la CVRS en pacientes pedi&#225;tricos con CC&#46; En particular&#44; la variaci&#243;n observada entre los distintos grupos de edad subraya la naturaleza multidimensional de la evaluaci&#243;n de la CVRS en esta poblaci&#243;n&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">El funcionamiento f&#237;sico result&#243; ser la dimensi&#243;n m&#225;s afectada en todos los grupos de edad&#44; lo que pone de manifiesto la magnitud del impacto de las CC sobre las actividades cotidianas y la movilidad de los pacientes pedi&#225;tricos<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">26</span></a>&#46; Este hallazgo subraya la necesidad de intervenciones personalizadas para abordar los problemas f&#237;sicos espec&#237;ficos a los que se enfrentan estos pacientes<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">27</span></a>&#44; ya que los ni&#241;os con CC no necesariamente tienen que evitar la actividad f&#237;sica&#46; De hecho&#44; en muchos casos puede ser recomendable un programa espec&#237;fico de rehabilitaci&#243;n cardiaca para mejorar los s&#237;ntomas<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">28</span></a>&#46; Por otro lado&#44; el funcionamiento social fue la dimensi&#243;n en la que se observaron los niveles m&#225;s altos de calidad de vida&#46; Es probable que estos resultados reflejen los grandes avances m&#233;dicos en la detecci&#243;n y el tratamiento de las CC realizados en las &#250;ltimas d&#233;cadas&#44; que abarcan campos como el diagn&#243;stico&#44; la cirug&#237;a cardiaca neonatal&#44; los cuidados intensivos pedi&#225;tricos y el cateterismo cardiaco&#44; entre otros<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Al mismo tiempo&#44; se observ&#243; una variaci&#243;n significativa en el funcionamiento emocional entre los grupos de edad&#44; con puntuaciones medianas m&#225;s altas en los ni&#241;os m&#225;s peque&#241;os en comparaci&#243;n con los adolescentes&#46; La ni&#241;os y adolescentes con CC tienen experiencias que difieren de las de sus compa&#241;eros de la misma edad&#44; ya que ven restringidas sus aspiraciones y pueden ser dependientes de sus padres&#46; Se sienten impotentes y ansiosos por las limitaciones f&#237;sicas y debilitantes de su enfermedad<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a>&#46; Esta disparidad resalta el cambio evolutivo en las necesidades psicosociales de los pacientes pedi&#225;tricos con CC a lo largo de la infancia y la adolescencia&#44; y justifica la implementaci&#243;n de mecanismos de apoyo e intervenciones psicol&#243;gicas apropiadas para la edad<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">31</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">El diagn&#243;stico espec&#237;fico tiene un impacto significativo en la calidad de vida de los ni&#241;os&#59; por ejemplo&#44; el diagn&#243;stico de atresia pulmonar se asoci&#243; a un deterioro del funcionamiento f&#237;sico en consonancia con los hallazgos de Ekman-Joelsson et al&#46;&#44; que encontraron un mayor nivel de s&#237;ntomas psicosom&#225;ticos en relaci&#243;n con la calidad de vida individual<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a>&#46; Por el contrario&#44; se ha descrito una asociaci&#243;n estad&#237;sticamente significativa con la edad y el sexo en los pacientes con ventr&#237;culo &#250;nico<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">33</span></a>&#46; Tambi&#233;n coincidiendo con la literatura previa&#44; el funcionamiento f&#237;sico&#44; el emocional y el escolar fueron las dimensiones de la calidad de vida afectadas en asociaci&#243;n con el diagn&#243;stico de ventr&#237;culo &#250;nico en el an&#225;lisis bivariante<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">34</span></a>&#46; Sin embargo&#44; en el modelo ajustado&#44; la asociaci&#243;n con el funcionamiento emocional fue la &#250;nica que continu&#243; siendo significativa&#46; Este hallazgo fue concordancia con varios estudios previos en los pacientes pedi&#225;tricos con ventr&#237;culo &#250;nico que identificaron problemas psicol&#243;gicos como ansiedad&#44; depresi&#243;n y s&#237;ntomas o trastornos del comportamiento&#46; Cabe destacar que&#44; a pesar de la consistencia de estos hallazgos&#44; los resultados de un metaan&#225;lisis reciente no fueron concluyentes<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">El an&#225;lisis tambi&#233;n encontr&#243; asociaciones significativas entre variables cl&#237;nicas espec&#237;ficas y las dimensiones de la CVRS&#46; En particular&#44; el antecedente de procedimientos cardiovasculares previos fue un predictor significativo de los resultados en la CVRS&#46; Este hallazgo subraya el impacto persistente de intervenciones m&#233;dicas previas en el bienestar general de los pacientes pedi&#225;tricos con cardiopat&#237;as cong&#233;nitas&#46; Adem&#225;s&#44; el desarrollo de eventos adversos se identific&#243; como un determinante significativo del funcionamiento escolar&#44; lo que sugiere que los ni&#241;os con CC tienen riesgo de presentar d&#233;ficits en el neurodesarrollo y alteraciones cognitivas que afectan los resultados escolares<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a>&#46; Por lo tanto&#44; es evidente que los ni&#241;os con cardiopat&#237;as cong&#233;nitas pueden requerir apoyo acad&#233;mico adicional o refuerzo en distintas etapas educativas para mitigar las posibles dificultades derivadas de su enfermedad<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">El presente estudio pone de manifiesto la asociaci&#243;n entre varias dimensiones de la CVRS en pacientes pedi&#225;tricos con CC&#44; destacando la importancia del manejo personalizado para responder a los retos f&#237;sicos y emocionales propios de estos pacientes&#46; Los hallazgos ponen de relieve la necesidad de recursos de apoyo e intervenciones psicol&#243;gicas apropiados para la edad con el fin de satisfacer las necesidades psicosociales de estos pacientes que van evolucionando durante la infancia y la adolescencia&#46; Por &#250;ltimo&#44; este estudio contribuye a nuestra comprensi&#243;n de las complejidades del manejo de las CC y el esfuerzo sostenido requerido para optimizar los resultados y mejorar el bienestar general de las personas afectadas&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Las limitaciones de este estudio incluyen la falta de control sobre variables externas o de confusi&#243;n que no se evaluaron &#40;como la complejidad de la CC&#41;&#44; lo que podr&#237;a limitar la capacidad de establecer relaciones de causalidad entre las variables bajo estudio y la calidad de vida de los pacientes&#46; Tampoco se utiliz&#243; el m&#243;dulo cardiaco del PedsQL&#46; Adem&#225;s&#44; el cuestionario mide la calidad de vida en referencia al &#250;ltimo mes&#44; lo que conlleva un riesgo de sesgo de informaci&#243;n al no haberse recogido datos espec&#237;ficos en tiempo real&#46; No obstante&#44; las CC son enfermedades cr&#243;nicas&#44; y la evaluaci&#243;n de la calidad de vida sigue siendo relevante a pesar de esta posible limitaci&#243;n&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusi&#243;n</span><p id="par0120" class="elsevierStylePara elsevierViewall">A pesar de los avances significativos en el tratamiento de las CC&#44; la evaluaci&#243;n de la CVRS de los ni&#241;os afectados sigue planteando dificultades&#46; El presente estudio revel&#243; un impacto variable en los distintos grupos de edad&#44; con asociaciones significativas entre diagn&#243;sticos concretos&#44; como la atresia pulmonar y el ventr&#237;culo &#250;nico&#44; y la disminuci&#243;n en las puntuaciones de la CVRS en las dimensiones f&#237;sica y emocional&#46; Adem&#225;s&#44; los eventos adversos y ciertas variables cl&#237;nicas se asociaron significativamente con el deterioro del funcionamiento social y escolar&#44; subrayando la necesidad de estrategias de manejo integral para responder a los desaf&#237;os multidimensionales que presentan los ni&#241;os con CC sometidos a cateterismo cardiaco&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Responsabilidades &#233;ticas</span><p id="par0125" class="elsevierStylePara elsevierViewall">El estudio fue aprobado por el Comit&#233; de &#201;tica en Investigaci&#243;n de la Fundaci&#243;n Cardiovascular de Colombia&#44; asegurando la adherencia a los est&#225;ndares &#233;ticos m&#225;s rigurosos a nivel nacional e internacional&#46; A lo largo de su ejecuci&#243;n&#44; se prest&#243; especial atenci&#243;n al cumplimiento de los principios y normas que rigen la investigaci&#243;n biom&#233;dica para garantizar la integridad y el bienestar de todos los participantes en el estudio&#46; En particular&#44; se obtuvo el consentimiento informado de todos los padres o tutores legales de los menores&#44; as&#237; como el asentimiento de los menores maduros&#44; seg&#250;n procediese&#46; El dise&#241;o del estudio garantiz&#243; la confidencialidad de la informaci&#243;n analizada&#44; respet&#225;ndose las gu&#237;as de &#233;tica y buena pr&#225;ctica en la obtenci&#243;n del consentimiento a la participaci&#243;n&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Autor&#237;as</span><p id="par0130" class="elsevierStylePara elsevierViewall">Maricel Licht-Ardila&#44; Alexandra Hurtado-Ortiz&#44; Fabi&#225;n Manrique-Hern&#225;ndez y Justo Jos&#233; Santiago Pe&#241;a participaron en la concepci&#243;n y ejecuci&#243;n del estudio&#44; contribuyeron a la redacci&#243;n y posterior edici&#243;n del manuscrito y aprobaron la versi&#243;n definitiva del manuscrito para su publicaci&#243;n&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Financiaci&#243;n</span><p id="par0135" class="elsevierStylePara elsevierViewall">El estudio no recibi&#243; financiaci&#243;n&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicto de intereses</span><p id="par0140" class="elsevierStylePara elsevierViewall">Los autores no tienen ning&#250;n conflicto de intereses que declarar&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Declaraci&#243;n sobre el uso de inteligencia artificial</span><p id="par0150" class="elsevierStylePara elsevierViewall">No se utiliz&#243; ning&#250;n tipo de inteligencia artificial&#46;</p></span></span>"
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    "fechaRecibido" => "2024-07-15"
    "fechaAceptado" => "2024-08-29"
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          "palabras" => array:6 [
            0 => "Calidad de vida"
            1 => "Defectos cardiacos"
            2 => "Cong&#233;nito"
            3 => "Pediatr&#237;a"
            4 => "Hemodin&#225;mica"
            5 => "Cardiolog&#237;a"
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          "palabras" => array:6 [
            0 => "Quality of life"
            1 => "Heart defects"
            2 => "Congenital"
            3 => "Paediatrics"
            4 => "Haemodynamics"
            5 => "Cardiology"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introducci&#243;n</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El manejo de la cardiopat&#237;a cong&#233;nita &#40;CC&#41; ha evolucionado&#44; mejorando el pron&#243;stico&#44; pero persisten desaf&#237;os para los pacientes&#44; subrayando la importancia de evaluar la calidad de vida relacionada con la salud &#40;CVRS&#41;&#46; El cuestionario de calidad de vida pedi&#225;trica PedsQL&#44; ampliamente utilizado&#44; resalta la relevancia de la evaluaci&#243;n de la CVRS&#44; especialmente en ni&#241;os sometidos a intervenciones m&#233;dicas&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Objetivo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Evaluar la CVRS de ni&#241;os con CC sometidos a cateterismo cardiaco&#44; examinando su relaci&#243;n con variables cl&#237;nicas y sociodemogr&#225;ficas en una instituci&#243;n de alta complejidad&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Materiales y m&#233;todos</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se llev&#243; a cabo un estudio transversal en pacientes pedi&#225;tricos de 2 a 18 a&#241;os sometidos a cateterismo para enfermedades cong&#233;nitas&#46; Se utiliz&#243; el cuestionario de calidad de vida pedi&#225;trica PedsQL para evaluar la CVRS&#46; El an&#225;lisis estad&#237;stico incluy&#243; estad&#237;sticas descriptivas&#44; pruebas de Chi-cuadrado&#44; pruebas de Kruskal-Wallis y modelos de regresi&#243;n lineal multivariante con el objetivo de identificar factores asociados&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Resultados</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El estudio involucr&#243; a 164 pacientes&#44; entre los que la atresia pulmonar y el ductus arterioso persistente fueron diagn&#243;sticos comunes&#46; La actividad f&#237;sica y la escolarizaci&#243;n se vieron significativamente afectadas&#44; con puntuaciones medianas de 32&#44;14 &#40;IR&#58; 17&#44;14-62&#44;87&#41; y 56 &#40;IR&#58; 28-88&#41;&#44; respectivamente&#46; El estado emocional y la actividad social mostraron mejores resultados&#44; con puntuaciones medianas de 62 &#40;IR&#58; 32-74&#41; y 68 &#40;IR&#58; 44-100&#41;&#44; respectivamente&#46; El diagn&#243;stico de ventr&#237;culo &#250;nico y la atresia pulmonar se asociaron con puntuaciones m&#225;s bajas de calidad de vida en el estado emocional &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;035&#41; y la funci&#243;n f&#237;sica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;048&#41;&#44; respectivamente&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusi&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este estudio subraya los desaf&#237;os continuos en la evaluaci&#243;n de la CVRS para ni&#241;os con CC&#46; Destaca asociaciones significativas entre diagn&#243;sticos espec&#237;ficos y puntuaciones disminuidas de la CVRS&#44; enfatizando la necesidad de estrategias de atenci&#243;n integral&#46;</p></span>"
        "secciones" => array:5 [
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            "titulo" => "Introducci&#243;n"
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            "titulo" => "Objetivo"
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          2 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Materiales y m&#233;todos"
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          3 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Resultados"
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          4 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Conclusi&#243;n"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The management of congenital heart disease &#40;CHD&#41; has evolved&#44; improving patient outcomes&#59; however&#44; challenges persist for patients&#44; emphasizing the importance of assessing health-related quality of life &#40;HRQoL&#41;&#46; The widely used Pediatric Quality of Life Inventory underscores the relevance of HRQoL assessment&#44; especially in children subject to medical procedures&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Objective</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">To evaluate HRQoL in children with congenital heart disease undergoing cardiac catheterization&#44; analysing its association with clinical and sociodemographic variables in a tertiary care hospital&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Materials and methods</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">We conducted a cross-sectional study in paediatric patients aged 2 to 18 years undergoing haemodynamic procedures for congenital heart diseases&#46; We used the Pediatric Quality of Life Inventory &#40;PedsQL&#41; to assess HRQoL&#46; The statistical analysis included descriptive statistics&#44; &#967;<span class="elsevierStyleSup">2</span> tests&#44; Kruskal-Wallis tests and multivariate linear regression analysis with the aim of identifying factors associated with HRQoL&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Results</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The sample included 164 patients&#44; among whom pulmonary atresia and patent ductus arteriosus were frequent diagnoses&#46; Physical functioning and school functioning were significantly impaired&#44; with median scores of 32&#46;14 &#40;IQR&#44; 17&#46;14-62&#46;87&#41; and 56 &#40;IQR&#44; 28-88&#41;&#44; respectively&#46; The results were more favourable for emotional functioning and social functioning&#44; with median scores of 62 &#40;IQR&#44; 32-74&#41; and 68 &#40;IQR&#44; 44-100&#41;&#44; respectively&#46; Single ventricle defects and pulmonary atresia were associated with lower quality of life scores in emotional functioning &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;035&#41; and physical functioning &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;048&#41;&#44; respectively&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclusion</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">This study highlights the current challenges in evaluating HRQoL for children with CHD&#46; It identified significant associations between specific diagnoses and decreased HRQoL scores&#44; emphasizing the need for comprehensive care strategies&#46;</p></span>"
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            "titulo" => "Material adicional"
            "identificador" => "sec0065"
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                  \t\t\t\t" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Mujer&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">63&#44;64&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">44&#44;74&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">26&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#46;300&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">45&#44;45&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">84&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;344&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;600&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diagn&#243;stico principal</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Comunicaci&#243;n interauricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;124&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Comunicaci&#243;n interventricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">600&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Atresia pulmonar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;300&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Miocardiopat&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">900&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ventr&#237;culo &#250;nico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;100&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ductus arterioso persistente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">Tipo de diagn&#243;stico</td><td class="td" title="\n
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                  \t\t\t\t">Postoperatorio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " rowspan="4" align="left" valign="\n
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                  \t\t\t\t">Nivel de riesgo &#40;CHARM&#41;</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">600&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;300&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">12&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
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                  \t\t\t\t">Vulnerabilidad</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#44;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">No se evalu&#243;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tipo de cateterismo</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intervencionista&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#44;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;527&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diagn&#243;stico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#46;300&#44;18&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complicaciones del procedimiento</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;485&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;700&#44;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99&#44;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eventos adversos</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;700&#44;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">149&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;580&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complicaciones en 24<span class="elsevierStyleHsp" style=""></span>h</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;700&#44;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">144&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;511&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t">&#8722;23&#44;61-2&#44;52&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;10&#44;85&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;23&#44;7-2&#44;01&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;11&#44;14&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;28&#44;83-6&#44;55&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="13" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="13" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;0&#44;15&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;9&#44;18-8&#44;88&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;3&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#8722;12&#44;91-5&#44;05&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;4&#44;46&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#8722;13&#44;33-4&#44;41&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;5&#44;44&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;16&#44;01-5&#44;13&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="13" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="13" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Diagn&#243;stico principal</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Comunicaci&#243;n interventricular&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;14&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;32&#44;88-4&#44;73&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;13&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;33&#44;15-5&#44;26&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;11&#44;88-26&#44;85&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;2&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#8722;25&#44;18-19&#44;52&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Atresia pulmonar&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;27&#44;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#8722;44&#44;92-&#8722;10&#44;01&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;9&#44;64&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;27&#44;47-8&#44;19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;20&#44;62-15&#44;33&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;9&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;32&#44;03-13&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Miocardiopat&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;6&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;28&#44;01-15&#44;61&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;58&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;18&#44;09&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;40&#44;37-4&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;47&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;18&#44;99-25&#44;93&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;76&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;9&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;35&#44;08-16&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ventr&#237;culo &#250;nico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;24&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;42&#44;56-&#8722;7&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;26&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;44&#44;45-&#8722;8&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ducto arterioso persistente&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " colspan="13" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tipo de cateterismo</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diagn&#243;stico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#8722;11&#44;14-7&#44;93&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;6&#44;79&nbsp;\t\t\t\t\t\t\n
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Impacto físico, social y emocional en los pacientes con cardiopatía congénita sometidos a cateterismo cardiaco
Physical, social, and emotional impact on patients with congenital heart disease undergoing cardiac catheterization
Maricel Licht-Ardilaa, Alexandra Hurtado-Ortiza,
Autor para correspondencia
alexandrajhop@gmail.com

Autor para correspondencia.
, Edgar Fabián Manrique-Hernándeza,b, Justo José Santiago Peñaa
a Fundación Cardiovascular de Colombia, Piedecuesta, Santander, Colombia
b Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">Las cardiopat&#237;as cong&#233;nitas &#40;CC&#41; engloban anomal&#237;as estructurales significativas del coraz&#243;n o de los grandes vasos del t&#243;rax&#44; presentes al nacer&#44; que pueden tener implicaciones funcionales<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a>&#46; Son el tipo m&#225;s prevalente de enfermedad cong&#233;nita&#44; y su incidencia es de aproximadamente 10-12 casos por cada 1&#46;000 nacidos vivos<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">2</span></a>&#46; Tambi&#233;n son la principal causa de mortalidad infantil entre las anomal&#237;as cong&#233;nitas<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a>&#46; No obstante&#44; el panorama del tratamiento de las CC ha evolucionado de manera radical&#46; Los avances del conocimiento en el campo cardiovascular y la b&#250;squeda asidua de nuevos m&#233;todos diagn&#243;sticos&#44; intervencionistas y quir&#250;rgicos han revolucionado la atenci&#243;n a estos pacientes<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a>&#46; Aun as&#237;&#44; la gravedad de la CC determina su pron&#243;stico&#44; y los pacientes afectados se enfrentan a complicaciones de grado variable<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">El amplio espectro de gravedad de las CC&#44; combinado con la heterogeneidad en su definici&#243;n en los distintos estudios publicados&#44; da lugar a una variaci&#243;n significativa en las estimaciones de su incidencia&#44; que oscila entre 4 y 50 por cada 1&#46;000 nacidos vivos<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">6</span></a>&#46; En cualquier caso&#44; el pron&#243;stico de los neonatos diagnosticados de CC ha mejorado notablemente&#46; En la actualidad&#44; se espera que el 96&#37; de los reci&#233;n nacidos con CC que sobreviven el primer a&#241;o de vida alcancen los 16 a&#241;os de edad<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">7</span></a>&#46; La edad mediana de los pacientes con CC grave ha aumentado de 11 a&#241;os en 1985 a 17 a&#241;os en 2000&#44; y la mediana de la esperanza de vida para las CC en conjunto ha aumentado de 37 a&#241;os en 2002 a 57 a&#241;os en 2007<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">8</span></a>&#46; Esta tendencia positiva se hace patente en el considerable descenso de la mortalidad entre los pacientes con CC en las 2 &#250;ltimas d&#233;cadas&#44; con reducciones que oscilan entre el 50 y el 70&#37; seg&#250;n el defecto&#46; Estos resultados demuestran un avance considerable en el manejo y en el tratamiento de las CC&#44; lo que refleja la eficacia de los avances en la atenci&#243;n sanitaria y las intervenciones terap&#233;uticas<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El cateterismo cardiaco se ha convertido en una herramienta fundamental en el diagn&#243;stico y tratamiento de los pacientes con CC&#46; Esta t&#233;cnica permite una evaluaci&#243;n exhaustiva de la anatom&#237;a y funci&#243;n cardiacas&#44; facilitando la detecci&#243;n de anomal&#237;as y proporcionando informaci&#243;n precisa para guiar las intervenciones terap&#233;uticas<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">10</span></a>&#46; Desempe&#241;a un papel crucial en el tratamiento de las enfermedades cardiacas en los pacientes pedi&#225;tricos al hacer posible la realizaci&#243;n de procedimientos m&#237;nimamente invasivos&#44; lo que puede mejorar la calidad de vida y la evoluci&#243;n a largo plazo del paciente&#46; Es especialmente &#250;til en los pacientes de mayor complejidad que requieren una evaluaci&#243;n y un manejo exhaustivos<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A pesar de los esfuerzos realizados para responder a las necesidades de estos pacientes&#44; es posible que sigan encontrando diversos obst&#225;culos en su vida cotidiana&#44; como dificultades en la escolarizaci&#243;n en el sistema de r&#233;gimen general&#44; movilidad restringida&#44; limitaciones en las actividades diarias&#44; cambios en las relaciones sociales tanto con sus padres como con ni&#241;os de su edad&#44; y dificultades en el afrontamiento de su situaci&#243;n&#44; incluyendo aspectos f&#237;sicos&#44; psicosociales&#44; cognitivos y emocionales<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a>&#46; Aparte de los retos inherentes a su enfermedad de base&#44; estos pacientes se enfrentan a desaf&#237;os adicionales por su impacto sobre la calidad de vida en m&#250;ltiples dimensiones como la social&#44; la educativa o la emocional&#46; En este contexto&#44; la integraci&#243;n de la evaluaci&#243;n de la calidad de vida emerge como un componente crucial en el manejo de estos pacientes<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">13</span></a>&#46; En las &#250;ltimas d&#233;cadas se han logrado avances significativos en el tratamiento de las CC&#44; y casi el 95&#37; de los ni&#241;os diagnosticados superan con &#233;xito la transici&#243;n a la adolescencia y a la edad adulta&#46; No obstante&#44; los adolescentes con CC sufren un deterioro en la calidad de vida relacionada con la salud &#40;CVRS&#41;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La CVRS es un constructo multidimensional y subjetivo que abarca diversos aspectos del bienestar&#44; incluyendo el funcionamiento f&#237;sico&#44; social y psicol&#243;gico&#46; En el &#225;mbito pedi&#225;trico&#44; la evaluaci&#243;n de la CVRS se erige como una necesidad absoluta que va m&#225;s all&#225; del &#225;mbito cl&#237;nico y ofrece una perspectiva integral del bienestar de los ni&#241;os y adolescentes desde el punto de vista del paciente o de los padres<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a>&#46; Se han desarrollado varios instrumentos con este objeto&#44; como el Child Health Questionnaire &#40;CHQ&#41;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">16</span></a>&#44; el KIDSCREEN<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">17</span></a>&#44; el Youth Quality of Life Instrument &#40;YQOL&#41;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">18</span></a>&#44; el Child Health and Illness Profile &#40;CHIP&#41;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a> y el Pediatric Quality of Life Inventory &#40;PedsQL&#41;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a>&#46; Entre ellos&#44; el PedsQL destaca por su uso generalizado y su validez transcultural&#44; se encuentra disponible en varios idiomas y se emplea con frecuencia en la investigaci&#243;n en salud pedi&#225;trica<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El PedsQL&#44; desarrollado por el profesor Varni et al&#46; en EE&#46; UU&#46; en 1987&#44; es una herramienta fundamental para evaluar la calidad de vida de los ni&#241;os de 2 a 18 a&#241;os de edad<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a>&#46; Su m&#243;dulo general &#40;PedsQL 4&#46;0&#41; incluye 23 &#237;tems distribuidos en cuatro dimensiones&#58; funcionamiento f&#237;sico&#44; funcionamiento emocional&#44; funcionamiento social y funcionamiento escolar<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a>&#46; En este contexto&#44; el objetivo principal del estudio fue evaluar la CVRS de los ni&#241;os con CC sometidos a cateterismo cardiaco en un solo centro de alta complejidad y analizar su asociaci&#243;n con factores cl&#237;nicos y sociodemogr&#225;ficos&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Material y m&#233;todos</span><p id="par0035" class="elsevierStylePara elsevierViewall">Estudio anal&#237;tico transversal en pacientes de 2 a 18 a&#241;os con CC sometidos a procedimientos hemodin&#225;micos pedi&#225;tricos en un hospital de alta complejidad&#44; que es un centro de referencia para las cardiopat&#237;as cong&#233;nitas&#44; en el a&#241;o 2023&#46; Se recogi&#243; informaci&#243;n de bases de datos desarrolladas en la plataforma REDCap como parte del proyecto de seguimiento institucional PID 366 y del proyecto del Departamento de Hemodin&#225;mica Pedi&#225;trica PID 520<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">22&#44;23</span></a>&#46; El proyecto institucional recoge datos sobre la calidad de vida durante la estancia hospitalaria del paciente&#44; obtenidos por el personal de enfermer&#237;a mediante entrevistas en persona o telef&#243;nicas&#46; Los datos para el proyecto de hemodin&#225;mica se obtienen mediante el registro directo por parte del especialista en hemodin&#225;mica pedi&#225;trica que realiza el procedimiento y el volcado autom&#225;tico desde el sistema de historias cl&#237;nicas electr&#243;nicas del hospital&#46; Se excluy&#243; a los pacientes con estancias inferiores a 24<span class="elsevierStyleHsp" style=""></span>h y a los pacientes de origen extranjero&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Las variables de estudio incluyeron factores sociodemogr&#225;ficos como el sexo y la edad&#44; y medidas antropom&#233;tricas como el peso&#44; la talla y la superficie corporal&#46; Tambi&#233;n se recogieron variables cl&#237;nicas como el diagn&#243;stico principal&#44; el tipo de diagn&#243;stico &#40;al nacer o postoperatorio&#41;&#44; la categor&#237;a de riesgo obtenida con la herramienta Catheterization for Congenital Heart Disease Adjustment for Risk Method &#40;CHARM&#41;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">24</span></a>&#44; la puntuaci&#243;n de vulnerabilidad hemodin&#225;mica&#44; el prop&#243;sito del cateterismo cardiaco &#40;intervencionista&#44; biopsia o diagn&#243;stico&#41;&#44; el n&#250;mero de procedimientos de cateterismo&#44; el &#233;xito del procedimiento &#40;definido como lograr el objetivo establecido de la intervenci&#243;n&#41;&#44; los eventos adversos&#44; las complicaciones durante el procedimiento y las siguientes 24<span class="elsevierStyleHsp" style=""></span>h&#44; la estancia hospitalaria y la calidad de vida durante el ingreso&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">La calidad de vida se evalu&#243; mediante la versi&#243;n en espa&#241;ol del PedsQL 4&#46;0 &#40;validada en el pa&#237;s de aplicaci&#243;n&#41;&#44; consistente en 23 &#237;tems que eval&#250;an 4 dimensiones&#58; funcionamiento f&#237;sico&#44; funcionamiento emocional&#44; funcionamiento social y funcionamiento escolar&#46; Cada dimensi&#243;n consta de 4 a 8 preguntas&#46; Las respuestas se dan en una escala Likert de 5 puntos &#40;de 0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#171;nunca es un problema&#187; a 4<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#171;casi siempre es un problema&#187; con respecto al &#250;ltimo mes&#41;&#46; Las respuestas se punt&#250;an de manera inversa con transformaci&#243;n lineal para dar lugar a una puntuaci&#243;n entre 0 y 100&#46; El ajuste de la puntuaci&#243;n se realiz&#243; de la siguiente manera&#58; &#171;nunca&#187; equival&#237;a a 100 puntos&#44; &#171;casi nunca&#187; a 75&#44; &#171;a veces&#187; a 50&#44; &#171;a menudo&#187; a 25 y &#171;casi siempre&#187; a 0&#59; donde puntuaciones m&#225;s altas indican una mejor calidad de vida en el ni&#241;o&#46; La escala est&#225; disponible en distintas versiones para grupos de edad espec&#237;ficos&#58; de 2 a 4 a&#241;os &#40;ni&#241;os peque&#241;os&#41;&#44; de 5 a 7 a&#241;os &#40;ni&#241;os&#41;&#44; de 8 a 12 a&#241;os &#40;ni&#241;os mayores&#41; y de 13 a 18 a&#241;os &#40;adolescentes&#41;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">25</span></a>&#46; Se obtuvo una licencia para el uso de la escala PedsQL 4&#46;0 con fines de investigaci&#243;n cient&#237;fica&#44; y se utiliz&#243; el cuestionario para padres en todos los grupos etarios&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">En el an&#225;lisis descriptivo se calcularon frecuencias y porcentajes para las variables categ&#243;ricas&#46; La normalidad se evalu&#243; mediante la prueba de Kolmogorov-Smirnov&#46; Para las variables que segu&#237;an una distribuci&#243;n normal se calcularon medias y desviaciones est&#225;ndar&#44; y para las que no&#44; medianas y rangos intercuart&#237;licos&#46; Se evaluaron las diferencias entre grupos de edad con la prueba de la &#967;<span class="elsevierStyleSup">2</span> o la prueba exacta de Fisher&#44; y se utiliz&#243; la prueba no param&#233;trica de Kruskal-Wallis para las variables continuas&#44; seg&#250;n la distribuci&#243;n&#46; A continuaci&#243;n&#44; se realiz&#243; un an&#225;lisis de regresi&#243;n lineal bivariante comparando cada dimensi&#243;n &#40;funcionamiento f&#237;sico&#44; emocional&#44; social y escolar&#41; con cada variable independiente para identificar las candidatas para el modelo final&#46; Por &#250;ltimo&#44; se ajustaron 4 modelos de regresi&#243;n lineal multivariante en los que la variable dependiente era la puntuaci&#243;n global en la dimensi&#243;n en cuesti&#243;n para identificar los factores asociados&#46; La significaci&#243;n estad&#237;stica se defini&#243; como p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; Todos los an&#225;lisis estad&#237;sticos se realizaron con el programa Stata 16&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><p id="par0055" class="elsevierStylePara elsevierViewall">El estudio incluy&#243; un total de 164 pacientes distribuidos en diferentes grupos de edad&#58; 20&#44;12&#37; de 2 a 4 a&#241;os&#44; 23&#44;17&#37; de 5 a 7 a&#241;os&#44; 29&#44;87&#37; de 8 a 12 a&#241;os y 26&#44;82&#37; de 13 a 18 a&#241;os&#46; La mayor proporci&#243;n de pacientes de sexo femenino se registr&#243; en el grupo de 2 a 4 a&#241;os &#40;63&#44;64&#37;&#41;&#46; En cuanto a los diagn&#243;sticos principales&#44; la atresia pulmonar fue m&#225;s frecuente en el grupo de 2 a 4 a&#241;os &#40;18&#44;75&#37;&#41; y en el de 8 a 12 a&#241;os &#40;13&#44;64&#37;&#41;&#46; El 15&#44;63&#37; de los pacientes de 2 a 4 a&#241;os ten&#237;an diagn&#243;stico de ductus arterioso persistente&#46; Con respecto al momento del diagn&#243;stico&#44; el diagn&#243;stico al nacer fue m&#225;s frecuente en todos los grupos de edad&#44; excepto en el grupo de 2 a 4 a&#241;os&#44; en el que predomin&#243; el diagn&#243;stico postoperatorio &#40;53&#44;13&#37;&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Las complicaciones durante el procedimiento fueron poco frecuentes &#40;0-2&#44;27&#37;&#41;&#44; sin diferencias significativas entre los grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;485&#41;&#46; Los eventos adversos tambi&#233;n fueron infrecuentes &#40;0-2&#44;94&#37;&#41;&#44; sin diferencias significativas entre los grupos de edad &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;58&#41;&#46; La incidencia de complicaciones en las primeras 24<span class="elsevierStyleHsp" style=""></span>h fue baja &#40;0-6&#44;06&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;511&#41;&#46; La duraci&#243;n de la estancia hospitalaria fue similar en todos los grupos de edad&#44; con una mediana de un d&#237;a y un rango de 0 a 87 d&#237;as&#44; sin diferencias significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;874&#41;&#46; Estos resultados se pueden consultar en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Al analizar cada una de las dimensiones&#44; se observ&#243; que el funcionamiento f&#237;sico era la m&#225;s afectada en estos pacientes&#44; con una puntuaci&#243;n mediana de 32&#44;14 &#40;RIC&#58; 17&#44;14-62&#44;87&#41;&#44; seguida del funcionamiento escolar&#44; con una mediana de 56 &#40;RIC&#58; 28-88&#41;&#46; Por otro lado&#44; los resultados fueron m&#225;s favorables para el funcionamiento emocional&#44; con una mediana de 62 &#40;RIC&#58; 32-74&#41;&#44; mientras que las puntuaciones en el funcionamiento social mostraron la mejor calidad de vida con una mediana de 68 &#40;RIC&#58; 44-100&#41;&#46; Al evaluar las puntuaciones por grupos de edad&#44; las puntuaciones m&#225;s altas de funcionamiento f&#237;sico se encontraron en los ni&#241;os de 8 a 12 a&#241;os&#44; con una mediana de 35&#44;71 puntos &#40;RIC&#58; 14&#44;25-64&#44;28&#41;&#44; seguidos del grupo de 13 a 18 a&#241;os con 34&#44;28 puntos &#40;RIC&#58; 21&#44;42-55&#44;71&#41;&#44; mientras que en el grupo de 2 a 4 a&#241;os fue de 30 puntos &#40;RIC&#58; 18&#44;57-52&#44;85&#41; y en el grupo de 5 a 7 a&#241;os de 29&#44;28 &#40;RIC&#58; 12&#44;85 a 62&#44;85&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;601&#41;&#46; De forma similar&#44; la puntuaci&#243;n mediana en la dimensi&#243;n de funcionamiento emocional fue mayor en el grupo de 5 a 7 a&#241;os&#44; con 69 puntos &#40;RIC&#58; 48-76&#41;&#44; seguido del grupo de 2 a 4 a&#241;os&#44; con 62 puntos &#40;RIC&#58; 42-70&#41;&#44; el grupo de 8 a 12 a&#241;os&#44; con 60 puntos &#40;RIC&#58; 34-76&#41; y&#44; con la puntuaci&#243;n m&#225;s baja&#44; el grupo de 13 a 18 a&#241;os&#44; con 52 puntos &#40;RIC&#58; 15-70&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;141&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">El an&#225;lisis de regresi&#243;n lineal bivariante revel&#243; una asociaci&#243;n significativa entre el diagn&#243;stico principal y el funcionamiento f&#237;sico&#46; As&#237;&#44; la atresia pulmonar &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y el ventr&#237;culo &#250;nico &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; se asociaban a un deterioro significativo en esta dimensi&#243;n&#46; Tambi&#233;n se identificaron diagn&#243;sticos que afectaban al funcionamiento emocional&#44; como el ventr&#237;culo &#250;nico &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; Asimismo&#44; se encontraron coeficientes negativos para la asociaci&#243;n con el diagn&#243;stico postoperatorio &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; El aumento de la superficie corporal tambi&#233;n se asociaba a un deterioro en el funcionamiento emocional &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">En el an&#225;lisis del funcionamiento social&#44; se observ&#243; que el peso del paciente ten&#237;a un impacto significativo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#44; mientras que otras variables no se asociaban con la calidad de vida en esta subescala&#46; El an&#225;lisis del funcionamiento escolar encontr&#243; una asociaci&#243;n significativa con el diagn&#243;stico de ventr&#237;culo &#250;nico &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46; De forma similar&#44; los pacientes con una clasificaci&#243;n de riesgo 2 &#40;CHARM&#41; tuvieron puntuaciones m&#225;s bajas en el funcionamiento escolar &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46; Por &#250;ltimo&#44; se observ&#243; una disminuci&#243;n considerable en la puntuaci&#243;n del funcionamiento escolar en los pacientes que presentaron eventos adversos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">El an&#225;lisis multivariante identific&#243; asociaciones entre distintas variables independientes y el funcionamiento f&#237;sico en ni&#241;os con CC&#46; Los pacientes con atresia pulmonar ten&#237;an puntuaciones m&#225;s bajas en esta dimensi&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;048&#41;&#46; En cuanto al funcionamiento emocional&#44; los pacientes con ventr&#237;culo &#250;nico mostraban puntuaciones m&#225;s bajas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;035&#41;&#44; indicativas de un deterioro significativo en esta dimensi&#243;n&#46; Por el contrario&#44; los pacientes que hab&#237;an sido sometidos a procedimientos cardiovasculares con anterioridad revelaron un deterioro mayor en el funcionamiento social &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;047&#41; y el escolar &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;048&#41;&#46; Por otra parte&#44; la edad se asoci&#243; con puntuaciones significativamente m&#225;s bajas en los grupos de 5 a 7 a&#241;os &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;016&#41; y de 8 a 12 a&#241;os &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;024&#41;&#46; Adem&#225;s&#44; una clasificaci&#243;n de riesgo 3 &#40;CHARM&#41; se asoci&#243; significativamente con puntuaciones m&#225;s bajas en el funcionamiento escolar &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#46; Por &#250;ltimo&#44; el desarrollo de eventos adversos tambi&#233;n se asoci&#243; con puntuaciones m&#225;s bajas en el funcionamiento escolar &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discusi&#243;n</span><p id="par0085" class="elsevierStylePara elsevierViewall">Las cardiopat&#237;as cong&#233;nitas constituyen un problema de salud importante a nivel mundial y afectan especialmente a la edad pedi&#225;trica&#46; Los avances en el conocimiento y las estrategias de tratamiento cardiovascular han mejorado de manera considerable el manejo y el pron&#243;stico de las cardiopat&#237;as cong&#233;nitas&#44; y las tasas de mortalidad han descendido dr&#225;sticamente en las &#250;ltimas d&#233;cadas&#46; Sin embargo&#44; el abordaje de las necesidades polifac&#233;ticas de los pacientes con CC sigue suponiendo un reto complejo&#44; especialmente en lo respectivo a su CVRS y bienestar psicosocial&#46; Los hallazgos de este estudio demuestran la compleja relaci&#243;n entre distintas dimensiones de la CVRS en pacientes pedi&#225;tricos con CC&#46; En particular&#44; la variaci&#243;n observada entre los distintos grupos de edad subraya la naturaleza multidimensional de la evaluaci&#243;n de la CVRS en esta poblaci&#243;n&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">El funcionamiento f&#237;sico result&#243; ser la dimensi&#243;n m&#225;s afectada en todos los grupos de edad&#44; lo que pone de manifiesto la magnitud del impacto de las CC sobre las actividades cotidianas y la movilidad de los pacientes pedi&#225;tricos<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">26</span></a>&#46; Este hallazgo subraya la necesidad de intervenciones personalizadas para abordar los problemas f&#237;sicos espec&#237;ficos a los que se enfrentan estos pacientes<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">27</span></a>&#44; ya que los ni&#241;os con CC no necesariamente tienen que evitar la actividad f&#237;sica&#46; De hecho&#44; en muchos casos puede ser recomendable un programa espec&#237;fico de rehabilitaci&#243;n cardiaca para mejorar los s&#237;ntomas<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">28</span></a>&#46; Por otro lado&#44; el funcionamiento social fue la dimensi&#243;n en la que se observaron los niveles m&#225;s altos de calidad de vida&#46; Es probable que estos resultados reflejen los grandes avances m&#233;dicos en la detecci&#243;n y el tratamiento de las CC realizados en las &#250;ltimas d&#233;cadas&#44; que abarcan campos como el diagn&#243;stico&#44; la cirug&#237;a cardiaca neonatal&#44; los cuidados intensivos pedi&#225;tricos y el cateterismo cardiaco&#44; entre otros<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Al mismo tiempo&#44; se observ&#243; una variaci&#243;n significativa en el funcionamiento emocional entre los grupos de edad&#44; con puntuaciones medianas m&#225;s altas en los ni&#241;os m&#225;s peque&#241;os en comparaci&#243;n con los adolescentes&#46; La ni&#241;os y adolescentes con CC tienen experiencias que difieren de las de sus compa&#241;eros de la misma edad&#44; ya que ven restringidas sus aspiraciones y pueden ser dependientes de sus padres&#46; Se sienten impotentes y ansiosos por las limitaciones f&#237;sicas y debilitantes de su enfermedad<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a>&#46; Esta disparidad resalta el cambio evolutivo en las necesidades psicosociales de los pacientes pedi&#225;tricos con CC a lo largo de la infancia y la adolescencia&#44; y justifica la implementaci&#243;n de mecanismos de apoyo e intervenciones psicol&#243;gicas apropiadas para la edad<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">31</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">El diagn&#243;stico espec&#237;fico tiene un impacto significativo en la calidad de vida de los ni&#241;os&#59; por ejemplo&#44; el diagn&#243;stico de atresia pulmonar se asoci&#243; a un deterioro del funcionamiento f&#237;sico en consonancia con los hallazgos de Ekman-Joelsson et al&#46;&#44; que encontraron un mayor nivel de s&#237;ntomas psicosom&#225;ticos en relaci&#243;n con la calidad de vida individual<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a>&#46; Por el contrario&#44; se ha descrito una asociaci&#243;n estad&#237;sticamente significativa con la edad y el sexo en los pacientes con ventr&#237;culo &#250;nico<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">33</span></a>&#46; Tambi&#233;n coincidiendo con la literatura previa&#44; el funcionamiento f&#237;sico&#44; el emocional y el escolar fueron las dimensiones de la calidad de vida afectadas en asociaci&#243;n con el diagn&#243;stico de ventr&#237;culo &#250;nico en el an&#225;lisis bivariante<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">34</span></a>&#46; Sin embargo&#44; en el modelo ajustado&#44; la asociaci&#243;n con el funcionamiento emocional fue la &#250;nica que continu&#243; siendo significativa&#46; Este hallazgo fue concordancia con varios estudios previos en los pacientes pedi&#225;tricos con ventr&#237;culo &#250;nico que identificaron problemas psicol&#243;gicos como ansiedad&#44; depresi&#243;n y s&#237;ntomas o trastornos del comportamiento&#46; Cabe destacar que&#44; a pesar de la consistencia de estos hallazgos&#44; los resultados de un metaan&#225;lisis reciente no fueron concluyentes<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">El an&#225;lisis tambi&#233;n encontr&#243; asociaciones significativas entre variables cl&#237;nicas espec&#237;ficas y las dimensiones de la CVRS&#46; En particular&#44; el antecedente de procedimientos cardiovasculares previos fue un predictor significativo de los resultados en la CVRS&#46; Este hallazgo subraya el impacto persistente de intervenciones m&#233;dicas previas en el bienestar general de los pacientes pedi&#225;tricos con cardiopat&#237;as cong&#233;nitas&#46; Adem&#225;s&#44; el desarrollo de eventos adversos se identific&#243; como un determinante significativo del funcionamiento escolar&#44; lo que sugiere que los ni&#241;os con CC tienen riesgo de presentar d&#233;ficits en el neurodesarrollo y alteraciones cognitivas que afectan los resultados escolares<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a>&#46; Por lo tanto&#44; es evidente que los ni&#241;os con cardiopat&#237;as cong&#233;nitas pueden requerir apoyo acad&#233;mico adicional o refuerzo en distintas etapas educativas para mitigar las posibles dificultades derivadas de su enfermedad<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">El presente estudio pone de manifiesto la asociaci&#243;n entre varias dimensiones de la CVRS en pacientes pedi&#225;tricos con CC&#44; destacando la importancia del manejo personalizado para responder a los retos f&#237;sicos y emocionales propios de estos pacientes&#46; Los hallazgos ponen de relieve la necesidad de recursos de apoyo e intervenciones psicol&#243;gicas apropiados para la edad con el fin de satisfacer las necesidades psicosociales de estos pacientes que van evolucionando durante la infancia y la adolescencia&#46; Por &#250;ltimo&#44; este estudio contribuye a nuestra comprensi&#243;n de las complejidades del manejo de las CC y el esfuerzo sostenido requerido para optimizar los resultados y mejorar el bienestar general de las personas afectadas&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Las limitaciones de este estudio incluyen la falta de control sobre variables externas o de confusi&#243;n que no se evaluaron &#40;como la complejidad de la CC&#41;&#44; lo que podr&#237;a limitar la capacidad de establecer relaciones de causalidad entre las variables bajo estudio y la calidad de vida de los pacientes&#46; Tampoco se utiliz&#243; el m&#243;dulo cardiaco del PedsQL&#46; Adem&#225;s&#44; el cuestionario mide la calidad de vida en referencia al &#250;ltimo mes&#44; lo que conlleva un riesgo de sesgo de informaci&#243;n al no haberse recogido datos espec&#237;ficos en tiempo real&#46; No obstante&#44; las CC son enfermedades cr&#243;nicas&#44; y la evaluaci&#243;n de la calidad de vida sigue siendo relevante a pesar de esta posible limitaci&#243;n&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusi&#243;n</span><p id="par0120" class="elsevierStylePara elsevierViewall">A pesar de los avances significativos en el tratamiento de las CC&#44; la evaluaci&#243;n de la CVRS de los ni&#241;os afectados sigue planteando dificultades&#46; El presente estudio revel&#243; un impacto variable en los distintos grupos de edad&#44; con asociaciones significativas entre diagn&#243;sticos concretos&#44; como la atresia pulmonar y el ventr&#237;culo &#250;nico&#44; y la disminuci&#243;n en las puntuaciones de la CVRS en las dimensiones f&#237;sica y emocional&#46; Adem&#225;s&#44; los eventos adversos y ciertas variables cl&#237;nicas se asociaron significativamente con el deterioro del funcionamiento social y escolar&#44; subrayando la necesidad de estrategias de manejo integral para responder a los desaf&#237;os multidimensionales que presentan los ni&#241;os con CC sometidos a cateterismo cardiaco&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Responsabilidades &#233;ticas</span><p id="par0125" class="elsevierStylePara elsevierViewall">El estudio fue aprobado por el Comit&#233; de &#201;tica en Investigaci&#243;n de la Fundaci&#243;n Cardiovascular de Colombia&#44; asegurando la adherencia a los est&#225;ndares &#233;ticos m&#225;s rigurosos a nivel nacional e internacional&#46; A lo largo de su ejecuci&#243;n&#44; se prest&#243; especial atenci&#243;n al cumplimiento de los principios y normas que rigen la investigaci&#243;n biom&#233;dica para garantizar la integridad y el bienestar de todos los participantes en el estudio&#46; En particular&#44; se obtuvo el consentimiento informado de todos los padres o tutores legales de los menores&#44; as&#237; como el asentimiento de los menores maduros&#44; seg&#250;n procediese&#46; El dise&#241;o del estudio garantiz&#243; la confidencialidad de la informaci&#243;n analizada&#44; respet&#225;ndose las gu&#237;as de &#233;tica y buena pr&#225;ctica en la obtenci&#243;n del consentimiento a la participaci&#243;n&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Autor&#237;as</span><p id="par0130" class="elsevierStylePara elsevierViewall">Maricel Licht-Ardila&#44; Alexandra Hurtado-Ortiz&#44; Fabi&#225;n Manrique-Hern&#225;ndez y Justo Jos&#233; Santiago Pe&#241;a participaron en la concepci&#243;n y ejecuci&#243;n del estudio&#44; contribuyeron a la redacci&#243;n y posterior edici&#243;n del manuscrito y aprobaron la versi&#243;n definitiva del manuscrito para su publicaci&#243;n&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Financiaci&#243;n</span><p id="par0135" class="elsevierStylePara elsevierViewall">El estudio no recibi&#243; financiaci&#243;n&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicto de intereses</span><p id="par0140" class="elsevierStylePara elsevierViewall">Los autores no tienen ning&#250;n conflicto de intereses que declarar&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Declaraci&#243;n sobre el uso de inteligencia artificial</span><p id="par0150" class="elsevierStylePara elsevierViewall">No se utiliz&#243; ning&#250;n tipo de inteligencia artificial&#46;</p></span></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introducci&#243;n</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El manejo de la cardiopat&#237;a cong&#233;nita &#40;CC&#41; ha evolucionado&#44; mejorando el pron&#243;stico&#44; pero persisten desaf&#237;os para los pacientes&#44; subrayando la importancia de evaluar la calidad de vida relacionada con la salud &#40;CVRS&#41;&#46; El cuestionario de calidad de vida pedi&#225;trica PedsQL&#44; ampliamente utilizado&#44; resalta la relevancia de la evaluaci&#243;n de la CVRS&#44; especialmente en ni&#241;os sometidos a intervenciones m&#233;dicas&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Objetivo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Evaluar la CVRS de ni&#241;os con CC sometidos a cateterismo cardiaco&#44; examinando su relaci&#243;n con variables cl&#237;nicas y sociodemogr&#225;ficas en una instituci&#243;n de alta complejidad&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Materiales y m&#233;todos</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se llev&#243; a cabo un estudio transversal en pacientes pedi&#225;tricos de 2 a 18 a&#241;os sometidos a cateterismo para enfermedades cong&#233;nitas&#46; Se utiliz&#243; el cuestionario de calidad de vida pedi&#225;trica PedsQL para evaluar la CVRS&#46; El an&#225;lisis estad&#237;stico incluy&#243; estad&#237;sticas descriptivas&#44; pruebas de Chi-cuadrado&#44; pruebas de Kruskal-Wallis y modelos de regresi&#243;n lineal multivariante con el objetivo de identificar factores asociados&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Resultados</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El estudio involucr&#243; a 164 pacientes&#44; entre los que la atresia pulmonar y el ductus arterioso persistente fueron diagn&#243;sticos comunes&#46; La actividad f&#237;sica y la escolarizaci&#243;n se vieron significativamente afectadas&#44; con puntuaciones medianas de 32&#44;14 &#40;IR&#58; 17&#44;14-62&#44;87&#41; y 56 &#40;IR&#58; 28-88&#41;&#44; respectivamente&#46; El estado emocional y la actividad social mostraron mejores resultados&#44; con puntuaciones medianas de 62 &#40;IR&#58; 32-74&#41; y 68 &#40;IR&#58; 44-100&#41;&#44; respectivamente&#46; El diagn&#243;stico de ventr&#237;culo &#250;nico y la atresia pulmonar se asociaron con puntuaciones m&#225;s bajas de calidad de vida en el estado emocional &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;035&#41; y la funci&#243;n f&#237;sica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;048&#41;&#44; respectivamente&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusi&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este estudio subraya los desaf&#237;os continuos en la evaluaci&#243;n de la CVRS para ni&#241;os con CC&#46; Destaca asociaciones significativas entre diagn&#243;sticos espec&#237;ficos y puntuaciones disminuidas de la CVRS&#44; enfatizando la necesidad de estrategias de atenci&#243;n integral&#46;</p></span>"
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        "resumen" => "<span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The management of congenital heart disease &#40;CHD&#41; has evolved&#44; improving patient outcomes&#59; however&#44; challenges persist for patients&#44; emphasizing the importance of assessing health-related quality of life &#40;HRQoL&#41;&#46; The widely used Pediatric Quality of Life Inventory underscores the relevance of HRQoL assessment&#44; especially in children subject to medical procedures&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Objective</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">To evaluate HRQoL in children with congenital heart disease undergoing cardiac catheterization&#44; analysing its association with clinical and sociodemographic variables in a tertiary care hospital&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Materials and methods</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">We conducted a cross-sectional study in paediatric patients aged 2 to 18 years undergoing haemodynamic procedures for congenital heart diseases&#46; We used the Pediatric Quality of Life Inventory &#40;PedsQL&#41; to assess HRQoL&#46; The statistical analysis included descriptive statistics&#44; &#967;<span class="elsevierStyleSup">2</span> tests&#44; Kruskal-Wallis tests and multivariate linear regression analysis with the aim of identifying factors associated with HRQoL&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Results</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The sample included 164 patients&#44; among whom pulmonary atresia and patent ductus arteriosus were frequent diagnoses&#46; Physical functioning and school functioning were significantly impaired&#44; with median scores of 32&#46;14 &#40;IQR&#44; 17&#46;14-62&#46;87&#41; and 56 &#40;IQR&#44; 28-88&#41;&#44; respectively&#46; The results were more favourable for emotional functioning and social functioning&#44; with median scores of 62 &#40;IQR&#44; 32-74&#41; and 68 &#40;IQR&#44; 44-100&#41;&#44; respectively&#46; Single ventricle defects and pulmonary atresia were associated with lower quality of life scores in emotional functioning &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;035&#41; and physical functioning &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;048&#41;&#44; respectively&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclusion</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">This study highlights the current challenges in evaluating HRQoL for children with CHD&#46; It identified significant associations between specific diagnoses and decreased HRQoL scores&#44; emphasizing the need for comprehensive care strategies&#46;</p></span>"
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                  \t\t\t\t">5&#46;300&#44;06&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#44;45&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;344&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">36&#44;36&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;600&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diagn&#243;stico principal</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Comunicaci&#243;n interauricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;124&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Comunicaci&#243;n interventricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">600&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Atresia pulmonar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;300&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Miocardiopat&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">900&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ventr&#237;culo &#250;nico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;100&#44;36&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">11&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ductus arterioso persistente&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Otro&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">Tipo de diagn&#243;stico</td><td class="td" title="\n
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                  \t\t\t\t">Al nacer&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Postoperatorio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " rowspan="4" align="left" valign="\n
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                  \t\t\t\t">Nivel de riesgo &#40;CHARM&#41;</td><td class="td" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">3&#46;600&#44;36&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">Vulnerabilidad</td><td class="td" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">No se evalu&#243;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">21&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tipo de cateterismo</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intervencionista&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">52&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">5&#46;200&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;638&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complicaciones del procedimiento</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;485&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;700&#44;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99&#44;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eventos adversos</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;700&#44;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">149&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;580&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complicaciones en 24<span class="elsevierStyleHsp" style=""></span>h</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;700&#44;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">144&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">0&#44;08&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Var&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Comunicaci&#243;n interventricular&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#8722;9&#44;21&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ventr&#237;culo &#250;nico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#8722;42&#44;56-&#8722;7&#44;07&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;44&#44;45-&#8722;8&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ducto arterioso persistente&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otro&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Tipo de diagn&#243;stico</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Postoperatorio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8722;16&#44;37-5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="13" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Nivel de riesgo CHARM</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="13" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tipo de cateterismo</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diagn&#243;stico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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Información del artículo
ISSN: 16954033
Idioma original: Español
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2024 Octubre 50 14 64

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