Effect of balloon dilatation angioplasty for native coarctation on left ventricular function echo-doppler study

The following Echocardiographic indices were measured in conjunction with cardiac catheterization in 14 adult patients with coarctation of the aorta [CoA] immediately before and 6 months after balloon dilatation angioplasty [BDA]: LV enddiastolic volume index [EDVI], left ventricular end-systolic volume index [ESVI], LV ejection fraction [EF], LV mass [LVM], and LV end systolic wall stress [ESS]. Results [mean +/- SD] showed striking reduction of peak systolic pressure gradient [from 69 +/- 23 to 8 +/- 13 immediately after BDA to 6 +/- 12 mmHg. 6 months later, P], ESS [from 574 +/- 447 to 364 293 10. dynes. cm2; P], LVM [from 330 +/- 263 to 249 +/- 197 g/m2; P], EDVI [from 187 +/- 116 to 137 +/- 108 ml/M2; P] and ESVI [from 40 +/- 32 to 30 +/- 24 ml/M2; P]. LVEF showed significant increase [from 75 +/- 7 to 78 +/- 5%, P]. The percent reduction in ESS correlated significantly with the degree of regression of LVM [r = 0.94, P] and of EDVI [r = 0.9, P]. Thus on short-term, there is significant regression of left ventricular hypertrophy associated with improvement in LV systolic function after BDA for adult native CoA

LITA-LAD revascularization without cardiopulmonary bypass

Two male patients with post-infarction angina and positive exercise test were submitted to left Internal Thoracic Artery-Left Anterior Descending corollary artery [LITA-LAD] without cardiopulmonary bypass [CPB]. Their ages were 43 and 47 years. The angiographic lesion was total obstruction of the left anterior descending artery that was visualized retrogradely from septal branches of PDA of right coronary artery. Their blood groups was A2B Rh-ve and O Rh-ve. The two cases were done as first case in day and CPB was in stand-by with clear fluid priming to be used for the second case in day. The exposure of the LAD was as usual and the LITA-LAD anastomosis was done using 7/0 Prolene. The immediate postoperative course was smooth, no blood transfusion was used, no perioperative myocardial infarction. Patients were extubated after 8 and 9 hours and discharged from ICU in 24 hours. In hospital control showed complete disappearance of the anginal pain, no new Q wave in resting ECG, CK level was within normal and no new abnormal wall motions by echocardiography. This technique has the advantage to avoid using CPB that may cause cerebral, pulmonary and renal complications, no blood transfusion, least heparin and protamine use, smooth postoperative course, early extubation and low cost wise