Résumé
We report our experience with percutaneous balloon valvotomy using the Inoue technique in 200 cases with rheumatic mitral stenosis. The procedure was successful in 195 (97.5%) cases with a fluoroscopy time of 9 +/- 2.7 and procedure time of 60 +/- 19 minutes. Mitral valve area as estimated by Gorlin's equation and pressure half time increased from 0.86 +/- 0.17 to 2.21 +/- 0.41 and from 0.94 +/- 0.14 to 1.90 +/- 0.26 (p < 0.001) respectively. Other hemodynamic variables including mitral valve gradient, cardiac output, left atrial mean and pulmonary artery pressure improved significantly. There were no deaths and the incidence of major complications was small. Increase in mitral regurgitation was observed in 35 (17.9%) with grade 2+ increase in 7 (3.6%). Inoue balloon technique is safe, easy to perform and provides excellent clinical and hemodynamic benefits in majority of cases.
Sujets)
Adulte , /méthodes , Échocardiographie , Femelle , Hémodynamique , Humains , Mâle , Sténose mitrale/physiopathologie , Grossesse , Rhumatisme cardiaque/complicationsRésumé
Two pregnant patients, one each with mitral and pulmonary valvar stenosis, underwent successful balloon valvotomy during their third trimester. Single balloon technique was utilised in both and this resulted in a short procedure and fluoroscopy time (9 minutes in patient with mitral stenosis and 3.5 minutes in pulmonary stenosis). The procedure produced satisfactory hemodynamic and symptomatic benefits in both cases with no complications. The patient remained asymptomatic without medications and delivered healthy full term babies at term. Balloon valvotomy is feasible, effective, and safe during pregnancy and should be considered as an alternative to surgery in symptomatic patients refractory to medical therapy.
Sujets)
Adulte , Femelle , Humains , Sténose mitrale/thérapie , Grossesse , Complications cardiovasculaires de la grossesse/thérapie , Sténose de la valve pulmonaire/thérapieRésumé
Pericardiocentesis was performed in 20 patients using a 7F diagnostic catheter in a cardiac catheterisation laboratory under fluoroscopic control, with haemodynamic and electrocardiographic monitoring. This technique offers several advantages over the bedside technique which utilises a sharp needle. The technique utilised for percutaneous aspiration is safe and simple and allows complete drainage of fluid. The haemodynamic monitoring before and after drainage aids in detecting cases of effusive constriction.
Sujets)
Adolescent , Adulte , Fonction auriculaire droite/physiologie , Pression sanguine/physiologie , Tamponnade cardiaque/physiopathologie , Enfant , Enfant d'âge préscolaire , Femelle , Cathétérisme cardiaque , Hémodynamique/physiologie , Humains , Mâle , Adulte d'âge moyen , Monitorage physiologique , Épanchement péricardique/thérapie , Techniques de fenêtre péricardique , Ponctions , Fonction ventriculaire droite/physiologieRésumé
Total anomalous pulmonary venous connection (TAPVC) is an uncommon cyanotic heart disease and survival beyond infancy is rare. We report a patient of TAPVC of the supracardiac variety who has survived till the age of 50 years without surgery.
Sujets)
Échocardiographie , Cathétérisme cardiaque , Cardiopathies congénitales/diagnostic , Communications interauriculaires/diagnostic , Humains , Mâle , Adulte d'âge moyen , Veines pulmonaires/malformationsRésumé
Two cases of supravalvar aortic stenosis secondary to familial hypercholesterolaemia (type II A hyperlipoproteinaemia) are reported and the role of echocardiography in the diagnosis of this uncommon condition is discussed. The management of these patients is difficult and in one patient the serum cholesterol decreased substantially after treatment with gemfibrozil.