RESUMO
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.
Assuntos
Adulto , /métodos , Ecocardiografia , Feminino , Hemodinâmica , Humanos , Masculino , Estenose da Valva Mitral/fisiopatologia , Gravidez , Cardiopatia Reumática/complicaçõesRESUMO
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.
Assuntos
Adulto , Feminino , Humanos , Estenose da Valva Mitral/terapia , Gravidez , Complicações Cardiovasculares na Gravidez/terapia , Estenose da Valva Pulmonar/terapiaRESUMO
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.
Assuntos
Adolescente , Adulto , Função do Átrio Direito/fisiologia , Pressão Sanguínea/fisiologia , Tamponamento Cardíaco/fisiopatologia , Criança , Pré-Escolar , Feminino , Cateterismo Cardíaco , Hemodinâmica/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Derrame Pericárdico/terapia , Técnicas de Janela Pericárdica , Punções , Função Ventricular Direita/fisiologiaRESUMO
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.
Assuntos
Ecocardiografia , Cateterismo Cardíaco , Cardiopatias Congênitas/diagnóstico , Comunicação Interatrial/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Veias Pulmonares/anormalidadesRESUMO
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.