Comparison of th immediate and intermediate term results of percutaneous balloon mitral valvuloplasty [inoue single - balloon versus double - balloon technique]

This study aimed to compare between the immediate-and intermediate- term results of two modalities of balloon dilatation [the Inoue single-balloon and the double-balloon techniques]. Fifty patients with significant rheumatic mitral stenosis [MS] were enrolled in this study from 1993 to 1996. They were randomly chosen and assigned to either one of the two treatment modalities. Both groups were statistically comparable and identical as regards the clinical examination, ECG, chest X-ray, color Doppler echocardiography and invasive hemodynamic data. After dilatation, the patients were followed up immediately, three and >/ six months later by clinical and echo-Doppler evaluation. An invasive hemodynamic study was also done immediately post-dilatation. Both techniques gave a highly significant improvement in the hemodynamics of both patient groups. They equally improved the mitral valve area [MVA] and the functional status of the patients, which was maintained during the follow-up period

Normal Foetal M-mode and doppler echocardiography

The study population consisted of 120 normal pregnant Egyptian ladies with uncomplicated pregnancies between 20 and 40 weeks gestation. The study was conducted between May 1991 and January 1993. Abnormalities in 2D examination were seen in 3 patients, these included a VSD in a 31 weeks old fetus and an atrial septal aneurysm in 2 fetuses [32 and 35 weeks old]. 15 fetuses from further evaluation were excluded, 3 wit abnormal 2D examination, 7 in which the 4 chamber view could not be obtained and 5 in which only the 4 chamber view could hardly be obtained and no other data available. Out of the 105 fetuses M-mode measurements was successfully obtained in 62 fetuses. In 2 measurements were obtained for the LV only and in 3 measurements were obtained for the RV only. It was found that M-mode measurements of ventricular chamber size and function can be obtained in slightly above 50% of the fetuses

Initial experience with native coarctation balloon angioplasty

Balloon angioplasty was performed in 13 patients with native coarctation of the aorta from November 1988 to October 1989. The patients ranged in age from 4 to 25 years with a mean of 13 years There were 7 females and 6 males. Four patients had associated aortic valvular stenosis; 2 of those had their aortic valves dilated during the procedure. The mean systolic pressure gradient across the coarctation dropped from 67 +/- 29 to 9.6 +/- 12.6 mmHg immediately after angioplasty. The mean diameter of the coarcted segment increased from 6.7 + 2.7 to 13.65 + 2.8 mm. The balloon size was chosen so that its diameter was equal to or 1 - 2 mm less than the diameter of the descending thoracic aorta at the level of the diaphragm, after correction for magnification. The diameter of the balloons used ranged from 12 to 20 mm while the balloon length ranged from 3 to 5.5 cm. One 15 years old male developed a right femoral arterio - venous fistula after the procedure, that was confirmed by subsequent angiography and he was scheduled for surgery. The initial results look promising and follow up of the patients is currently taking place for defining the exact role of angioplasty in dilating native coarctations