Estenosis pulmonar del adulto: valvuloplastía percutánea con balón / Pulmonary stenosis of adult: percutaneous balloon valvuloplasty

The results of balloon valvuloplasty as treatment for pulmonary stenosis in 8 adults (6 male) whose ages ranged from 17 to 58 years are presented. Three patients had been subjected to cardiac surgery 32, 40 and 10 years before. The procedure was performed through the right femoral vein using one or two balloons with a diameter of not less than 20 mm, without complications and excellent tolerance. The pulmonary gradient and the right ventricular pressure were reduced in 7 patients from 81.4 ñ 26.9 to 26.6 ñ 11.3 and from 99.3 ñ 25.5 to 47.7 ñ 13.6 mm Hg respectively (p<0,0005). During follow up, 6 of the patients have remained in functional capacity I and in two Doppler ultrasound examination showed a further reduction in valvular gradient. These results are in accordance with other reports and confirm that this technique is the treatment of choice for adult pulmonary stenosis

Compromiso cardíaco en polimiositis-dermatomiositis asociado a síndrome de Sjogren / Cardiac involvement in polymyositis-dermatomyositis associated with Sjogren`s sndrome

A 41 yers old woman with polymyositis-dermatomyositis with cardiac involvement is presented. The patient evolved with congestive heart failure, the electrocardiogram showed a left anterior hemiblock, lack of progression of R waves from V1 to V4 and unespecific ST and T alterations. Echocardiogram and cardiac catheterization showed global ventricular disfunction and pulmonary hypertension. An endomyocardial biopsy performed at the apex of the right ventricle showed mononuclear inflammatory infiltration myocardial fiber degeneration and fibrosis. Initially the patient responded well to diuretic vasodilator and steroid therapy. Posteriorly she developed an atrial flutter that reqquired electrical cardioversion and later died suddenly during the course of an acute pneumonia

Estenosis tricuspídea: diagnóstico y tratamiento quirúrgico / Tricuspid stenosis: diagnosis and surgical treatment

La Estenosis Tricuspídea, es una valvulopatía poco frecuente y se ha presentado en el 1.6% de los pacientes operados de diferentes valvulopatías durante los últimos 12 años en nuestro grupo. Siempre ha existido asociada a un compromiso valvular mitral y un 56% además coexiste una lesión valvular aórtica. Debe buscarse sistemáticamente en enfermos polivalvulares, especialmente cuando hay una onda "a" del pulso venoso yugular, ritmo sinusal y crecimiento de la aurícula derecha al electrocardiograma y signos de crecimiento de la aurícula derecha en la radiografía de tórax, especialmente en ausencia de hipertensión arterial pulmonar importante. El diagnóstico se confirma al encontrar los hallazgos característicos auscultatorios, ecocardiográficos, hemodinámicos y angiográficos. El tratamiento es quirúrgico, pero conservador, evitando en lo posible el reemplazo valvular tricuspídeo