ABSTRACT
OBJECTIVE: To evaluate the use of the intraaortic balloon (IAoB) in association with coronary angioplasty in high-risk patients. METHODS: Fourteen high-risk patients unresponsive to clinical therapy and with formal contraindication to surgical revascularization were treated by coronary angioplasty, most of which was followed by stenting. All procedures were performed with circulatory support with the IAoB. This study reports the early results and the late findings after 12 months of follow-up. Six patients had multivessel coronary disease; of these, four had left main equivalent lesions and two had unprotected left main coronary artery disease, one of whom had severe "end-vessel" stenosis and the other was a patient with Chagas' disease with single-vessel lesion. Eleven patients had a left ventricular ejection fraction < 30%. RESULTS: In 100% of the patients, the procedures were initially successful. Two patients had severe bleeding during the withdrawal of the left femoral sheath. At the end of twelve months, 4 patients were asymptomatic and the others were clinically controlled. There were two late deaths in the 7th and 11th months. CONCLUSION: The combined use of the intraaortic balloon pump and percutaneous coronary angioplasty in high-risk patients with acute ischemic syndromes provides the necessary hemodynamic stability to successfully perform the procedures.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Disease/therapy , Intra-Aortic Balloon Pumping , Aged , Coronary Artery Disease/therapy , Humans , StentsABSTRACT
Quarenta e cinco pacientes com emergencia hipertensiva foram tratados com verapamil, na dose de 5,48 a 6,68 micrograma/min, administrado por EV em gotejamento continuo de uma solucao contendo 50 mg da droga diluidos em 200 ml de soro glicosado a 5%. Nao se observou alteracao substancial da frequencia cardiaca apos a administracao do farmaco (reducao de 9,7%). Seus efeitos na pressao arterial foram observados ja a partir de 2 min de infusao, com reducao da PA media de 169 mais ou menos 22 para 120 mais ou menos 16 mm/Hg (30%) em 2 hs. Nao houve diferenca entre a reducao da pressao arterial sistolica e diastolica. O controle imediato da pressao arterial, a obtencao de niveis tensionais adequados e a quase ausencia de efeitos colaterais justificam o uso do verapamil para o tratamento das emergencias hipertensivas
