ABSTRACT
The metallic commissurotome (MC) technique is a cheaper alternative to the Inoue balloon (IB) technique for percutaneous mitral valvuloplasty (PMV). There are no randomized trials comparing these techniques with longer follow-up of the patients. The objective of this study was to compare the immediate results and short- and medium-term follow-up of PMV using either the IB or the MC technique. Fifty patients with rheumatic mitral stenosis were randomly assigned to PMV using the IB (n = 27) or the MC (n = 23) technique. There were no significant differences between the groups regarding baseline clinical, echocardiographic, and hemodynamic data. Clinical and echocardiographic follow-up were done 6 months and 3 years after the procedure. The success rate was 100% in the IB group and 91.3% in the MC group (P = 0.15); two patients in the latter group developed mitral regurgitation grade 3/4, requiring elective surgery. The mean final mitral valve area was bigger in the MC group (2.17 +/- 0.13 vs. 2.00 +/- 0.36 cm2; P = 0.04), but after 6-month and 3-year follow-up, this difference was no longer significant (2.06 +/- 0.27 vs. 1.98 +/- 0.38 cm2, P = 0.22, and 1.86 +/- 0.32 vs. 1.87 +/- 0.34 cm2, P = 0.89, respectively). This finding suggests valve stretching as an important mechanism of valve dilation with the MC. Three patients in the MC group and two patients in the IB group (P = 0.65) developed mitral valve restenosis; one of them underwent repeat PMV and the other four, all asymptomatic, were clinically followed. PMV performed either with the IB or the MC technique is effective and provides excellent short- and medium-term outcomes regardless of the technique employed.
Subject(s)
Catheterization/instrumentation , Mitral Valve Stenosis/therapy , Rheumatic Heart Disease/therapy , Adolescent , Adult , Echocardiography , Electrocardiography , Equipment Design , Female , Follow-Up Studies , Humans , Male , Middle Aged , Mitral Valve Stenosis/diagnostic imaging , Mitral Valve Stenosis/physiopathology , Retrospective Studies , Rheumatic Heart Disease/diagnostic imaging , Rheumatic Heart Disease/physiopathology , Treatment OutcomeABSTRACT
The patient is a male with risk factors for coronary artery disease, who was referred for cardiac catheterization after acute myocardial infarction in the inferior wall. The patient underwent transluminal coronary angioplasty in the right coronary artery with successful stent implantation.
Subject(s)
Coronary Artery Disease/etiology , Coronary Vessel Anomalies/complications , Angioplasty, Balloon, Coronary , Coronary Artery Disease/therapy , Coronary Vessel Anomalies/therapy , Humans , Male , Middle Aged , Myocardial Infarction/etiology , Myocardial Infarction/therapy , Risk Factors , StentsABSTRACT
The patient is a male with risk factors for coronary artery disease, who was referred for cardiac catheterization after acute myocardial infarction in the inferior wall. The patient underwent transluminal coronary angioplasty in the right coronary artery with successful stent implantation
Subject(s)
Humans , Male , Middle Aged , Aorta, Thoracic/abnormalities , Coronary Artery Disease/etiology , Coronary Vessel Anomalies/complications , Angioplasty, Balloon, Coronary , Coronary Artery Disease/therapy , Coronary Vessel Anomalies/therapy , Myocardial Infarction/etiology , Myocardial Infarction/therapy , Risk Factors , StentsABSTRACT
Aneurysm of the left main coronary artery is a rare angiographic finding, with few cases described in the international literature. We report the case of a 42-year-old male with a previous history of acute myocardial infarction, whose coronariography indicated triple vessel coronary disease and an aneurysm of the left main coronary artery. A review of the etiology, clinical aspects, and surgical management of coronary arterial aneurysm is presented
