[Balloon catheter valvuloplasty for calcified aortic stenosis in adults. Report of a case and review of the literature]. / Valvuloplastía con catéter de balón en la estenosis aórtica calcificada del adulto. Reporte de un caso y revisión de la literatura.

The first procedure of balloon valvuloplasty in adult calcific aortic stenosis was performed in Mexico on July 17 of 1987. It was a 69 year old female with calcific aortic stenosis and unstable, progressive angina pectoris. Cardiac catheterization showed trans-aortic gradient of 90 mmHg, minimal aortic regurgitation and ejection fraction of 85 percent. Aortic valvuloplasty was performed immediately after cardiac catheterization using the arterial retrograde way by means of a 15 mm. in diameter catheter initially and another of 18 mm. in diameter afterwards. At the end of procedure the gradient diminished to 56 mmHg and an slight increase of the aortic insufficiency was observed. The Doppler echocardiogram showed decreased severity of the stenosis. The patient was discharged asymptomatic and continued to do well for six months. She died suddenly after that period of time. A review of the literature is also presented.

[A comparative clinical study of calcium blockers, gallopamil and nifedipine, in the treatment of stable chest angina]. / Estudio clínico comparativo de los bloqueadores del calcio, galopamil y nifedipina, en el tratamiento de la angina de pecho estable.

Twenty seven patients, 43 to 69 years of age, all with disabling stable angina and positive Bruce stress test, no amendable for revascularization procedures mainly because of poor distal coronary run-off by angiography, were studied with two calcium-channel blockers, the recently developed gallopamil hydrochloride and nifedipine hydrochloride. According to a double blind, cross-over protocol of 12 week duration and after a 2-week washout period, the patients randomly received during 4 weeks 50 mg gallopamil capsules t i d, or 10 mg nifedipine capsules t i d. After a second 2-week wash-out, the alternative drug was administered for another 4 weeks. The number of anginal episodes decreased significantly (p less than 0.01) with both treatments (from 6.4 to 1.8 crisis with gallopamil and from 6.2 to 2.1 with nifedipine). Heart rate (HR) was progressively reduced with gallopamil (-7.9%, p less than 0.05) but increased with nifedipine (+5.7%) in relation to basal figures. Both medications reduced the level of ST depression during the stress test (52.4% with gallopamil and 41.8% with nifedipine, N.S.). The time for angina at the stress test increased 92.5% with gallopamil and 40.7% with nifedipine (p less than 0.05). HR systolic product at peak exercise was 23,101 with gallopamil and 24,906 with nifedipine (p less than 0.001). Both calcium-channel blockers are drugs with significant anti-anginal effects in patients with stable, disabling angina.(ABSTRACT TRUNCATED AT 250 WORDS)