ABSTRACT
Tricuspid stenosis was treated in four patients by percutaneous balloon valvotomy. A mean pressure gradient equal or higher than 3 mmHg across the tricuspid valve using Doppler echocardiography and the increase of this pressure gradient during inspiration were the most significant criteria for diagnosis and quantification of tricuspid stenosis. There was a considerable hemodynamic improvement with reduction of the tricuspid valve gradient and relief of symptoms after balloon tricuspid valvotomy.
Subject(s)
Catheterization , Tricuspid Valve Stenosis/therapy , Adolescent , Adult , Blood Pressure , Echocardiography, Doppler , Female , Humans , Male , Middle Aged , Tricuspid Valve Stenosis/diagnosisABSTRACT
Percutaneous mitral and tricuspid balloon valvuloplasty was realized in the same procedure using a double lumen exchange catheter that could accommodate two guide wires and two balloons (19 mm and Trefoil 3 c 10 mm--Schneider) with simultaneous insufflation. Hemodynamically successful was accomplished as evidenced by a decrease in mean mitral gradient from 34 mmHg to 1 mmHg and a decrease in mean tricuspid gradient from 5 mmHg to 3 mmHg. These results were confirmed by serial Doppler echocardiographic studies and by correspondent reduction in symptoms.
Subject(s)
Catheterization/methods , Mitral Valve Stenosis/therapy , Tricuspid Valve Stenosis/therapy , Adolescent , Cineangiography , Echocardiography, Doppler , Female , Humans , Mitral Valve Stenosis/complications , Time Factors , Tricuspid Valve Stenosis/complicationsABSTRACT
The authors reviewed 1474 consecutive selective coronary arteriograms performed on patients with suspected coronary insufficiency for the diagnosis of obstructive coronary disease and found 281 (19.1%) cases of apparently normal coronary arteries. These patients presented mean age of 47 +/- 10 years; they were 135 (48%) males and 146 (52%) females. The objective of this study was to obtain the hemodynamic profile of these patients for the following parameters: a) aortic and left ventricular pressures; b) volumes, ejection fraction, segmentary contraction, wall thickness and mass of left ventricle; c) morphology, mobility and competence of the mitral valve. Eight groups of patients were selected: 1) without hemodynamic alterations - 18.9%; 2) with systemic arterial hypertension - 48.7%; 3) with abnormal myocardial contraction - 16.7%; 4) with idiopathic left ventricular hypertrophy - 6.4%; 5) with mitral valve prolapse - 2.5%; 7) with myocardial bridge of the left anterior descending coronary artery - 1.8%; 8) with coronary arterial microfistula of the left ventricle - 0.4%. It is desirable to determine before situations of cardiac emergencies, whether provoked ischemia, as detected by noninvasive stress testing, is present before the performing coronary arteriography in patients, specially females, with systemic arterial hypertension, left ventricular hypertrophy, disorders of ventricular contraction or mitral valve prolapse.
