[Use of nitric oxide in the evaluation of pulmonary arterial hypertension]. / Uso del óxido nítrico en la valoración de la hipertensión arterial pulmonar.

The purpose of this article is to describe a patient with severe pulmonary artery hypertension, who was evaluated in the catheterization laboratory with the use of nitric oxide to check the degree of reversibility of the pulmonary hypertension. The patient is a 18 months old baby with atrio-ventricular canal and severe pulmonary hypertension, whose vascular resistance dropped from 8.75 Wood U/m2 to 1.32 Wood U/m2. With these findings the pulmonary artery hypertension was considered reversible and made him a good candidate for successful corrective surgery. The use of nitric oxide is very useful for the evaluation of the degree of reversibility of the pulmonary vascular resistance in cases with severe pulmonary artery hypertension with a left to right shunt.

[Coronary and renal percutaneous angioplasty performed in the same procedure. A report on 5 consecutive cases]. / Angioplastía percutánea coronaria y renal realizadas en el mismo procedimiento. Reporte de 5 casos consecutivos.

Percutaneous transluminal coronary and renal angioplasty (PTA and Renal PTA) were performed during the same procedure in five of 100 patients who underwent PTCA between August 1989 and June 1990. All patients were male, with systemic hypertension (HT) with angina grade I to IV. The median age was 62 years (range 53 to 74). Three patients had controlled HT with 2 to 4 drugs and 2 were uncontrolled even after multiple antihypertensive treatment. Two patients were diabetic and the serum creatinine levels were normal except in one patient (1.9 mg/dL). Lesions more than 70% obstruction of luminal diameter were approached. Multivessel PTCA was done in one patient, multi-lesion in 2 and single lesion in other two. A total of 11 lesions were dilated, 4 in LAD, 5 in Cx and 2 in RCA (type A = 2, type B = 9). Complete revascularization was achieved in all cases. Five renal lesions were approached, 4 in the proximal third and one on the middle third. In 2 patients the blood pressure (BP) fell within normal limits without medication. In other 2 there was an improvement and were easily controlled with just one drug. One patient had no improvement and required multiple therapy to control it. The only complication observed was in a diabetic with previous abnormal serum creatinine who developed non-oliguric renal failure and returned to basal creatinine level at the third day post PTCA. In selected cases PTCA and renal PTA can be safely performed during the same procedure, with the advantage of cost reduction.