Asunto(s)
Angiocardiografía/métodos , Coartación Aórtica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/patología , Coartación Aórtica/complicaciones , Coartación Aórtica/cirugía , Dolor en el Pecho/etiología , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Positioning of the transseptal needle during percutaneous transvenous mitral commissurotomy (PTMV) can become a difficult and risky procedure when distortion of the interatrial septum exists. We present two cases where intracardiac echocardiography (ICE) facilitated the transseptal puncture in the presence of bulging of the fossa ovalis into the right atrium.
Asunto(s)
Cateterismo/métodos , Ecocardiografía/métodos , Endosonografía , Defectos del Tabique Interatrial/complicaciones , Tabiques Cardíacos/cirugía , Estenosis de la Válvula Mitral/terapia , Punciones , Anciano , Cateterismo Cardíaco , Femenino , Defectos del Tabique Interatrial/diagnóstico por imagen , Tabiques Cardíacos/diagnóstico por imagen , Humanos , Masculino , Estenosis de la Válvula Mitral/diagnóstico por imagenRESUMEN
Myocardial blood flow under normal physiologic conditions remains relatively unaltered by coronary lesions with diameter stenosis of less than 70%. However, during cardiac arrest and cardiopulmonary resuscitation (CPR), autoregulation of coronary blood flow is compromised. We studied the effect of previously considered 'trivial' coronary stenoses of 10, 25 and 50% on distal myocardial perfusion in 39 swine undergoing CPR for cardiac arrest. Endocardial blood flow distal to the stenosis was significantly less than that proximal in all the different stenoses groups (P < 0.05). A 50% diameter stenosis also compromised epicardial blood flow distal to the stenosis (P < 0.05). This study suggests that any coronary lesion may compromise myocardial perfusion during CPR. Since the vast majority of cardiac arrest victims have coronary artery disease, careful attention to maximizing myocardial blood flow during CPR is needed.