[Preliminary pilot study in humans with coronary endovascular prosthesis (stent SAQ). Immediate and medium-term results]. / Estudio piloto preliminar en humanos con la prótesis endovascular coronaria (stent SAQ). Resultados inmediatos y a mediano plazo.

We report the results obtained of 23 patients in whom 25 intracoronary stents (SAQ) were placed. All had atherosclerotic coronary artery disease with different clinical types of presentation, such as stable angina, unstable angina, myocardial infarction. In others cases the reason for the procedure was postangioplasty complications. The majority of cases had complex lesions: total occlusion, long plaques and patients in critical and unstable state. The immediate results were considered satisfactory due to the fact that there was angiographic improvement compared to just conventional angioplasty, the final flow was TIMI-3 in 23 and TIMI-2 en two others, in these cases the initial flow was TIMI-0. The arterial diameter improved compared to prior angioplasty. Acute thrombosis occurred in one case and was resolved with repeated dilatation, in two cases the atherosclerotic plaque protruded within the stent, in both cases the occlusion was considered non significant, without modifications in the flow. All patients had a 3 months follow up with treadmill test. In 10 cases angiography was indicated, in 4 due to positive treadmill. Restenosis was resolved in three cases, in another coronary arterial by-pass was necessary. In all other cases angiographic findings were normal, included one patient with two stents.

[Design and development of a stent (SAQ) for the treatment of arterial coronary arterioscleotic obstruction]. / Desarrollo y diseño de un stent (SAQ) para el tratamiento de obstrucciones arteriales aterosclerosas coronarias.

The practice of percutaneous transluminal coronary angioplasty has shown that the major complications are acute dissection as well as suboptimal results and restenosis. The effort to reduce these complications has led to create an intravascular device called Stent. The technology is complex and very expensive, for this reason we designed and made a new model of stent named SAQ. We introduce: The methodology of development, fabrication and modifications of a new intravascular device Stent SAQ. The results obtained in coronary arteries of ex vivo hearts of pigs and humans. The results in two model of animals, rabbit aorta and peripheral arteries in dogs. This investigation at this phase, shows satisfactory properties of SAQ which is secure and effective, with similar properties to the stents in use.

[Electrocardiographic data suggesting anteroseptal myocardial infarction, in presence of infarction of the left ventricle]. / Datos electrocardiográficos sugestivos de infarto del miocardio anteroseptal, en presencia de infarto del ventrículo derecho.

We present a case of right ventricular myocardial infarction, secondary to postangioplasty occlusion of ventricular ramus of the right coronary artery, that developed electrocardiographic changes suggestive of septal myocardial infarction, this diagnosis was eliminated through angiographic study. We conclude that the carefully analysis of the electrocardiographic changes in ST segment in V1 to V4 can guide to the diagnosis of right ventricular myocardial infarction. For that reason we recommend the routinary register of the right electrocardiographic derivations as V3R and V4R, and left derivations V7 and V8, that is, the thoracic circle, in all patients with acute myocardial infarction regardless its location.

Trombolisis en la disfuncion de protesis tricuspidea de Bjork-Shilley. / Thrombolysis in the dysfunction of the Bjork-Shilley tricuspid prosthesis

Se informa la mejoria obtenida en una protesis tricuspidea de Bjork - Shilley obstruida por trombosis en una paciente con cardiopatia reumatica y empeoramiento progresivo de su disfuncion, que mejoro con el uso de estreptocinasa como farmaco trombolitico. Se administraron 100,000 UI durante la primera hora para bloquear los anticuerpos antiestreptocinasa, y posteriormente 57,500 UI cada hora, hasta completar 3.8 millones de UI en total. Para descartar tromboembolias pulmonares se realizaron gammagramas pulmonares antes y despues del uso de la estreptocinasa y, mediante ecocardiogramas seriados en modo M, bidimensional y Doppler pulsado, se valoro la mejoria paulatina de la protesis obstruida. El estudio hemodinamico realizado al finalizar la aplicacion de la estreptocinasa comprobo la disminucion del gradiente transtricuspideo encontrado en forma inicial. Se concluye que el uso del ecocardiograma acompanado de registro de flujos mediante el sistema Doppler como estudios no invasores, permite valorar el grado de disfuncion, la evolucion y la mejoria despues del empleo de substancias tromboliticas, lo que puede ser un metodo alterno al tratamiento quirurgico en los casos de oclusion trombotica de las protesis cardiacas