RESUMO
A 49-year-old woman with a history of Takayasu's arteritis underwent stent placement of the celiac and mesenteric arteries after unsuccessful balloon angioplasty. Stents may prove to be a beneficial alternative to angioplasty for treatment of the dense fibrotic lesions often associated with this disease.
Assuntos
Stents , Arterite de Takayasu/terapia , Angioplastia Coronária com Balão , Cateterismo/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Radiografia , Recidiva , Arterite de Takayasu/diagnóstico por imagemRESUMO
Amiodarone appears to be an effective antiarrhythmic agent for reducing mortality in the postmyocardial infarction patient with ventricular ectopic activity. Such activity has long been recognized to have an adverse effect on prognosis after acute myocardial infarction. When a strong correlation between ectopic activity and left ventricular dysfunction was demonstrated, ventricular ectopic activity was thought to be a consequence of underlying myocardial damage. However, ventricular ectopic activity is now considered to be an independent risk factor for mortality after myocardial infarction. Because of the basic premise that a positive correlation existed between arrhythmia suppression and improved survival, it had been common practice to use antiarrhythmic agents to treat asymptomatic ventricular ectopic activity in the postinfarction patient. After the results of the Cardiac Arrhythmia Suppression Trial (CAST) were released, this practice was largely abandoned. In the post-CAST era, however, amiodarone has appeared to improve survival in patients who have sustained myocardial infarctions. In this report, we briefly review the pharmacology of amiodarone and discuss the results of relevant clinical trials. Large, multicenter trials currently under way may clarify some of the unanswered questions surrounding the use of this promising antiarrhythmic agent in postmyocardial infarction patients.
Assuntos
Amiodarona/uso terapêutico , Infarto do Miocárdio/tratamento farmacológico , Taquicardia Ventricular/tratamento farmacológico , Amiodarona/efeitos adversos , Causas de Morte , Ensaios Clínicos como Assunto , Eletrocardiografia/efeitos dos fármacos , Humanos , Infarto do Miocárdio/mortalidade , Taxa de Sobrevida , Taquicardia Ventricular/mortalidadeRESUMO
Percutaneous transluminal coronary angioplasty of anomalous coronary arteries presents several technical challenges to interventional cardiologists. Choosing the best guiding catheter and other equipment is crucial to the technical success of the procedure. We performed successful coronary angioplasty of an anomalous left anterior descending artery lesion in a 51-year-old man who had a left coronary artery originating from the right coronary sinus. We review his case, along with this rare anomaly and the technical considerations for successful percutaneous transluminal coronary angioplasty in such a patient.
