RESUMO
Mitral balloon valvuloplasty was performed successfully in two patients with moderately severe mitral stenosis by using a retrograde transventricular arterial approach. This technique is less costly and less time consuming as compared with the transseptal technique. It avoids the creation of an atrial septal defect, which can result in significant left to right shunt that can make interpretation of haemodynamic data difficult. The major drawback with this technique is the size of the balloon catheters in current use, which can make their introduction into the brachial artery difficult. This paper discusses technical aspects of retrograde crossing of the mitral valve.
Assuntos
Cateterismo/métodos , Estenose da Valva Mitral/terapia , Adulto , Pressão Sanguínea , Artéria Braquial , Feminino , Insuficiência Cardíaca/terapia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Selective coronary arteriography (using the Sones technique) was performed in 67 patients with congenital heart disease aged 1 to 33 years. Five of the 23 patients with cyanotic congenital heart disease had collateral vessels between the coronary and bronchial arteries; none of the 44 patients with noncyanotic congenital heart disease had such vessels. Each of the five patients with collateral vessels had severe obstruction of the right ventricular outflow tract or the pulmonary valve plus a ventricular septal defect and a right to left shunt. It appears that such collateral vessels from the coronary arteries provide an increment to pulmonary blood flow in patients with cyanotic congenital heart disease and diminished pulmonary flow.
