[Percutaneous transluminal angioplasty of the vena cava inferior]. / Angioplastía transluminal percutánea de la vena cava inferior.

We describe a 65-years-old female, with percutaneous balloon angioplasty (PBA) of inferior vena cava. The patient had massive calcification of the right atrium, the tricuspid anulus as well as obstruction of the tricuspid valve (percutaneous tricuspid valvuloplasty was performed 2.5 years before). The only predisposing factor for calcification was, a cerebral-right atrial shunt (cerebral cysticercosis) for 32 years. PBA was performed. We discuss some events that occurred after dilatation. We describe the technique in this uncommon case. We conclude that percutaneous balloon angioplasty is another alternative to surgical repair in inferior vena cava obstruction.

[Percutaneous mitral commissurotomy with an Inoue catheter in congenital mitral stenosis]. / Comisurotomía mitral percutánea con catéter de Inoue en estenosis mitral congénita.

We describe a 3-years-old boy, with congenital mitral stenosis, who underwent percutaneous transvenous mitral commissurotomy (PTMC) with Inoue balloon. The mitral gradient decreased from 24 to 4 mmHg, the mitral valvular area (MVA) increased from 1.2 to 1.6 cm2 without modification in mitral regurgitation. One year later the recatheterization showed decreased pulmonary pressures, and a 7.5 mmHg mitral valvular gradient without mitral insufficiency. MVA by echo is 1.8 cm2 with mild regurgitation. As far as we know there is no experience with Inoue balloon in children. We conclude that PTMC with Inoue balloon could be an attractive alternative in some patients with congenital mitral stenosis.

[Percutaneous mitral commissurotomy with Inoue's technic and pregnancy. The initial experience in Mexico]. / Comisurotomía mitral percutánea con técnica de Inoue y embarazo. Experiencia inicial en México.

From March 1986 to January 1993, we performed percutaneous balloon mitral commissurotomy (PBMC) in ninety-one patients with rheumatic mitral stenosis, two of them during pregnancy. The gestational age at the time of valvotomy was thirty and twenty-seven weeks respectively. Balloon Inoue technique in both cases resulted in improvement in mitral valve area (0.8 vs 1.6 and 0.7 vs 1.9 cm2) and in mean mitral gradient (19 vs 4 and 12 vs 0 mm Hg) immediately after dilation, without residual atrial septal defect or mitral insufficiency. There were no complications. The estimated radiation exposure to the fetus was of 6.4 minutes of fluoroscopy and 6 seconds of angiography. To limit of X-ray irradiation, we used color Doppler echocardiography during dilatation in both cases. The subsequent course of gestation was uncomplicated and normal babies were delivered in both cases. Fetus protection against ionising radiation was assured by lead mantles. In the follow-up the mitral valve area was 1.7 and 2.1 cm2, 15 and 4 months later respectively. PBMC can be performed safely during pregnancy and is effective in increasing the valvular area and relieving symptoms. It offers an excellent alternative for the pregnant patients, with severe mitral stenosis. The risk to the fetus appears lower than previous reports of surgical commissurotomy performed during pregnancy.