The value of serum-ascites albumin gradient for the determination of portal hypertension in the diagnosis of ascites.

BACKGROUND/AIMS: The aim of the present study was to evaluate the correlation between serum-ascites albumin gradient and portal pressure gradient in a population with ascites related to multiple conditions. METHODOLOGY: Thirty-seven patients were divided into two groups: group 1: 30 patients with cirrhosis as the cause of ascites, and group 2: 7 patients with ascites due to other causes. All patients were submitted to paracentesis and blood examination to determine the serum-ascites albumin gradient and the hepatic venous pressure gradient was measured. RESULTS: Mean serum-ascites albumin gradient was 2.0 g/dL in group 1 and 0.6 g/dL in group 2. Mean hepatic venous pressure gradient was 14.7 mm Hg in group 1 and 1.3 mm Hg in group 2. CONCLUSIONS: There was a significant correlation between the serum-ascites albumin gradient and the hepatic venous pressure gradient (r = 0.502), indicating the reliability of the serum-ascites albumin gradient in demonstrating the presence of portal hypertension and its relationship with the origin of ascites.

[Percutaneous valvuloplasty in congenital aortic valve stenosis]. / Valvuloplastia percutânea em estenose valvular aórtica congênita.

PURPOSE: To show the initial experience of Institute of Cardiology of Rio Grande do Sul in the treatment of congenital valvular aortic stenosis with percutaneous balloon aortic valvuloplasty. METHODS: Twenty four patients were submitted to the procedure, 14 males and 10 females. The mean age 7 years (4 days-17 years). Four patients were aged below 30 days and three patients had previous surgical valvuloplasty. The percutaneous balloon aortic valvuloplasty were made the retrograde approach in all patients. RESULTS: The peak systolic pressure gradient was reduced from 65.96 +/- 22.68 to 27.08 +/- 18.74 mmHg. The procedure resulted in aortic regurgitation in seven patients and worsened aortic regurgitation in two patients. One patient had cardiac arrest that was reverted by cardiopulmonary resuscitation, this patient had hospital discharge without sequel. Five patients had acute femoral artery thrombosis, and hemorrhage in the site of puncture happened in one patient. CONCLUSION: The percutaneous balloon aortic valvuloplasty results in effective reduction of the peak systolic pressure gradient, it is a save and effective therapy in patients with congenital valvular aortic stenosis. Further evaluation of the long term results are necessary for definitive conclusions.

[Coronary transluminal angioplasty after the use of thrombolytic therapy in acute myocardial infarction]. / Angioplastia transluminal coronária após o uso de trombolítico no infarto agudo do miocárdio.

PURPOSE: To present the Cardiology Institute of Rio Grande do Sul experience with percutaneous coronary angioplasty (PTCA), after thrombolytic therapy in acute myocardial infarction (AMI). METHODS: Fifty-three patients with transmural AMI in whom early successful intravenous streptokinase recanalization was followed by PTCA. The mean age was 50 years, male patients were more frequent, the predominant area of infarct was anterior wall and more frequently the "culprit" coronary was the left anterior descendent. The main indication of PTCA was uniarterial lesion with less than 20 mm of length. RESULTS: The success comes out in 44 patients (81.5%). Ten patients (18.5%) were considered unsuccessful and were referred to emergency bypass graft surgery. The in-hospital AMI rate after PTCA was 5.5%. In the follow-up the reestenoses rate was 11% and reocclusion was 3.7%. New PTCA was necessary in 3 patients (5.5%) and in one, by-pass graft (1.8%). CONCLUSIONS: PTCA is an important and secure modality of complementary therapy after thrombolytic therapy with low morbidity and mortality.

[Dysplastic pulmonary valve and pulmonary valvuloplasty. A case report]. / Valva pulmonar displásica e valvuloplastia pulmonar. Relato de caso.

The authors report a case of dysplastic pulmonary valve which undergone unsuccessfully balloon dilation. Clinical, non-invasive and angiographic diagnostic criteria are discussed.