RESUMO
We compared in-hospital femoral complications of Angio-Seal, Perclose, and manual compression in consecutive patients who underwent percutaneous coronary interventions in the era of glycoprotein IIb/IIIa platelet inhibition. Femoral closure devices have a similar overall risk profile as manual compression, even in patients treated with glycoprotein IIb/IIIa platelet inhibition, although certain rare complications such as retroperitoneal hemorrhage and severe access-site infection may be more common with the use of these devices.
Assuntos
Angioplastia Coronária com Balão , Artéria Femoral , Técnicas Hemostáticas/efeitos adversos , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/antagonistas & inibidores , Doenças Vasculares/etiologia , Feminino , Artéria Femoral/lesões , Humanos , Masculino , Pessoa de Meia-Idade , Pressão/efeitos adversos , Estudos Prospectivos , Análise de Regressão , Segurança , Técnicas de Sutura/efeitos adversosRESUMO
Between July 1983 and March 1985, 45 patients with severe mitral regurgitation underwent mitral valvuloplasty with insertion of a semirigid Carpentier ring. No patient had echocardiographic evidence of systolic anterior motion (SAM) preoperatively, whereas 5 patients had this echocardiographic finding postoperatively. All 5 had mitral valve prolapse as their underlying disease process and SAM developed at varying intervals after valvuloplasty. The development of SAM is related to insertion of the semirigid ring, persistence of a redundant anterior mitral leaflet, narrowing of the left ventricular (LV) outflow tract and the Venturi effect. LV and aortic pressure measurements with simultaneous Doppler echocardiography have confirmed the presence of a significant LV outflow tract gradient in these patients. Although all 5 patients are functionally improved after mitral valvuloplasty, the long-term implications of SAM after valvuloplasty are unknown.
