RESUMO
OBJETIVO - Avaliar o efeito sublingual do mononitrato-5 de isossobida (MN5IS) e nitroglicerina (NTG) sobre o diâmetro luminal de artérias coronárias epicárdicas, pressão arterial média e efeitos colaterais. MÉTODOS - Cinqüenta pacientes foram submetidos a cateterismo cardíaco e cinecoronariografia, na condição inicial e 5 min após administração sublingual de MN5IS grupo A (GA) ou NTG grupo B (GB). RESULTADOS - O diâmetro coronário de referência aumentou em ambos os grupos, sem significância estatística entre os mesmos. Nos GA e GB foram demosntrados uma diminuição (1,66mmHg) e um aumento (0,79mmHg) na pressão arterial média, respectivamente (p=0,123). Não foram observados efeitos colaterais com o uso destas drogas. CONCLUSÄO - MN5IS sublingual é uma alternativa à administração de NTG durante cinecoronariografia e representa um alternativa terapêutica para o tratamento de doença cardíaca isquêmica.
Assuntos
Humanos , Doença das Coronárias , Angina Microvascular , Nitratos/história , Nitroglicerina , Vasodilatadores , Administração Sublingual , Incidência , Monitorização FisiológicaRESUMO
We report the use of excimer-laser angioplasty for the treatment of Wiktor and Gianturco-Roubin in-stent restenosis of in two patients. Case 1-a 48-year-old man presented unstable angina five months after Wiktor stent was deployed in right coronary artery. Cardiac catheterization revealed stenosis (95%) within the stent. Case 2-a 65-year-old man presented stable angina four months after Gianturco-Roubin stent was deployed in left anterior descending artery. Cardiac catheterization revealed stenosis (80%) within the stent. Excimer-laser angioplasty within the stent reduced the stenosis to 19% and 30%, respectively. The patients recovered and currently, six months post-procedure, are free of chest pain, and cardiac catheterization revealed stenosis to 30% and 35%, respectively, within the stent. Therefore, the procedure was an effective means of treating restenosis after coronary stent placement, and a prospective comparison of excimer-laser angioplasty and other management alternatives to in-stent restenosis is needed.
Assuntos
Angioplastia com Balão a Laser/métodos , Doença das Coronárias/cirurgia , Idoso , Angiografia Digital , Cateterismo Cardíaco , Doença das Coronárias/diagnóstico , Doença das Coronárias/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Stents/efeitos adversos , Resultado do TratamentoRESUMO
PURPOSE: To evaluate the effect of sublingual isosorbide-5 mononitrate (ISMN) and nitroglycerin (NTG) on luminal diameter of epicardial coronary arteries, mean arterial pressure and deleterious effects. METHODS: Fifty patients were submitted to cardiac catheterization and coronary arteriography, at baseline, and 5 min after sublingual administration of ISMN, group A (GA) or NTG, group B (GB). RESULTS: Reference vessel diameter increased in both groups, without statistical significance. In GA and GB, a decrease (1.66 mmHg) and an increase (0.79 mmHg) in mean arterial pressure, respectively, were demonstrated (p = 0.123). There were no deleterious effects with the use of these drugs. CONCLUSION: Sublingual ISMN is an alternative to administration of NTG during coronary arteriography, and represents a therapeutic alternative to ischemic heart disease treatment.
Assuntos
Pressão Sanguínea/efeitos dos fármacos , Cateterismo Cardíaco , Cineangiografia/métodos , Vasos Coronários/efeitos dos fármacos , Dinitrato de Isossorbida/análogos & derivados , Nitroglicerina/farmacologia , Vasodilatadores/farmacologia , Administração Sublingual , Feminino , Humanos , Dinitrato de Isossorbida/administração & dosagem , Dinitrato de Isossorbida/farmacologia , Masculino , Pessoa de Meia-Idade , Nitroglicerina/administração & dosagem , Vasodilatadores/administração & dosagemRESUMO
PURPOSE: To evaluate the immediate and long term results of percutaneous transluminal coronary balloon angioplasty (PTCA) in patients over 80 years old. METHODS: From 1/1/89 to 6/31/95, 97 patients with 80 years of age or older were submitted to PTCA and were divided into three groups: group A (GrA)-30 patients with stable angina, mean age of 82.5 years, 24 (80%) men; group B(GrB)-40 patients with unstable angina, mean age 81.2 years, 31 (77.5%) men; group C (GrC)-27 patients with myocardial infarction (MI), mean age of 82 years, 16 (59.2%) men. RESULTS: Early outcome-general success rate of 84.5% and mortality rate of 5.1%. The success and mortality rate were in GrA 83.3% and 3.3%, in GrB 85% and 5% and in GrC 85.2% and 7.4%, respectively. Late outcome-the number and percentage of patients with late follow-up and the clinic-angiographic and angiographic restenosis rates were for GrA 19(76%), 52.9%, 75%; GrB 30(88.2%), 30.8%, 61.5% and GrC 12(52.2%), 66.6%, 85.7%, respectively. CONCLUSION: PTCA can be considered an important revascularization alternative in octogenarian patients because of high early success rate, low mortality and acceptable long-term outcome.
Assuntos
Angina Pectoris/terapia , Angioplastia Coronária com Balão , Infarto do Miocárdio/terapia , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , MasculinoRESUMO
Endomyocardial fibrosis is an endemic cardiac disease, characterized by the presence of fibrous tissue in the endocardium, eventually extending to the myocardium. Massive endocardial calcification of the left ventricle is a rare finding, with only a few cases reported in the literature. We reported a first case of biventricular massive endocardial calcification associated with endomyocardial fibrosis in a 22 year old woman.
Assuntos
Calcinose/complicações , Fibrose Endomiocárdica/complicações , Ventrículos do Coração , Adulto , Calcinose/diagnóstico , Fibrose Endomiocárdica/diagnóstico , Evolução Fatal , Feminino , Hemodinâmica , HumanosRESUMO
The authors describe a rare case of circumflex coronary artery perforation during rotational coronary atherectomy complicated with cardiac tamponade and good outcome. The possible causes of perforation are discussed and the burr oversize (burr/artery ratio was 0.58) was refused. Shortening and artery plicature (accordeon effect) might have been the cause of this event. Quantitative measurement was made in order to strengthen this hypothesis. It is emphasized the importance of selecting lesions that should be submitted to rotational coronary atherectomy.
Assuntos
Aterectomia Coronária/efeitos adversos , Tamponamento Cardíaco/etiologia , Doença das Coronárias/cirurgia , Vasos Coronários/lesões , Aterectomia Coronária/instrumentação , Cineangiografia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We describe the rare angiographic finding of the right coronary artery arising from the middle portion of the left anterior descending coronary artery in a patient with atherosclerotic coronary artery disease and acute myocardial infarction. This anatomic variation has been previously described only four times in the modern literature.
Assuntos
Anomalias dos Vasos Coronários/diagnóstico , Infarto do Miocárdio/etiologia , Adulto , Angiografia Coronária , Anomalias dos Vasos Coronários/complicações , Eletrocardiografia , Humanos , MasculinoRESUMO
A 70 years-old man, with acute myocardial infarction, was submitted to successfull percutaneous transluminal coronary angioplasty of the left main stem coronary artery, following recanalization of that artery.
Assuntos
Angioplastia Coronária com Balão , Doença das Coronárias/terapia , Infarto do Miocárdio/terapia , Idoso , Angiografia Coronária , Eletrocardiografia , Humanos , MasculinoRESUMO
Homem de 70 anos, portador de infarto agudo do miocário, foi submetido, com sucesso, à angioplastia percutânea do tronco de artéria coronária esquerda.
A 70 years-old man, with acute myocadial infarction, was submitted to successfull percutaneous transluminal coronary angioplasty of the left main stem coronary artery, follow in a recanalization of that artery
Assuntos
Angioplastia com Balão , Doença das Coronárias , Infarto do MiocárdioRESUMO
A 43 year-old female patient with angina pectoris and vasospasm demonstrated in the anomalous left circumflex (Cx) and right coronary (RCD) arteries by coronary angiograph. Origin of the left Cx from the RCD is the most common coronary anomaly and generally, is considered to be benign. Nevertheless, myocardial ischemia in patient with this anomaly has been described. To our knowledge, this is the first reported case of coronary vasospasm occurring simultaneously in the anomalous left Cx and RCD arteries. The diagnostic troubles and the potential danger of this association were emphasized.