RESUMO
We analyzed 69 consecutive PTCA performed upon 64 patients from January 1990 to May 1992. Age was 55 +/- 12 years and 80% were male. Fifty-nine percent were smokers, 32% had hypertension, 16% a remote myocardial infarction, 14% diabetes, 12% previous PTCA, and 6% previous coronary artery bypass surgery. Total cholesterol was 238 +/- 75 mg/dl. Most of the subjects had an acute coronary syndrome, with unstable angina in 31 and a recent myocardial infarction in 23. Angiographically, 52% had single vessel disease, 39% had double vessel and 9% triple vessel disease. LVEF was 55 +/- 11%, LVEDP 17 +/- 10 mm Hg, and 44% had wall motion abnormalities. We dilated 1.4 lesions/patient (1-4), for a total of 100 lesions. Luminal stenosis was reduced from (mean +/- SEM) 88.5 +/- 1.1% to 22.6 +/- 2.2% (p < 0.0001). The procedure was a total clinical success in 85.6% of the patients and a partial clinical success in 4.3%. Complete revascularization was achieved in 62.3% and incomplete but adequate revascularization in 26%. Multiple lesions dilatation was performed in 30% of the patients and multiple vessel angioplasty in 17%. Forty-seven lesions were on the LAD distribution (91.5% angiographic success), 24 on the circumflex (95.8% angiographic success), 26% on RCA (88.4% angiographic success) and 3 in others. There was a 10% failure and 13% complication rates, but more than half of them were successfully managed medically, although 5.7% required urgent CABG. One patient died.
Assuntos
Angioplastia Coronária com Balão , Hospitais Gerais , Adulto , Fatores Etários , Idoso , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/estatística & dados numéricos , Doença das Coronárias/diagnóstico , Doença das Coronárias/epidemiologia , Doença das Coronárias/terapia , Feminino , Hospitais Gerais/estatística & dados numéricos , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Risco , Fatores Sexuais , Falha de Tratamento , Resultado do TratamentoAssuntos
Arritmias Cardíacas/diagnóstico , Eletrocardiografia , Ataque Isquêmico Transitório/etiologia , Síncope/etiologia , Idoso , Arritmias Cardíacas/complicações , Eletrocardiografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Convulsões/etiologiaRESUMO
We report five patients with Myxomas of the left atrium studied by catheterization and/or Echocardiography between november 1976 and october 1978. Four patients were operated immediately with extracorporeal circulation which confirmed the diagnosis. The last patient died before surgical intervention due to a severe hepatorenal syndrome and extensive pulmonary infection. Another patient died postoperatively on the second day due to irreversible pulmonary hypertensión. The remaining three patients are asymptomatic (average 28 months after surgery). Reviewing the diagnostic methods, particularly the Echocardiogram, we found that it is a good diagnostic tool, making catheterization with the risks of myxomatous embolization unnecessary. Furthermore, the Echo facilitates simple and economic observation for the detection of relapses. Finally, broad and careful surgical management most be emphasized in order to avoid transoperative emboli, tumoral dissemination, and latent relapses, mediated by the greater use of filters and a broad resection of the implantation pedicule.