Marcello Augustus de Sena

Balão único versus balão de Inoue na valvoplastia mitral percutânea por balão. Resultados imediatos e complicações

PURPOSE: To assess short-term results and complications of percutaneous mitral balloon valvuloplasty (PMBV) performed with Inoue balloon (IB) and single low profile balloon (SB). METHODS: We performed 390 PMBV procedures, 29 with IB and 337 with SB . There were no differences in age, sex, echocardiographic score distribution and echocardiographic mitral valve area (MVA). RESULTS: We performed 29 complete procedures with IB and 330 of 337 in SB group. Comparing IB and pre and pos-PMBV data we obtained: mean pulmonary artery pressure (MPAP) 36±15 and 39±14mmHg, p=0.2033, mean mitral gradient 17±6 and 20±7mmHg, p=0.0396 and MVA 0.9±0.2 and 0.9±0.2cm2, p=0.8043 and pos-PMBV: MPAP 25±8 and 28±10mmHg, p=0.2881, gradient 5±3 and 5±4mmHg, p=0.2778 and MVA 2.2±0.2 and 2.0±0.4cm2, p=0.0362. Mitral valve (MV) was competent in 26 patients in IB and in 280 in SB group and we had +/4 mitral regurgitation in 3 patients in IB and in 57 in SB group (p=0.3591) pre-PMBV respectively and pos-PMBV there was also no difference in MV competence (p=0.7439). CONCLUSION: Both techniques were effective. Hemodynamic data were also similar although MVA was greater in IB group after PMBV.

Influência do sexo na evolução imediata e a médio prazo após a intervenção coronariana percutânea primária e análise dos fatores independentes de risco para óbito ou eventos

OBJECTIVE Determine gender-related differences and risk factors for death and events, both in-hospital and at six-month evolution, of patients admitted within the first twelve hours of ST-segment elevation acute myocardial infarction and who underwent primary percutaneous coronary intervention. METHODS Between July 1998 and December 2000, 199 consecutive patients were enrolled in the study, with elevation myocardial infarction and without cardiogenic shock, outcome, in-hospital and six-month progression were studied. RESULTS Clinical characteristics were similar in both groups, except that women were older than men (67.04 +/- 11.53 x 59.70 +/- 10.88, p < 0.0001). In-hospital mortality was higher among women (9.1% x 1.5%, p = 0.0171), as was the incidence of major events (12.1% x 3.0%, p = 0.0026). The difference in mortality rates remained the same at six months (12.1% x 1.5%, p = 0.0026). The multivariate analysis predicted death: female gender and an age over eighty years, and major events and/or stable angina multivessel: disease and severe ventricular dysfunction. CONCLUSION Female gender and an age over eighty years were independent predictors of mortality, six months of patients who had undergone primary percutaneous intervention.