Discrete Subaortic Stenosis

ABCIC

Editorial

Choice of Imaging Methods in Hypertrophic Cardiomyopathy

Murillo de Oliveira Antunes et al. Edmundo Arteaga-Fernández Charles Mady

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Editorial

Which Risk Score Best Assesses Clinical Objectives in Patients with Hypertrophic Cardiomyopathy?

Eduardo Alberto de Castro Roque

Hypertrophic cardiomyopathy (HCM) is a genetic disorder characterized by commonly asymmetric unexplained left ventricular hypertrophy, with greater thickening of the basal interventricular septum. Left ventricular outflow tract obstruction is present at rest in around one third of patients and can be caused in another third. The histological features of HCM include hypertrophy and myocyte disorder, in addition to interstitial fibrosis. Hypertrophy is also often associated with left ventricular diastolic dysfunction.

The first case of HCM was described by Henri Liouville in 1869 in the Gazette Medecine Paris. In 1907, Dr. A. Schmincke, a German pathologist, described two hearts with left ventricular hypertrophy; both were seen in women in their fifth decade of life. Levy and von Glahn, in 1944, from the University of Colombia, in New York, published a series of cases that resembled HCM. In 1949, William Evans, a cardiologist from London, described the familial occurrence of cardiac hypertrophy in a series of patients similar to those described in the article by Levy and von Glahn. Dr. Eugene Braunwald and Dr. Andrew Glenn Morrow published a series of studies where they detailed the clinical and hemodynamic aspects of this disease, allowing the establishment of therapeutic objectives.^–

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Artigo Original

Balloon dilatation for the treatment of membranous subaortic stenosis

José Luiz B. Jacob et al. Nilton Carlos S. Machado Wilson Miguel C. Coelho Sérgio Aloisio C. Garzon

PURPOSE: This study sought to evaluate the immediate and follow-up results of percutaneous balloon dilatation for the treatment of membranous subaortic stenoses. METHODS: Fourteen patients with mean age 11.4± 5.2 years, were submitted to the procedure. They were selected when the echocardiogram showed a thin subaortic membrane that was far from the aortic valve, no fibro-muscular obstruction and only mild or moderate aortic regurgitation. After measuring the pressure gradient and analysis of the angiographic features, the balloon dilatation was made by applying a fast manual inflation until the balloon waist disappeared. The balloon diameter was the same as that of the outflow tract of left ventricle, immediately bellow the aortic valve. Pressure measurement, left ventriculogram and aortogram were repeated. Doppler echocardiogram was repeated in the following day, after 3 months and every 6 months thereafter. RESULTS: All 17 procedures were successful. The mean gradient was 76.1±21.2mmHg before and 29.8±8.8mmHg after dilatation (p<0.01). There was no increase in aortic regurgitation or death after the procedure or during the follow-up. Twelve patients were discharged 24h after the procedure. Surgical treatment for femoral artery thrombosis was performed in 2 patients. In the follow-up of 33.3±23.6 months, 4 patients developed restenosis and 3 of them were submitted to successful redilatation. CONCLUSION: We conclude that in selected cases, the procedure is safe and effective, and restenosis may be treated by percutaneous balloon redilatation.

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Choice of Imaging Methods in Hypertrophic Cardiomyopathy

Which Risk Score Best Assesses Clinical Objectives in Patients with Hypertrophic Cardiomyopathy?

Balloon dilatation for the treatment of membranous subaortic stenosis

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)