1/50. femoral neuropathy following cardiac catheterization for balloon mitral valvotomy.femoral neuropathy is a very rare complication of cardiac catheterization. We report an adult female who developed femoral neuropathy after undergoing cardiac catheterization through femoral vein for balloon mitral valvotomy. Neuropathy was confirmed by electromyography and nerve conduction studies and the patient showed spontaneous recovery over a course of 6 months. Use of prolonged digital pressure for post-procedural hemostasis is implicated as possible etiology. Such complications can be prevented by minimising the procedural time, avoiding injury to the vessels and maintaining optimal posture of patient's thigh by limiting abduction and external rotation of hip.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/50. Aberrant infrarenal inferior vena cava as a hindrance to percutaneous transvenous mitral valvuloplasty in a patient with mitral stenosis: case report.cardiac catheterization and percutaneous transvenous mitral commissurotomy using the Inoue technique were attempted in a 44-year-old woman with mitral stenosis. The pulmonary arterial wedge pressure was 25 mmHg, mean transmitral diastolic pressure gradient 20.3 mmHg, cardiac index 1.80 L/min/m2, and mitral valve area 0.70 cm2. After the diagnostic catheterization, the guide wire for the transseptal procedure was checked in the middle of the inferior vena cava (IVC). A 7-French end-holed Bermann catheter was then used to detect the course of the IVC. It was found that the IVC coursed along the left border of the 4th and 5th lumbar vertebrae, to the left of the abdominal aorta. At the upper border of the third lumbar vertebra, the IVC returned to the right side of the vertebra. In consideration of the inability to pass the Brockenbrough needle through the detoured infrarenal IVC and the risk of rupturing the vessel, the transseptal procedure and attempted percutaneous transvenous mitral commissurotomy were aborted. Therefore, the patient underwent open mitral commissurotomy instead.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
3/50. Successful percutaneous balloon mitral valvuloplasty using left ventricular pressure as a guide to cross the mitral valve--a case report.Percutaneous balloon mitral valvuloplasty (PBMV) provides an effective alternative to surgery in a selective group of patients with symptomatic mitral stenosis. The Inoue balloon technique involves transseptal catheterization followed by catheter manipulation to cross the mitral valve. The authors describe a case of successful percutaneous balloon mitral valvuloplasty in a patient with severe mitral stenosis and pulmonary hypertension. Left ventricular systolic pressure was used as a guide to locate and to advance the balloon catheter across the mitral valve. This technique to cross the mitral valve has not been reported in the literature.- - - - - - - - - - ranking = 5keywords = pressure (Clic here for more details about this article) |
4/50. "Low pressure" left ventricular tamponade in a patient with rheumatic mitral stenosis and hiv-related acute pericarditis.A case report of isolated left ventricular tamponade in a patient with rheumatic mitral stenosis and effusive pericarditis is presented. The haemodynamics and management of this under-diagnosed pathology is discussed.- - - - - - - - - - ranking = 4keywords = pressure (Clic here for more details about this article) |
5/50. Thrombolysis for prosthetic valve malfunction: case report and review.A 40 year old female with severe mitral valve stenosis, underwent mitral valve replacement by single disc valve 4 years ago. She presented at this admission with a new onset of congestive heart failure. The prothrombin time was inadequate with international normalized ratio (INR) 1.43. Transthoracic echocardiography revealed high pressure gradient across the mitral valve. fluoroscopy demonstrated restrictive opening of single disc motion. Intravenous thrombolysis was given for presumptive diagnosis of prosthetic valve thrombosis. The patient gradually improved and did not have to undergo surgical correction.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/50. Exercising pulmonary blood flow in mitral stenosis with anomalous pulmonary venous connection.Exercising pulmonary blood flow was estimated from indicator-dilution curves in a patient with the infrequent combination of rheumatic mitral stenosis and anomalous pulmonary venous connection from the left lung. During supine exercise against progressively increasing external workloads, the proportion of flow to each lung remained nearly constant. The pulmonary vascular resistance was highest in the left lung, which emptied into the low-pressure systemic vein. Although right and left atrial pressures differed markedly during supine exercise, the proportion of pulmonary blood flow shunted to the systemic venous sytem remained essentially unchanged.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
7/50. Interpretation of cardiac pathophysiology from pressure waveform analysis: mitral valve gradients: Part I.The mitral valve gradient is dependent on the precise measurement of left atrial (or pulmonary capillary wedge) and left ventricular pressures. artifacts involving either pressure measurement will produce inaccuracies which may have clinical significance. Several methods and formulas using both invasive and noninvasive techniques should verify clinical findings and confirm the severity of mitral valve disease prior to definite therapy. The changes in mitral valve gradients after balloon catheter valvuloplasty will be discussed in part II of this hemodynamic rounds.- - - - - - - - - - ranking = 6keywords = pressure (Clic here for more details about this article) |
8/50. Overestimation of severity of mitral stenosis during cardiac catheterization due to a large left atrial thrombus.We report a case of mitral stenosis with a large left atrial thrombus which was obstructing pulmonary venous inflow where the conventional use of the pulmonary capillary wedge pressure as an approximation of the left atrial pressure during diagnostic cardiac catheterisation led to the over-estimation of the severity of mitral stenosis.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
9/50. Percutaneous mitral valvuloplasty in a mid-term pregnant woman with severe rheumatic mitral stenosis.A 28-year-old woman with severe mitral stenosis underwent percutaneous mitral valvuloplasty at 26 weeks' gestation. Balloon dilation using a double 18-18 mm balloon resulted in improvement in mean mitral pressure gradient (32 to 8 mmHg) and in calculated mitral valve area (0.9 to 2.4 cm2) without complications and any evidence of fetal distress during procedures with an estimated radiation exposure to the fetus of 0.13 rem. This procedure resulted in the disappearance of symptoms of congestive heart failure and allowed for normal full term spontaneous delivery of a 3.51 Kg boy without any complication.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/50. Treatment with epoprostenol of pulmonary arterial hypertension following mitral valve replacement for mitral stenosis.Pulmonary hypertension frequently complicates mitral stenosis. Increased pulmonary artery pressure results from raised left atrial pressure, pulmonary arteriolar constriction, and obliterative changes in the pulmonary vascular bed, and usually responds to surgical relief of mitral stenosis. However, severe pulmonary hypertension may persist after surgical treatment of mitral stenosis. We describe a patient whose severe pulmonary hypertension following mitral valve replacement was treated successfully with continuous intravenous epoprostenol.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
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