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Biomedical subjects

E Zavala

Publications and source records attributed to E Zavala.

46 records · Page 3Linked to original sources
PubMedDate not supplied

[Usefulness of electrophysiologic studies. Report of 224 cases].

Two hundred and twenty four electrophysiologic studies were performed in 194 patients during a two-year period. One hundred and six (54.6%) had tachyarrhythmias: 21 had atrial tachycardia, 28 had the Wolff-Parkinson-White syndrome. Of 51 patients with a normal electrocardiogram a concealed left Kent bundle was observed in 21 cases and only one concealed right Kent bundle; functional James fibers were seen in 7 patients and Mahaim fibers in two. In 15 patients A-V nodal reentry was diagnosed and functional ectopy was observed in 5 patients. The sick-sinus-syndrome was seen in 24 patients and atrial arrest in three. Thirty patients underwent a second electrophysiologic study to evaluate proper antiarrhythmic therapy. Atrioventricular conduction was evaluated in 52 patients. A "suprahisian" delay was found in 34%, troncular lesions were diagnosed in 31%, a distal delay in 25% and mixed conduction disturbances in 10%. We conclude that electrophysiologic studies are a useful procedure to: 1) establish the etiologic diagnosis of tachyarrhythmias; 2) evaluate their potential danger; 3) objectively evaluate antiarrythmic therapy; 4) establish the need for surgical treatment; 5) give the topographic diagnosis and severity of A-V conduction disturbances and 6) indicate the need for definitive pacemaker implant.

Arrhythmias, Cardiac↗
PubMedDate not supplied

[Echocardiographic evaluation of the tricuspid valve in rheumatic mitral valvulopathy].

The recognition of tricuspid valve involvement in presence of rheumatic mitral valve disease is important when surgery is contemplated. At the National Institute of Cardiology in Mexico City, we studied 57 patients with preoperative echocardiogram and catheterisation on whom the tricuspid valve (TV) was explored during surgical repair of mitral valve disease. TV was normal in 17 patients (group I), 28 had functional tricuspid insufficiency (group II) and 12 had rheumatic involvement (group III). Surgical treatment over TV was required in 22 (20 annuloplasty, 1 comissurotomy and 1 homograft valve replacement). We found pure mitral stenosis in 15, mitral stenosis and regurgitation in 36 and 6 with pure mitral insufficiency; the surgical repair over the mitral valve consisted in: 4 comissurotomies and 53 prosthetic valve replacement. At catheterisation, no significant pressure differences were found among the groups (right atrium, end diastolic of right ventricle, systolic pulmonary artery and capillary wedge). Echocardiogram showed E-F slope velocity diminished in group III (P less than 0.01), a diastolic anterior motion of septal leaflet of TV was found in 22 patients. No significant differences in the right ventricle measurements were found. In 7 patients a systolic anterior motion of interventricular septum was observed, all had mitral stenosis, 6 from group II and 1 from group III. We conclude that: echocardiogram study is a useful tool for the evaluation of TV involvement in patients with rheumatic mitral valve disease.

Adolescent↗
PubMedDate not supplied

[Coronary angioplasty with the Monorail system via 6 French diagnostic catheters].

We studied the use of "Monorail" system with Express (Scimed) balloon catheters for coronary angioplasty through 6 French (F) "high-flow" diagnostic catheters (Novoste, USCI). Prospectively, from July 1992 to January 1993, angioplasty of 31 lesions in 24 patients was attempted (1.3 lesions/procedure). Twenty procedures were of a single lesion and four were multi-vessel angioplasty. Fourteen lesions were in the left anterior descending or in its branches, 10 in the left circumflex or in its branches, 6 in the right coronary artery, and one in the distal anastomosis of an internal mammary artery graft. Thirteen lesions (42%) were type A, 17 (55%) type B and one (3%) type C. Balloon sizes varied between 2.0 and 3.5 mm. Twenty-nine lesions could be successfully dilated (93.5%); two cases were unsuccessful due to an acute occlusion in one and residual stenosis of more than 50% in the other. For only one case, another balloon catheter different from the "Monorail" system was necessary to complete a multi-vessel angioplasty. Coronary visualization and manipulation of the balloon through the tip of the diagnostic catheter were satisfactory in all cases, except with the 3.5 mm balloon catheter. Coronary angioplasty with "Monorail" system balloon catheters through 6 F "high-flow" diagnostic catheters is feasible and provides a high success rate in simple and moderately complex selected lesions, including multivessel angioplasty with advantages of smaller artery punction and the feasibility of performing coronary angioplasty with the same catheter used for diagnostic angiography.

Adult↗