Background-The newly developed percutaneous heart valve (PHV) implantation technique decreases transaortic pressure gradient in patients with aortic stenosis. PHV replacement effects on left ventricular (LV) global and regional systolic function are currently unknown. Methods and Results-Eight patients with severe aortic stenosis had 2D echocardiography at baseline and 24 hours after PHV implantation to evaluate changes in LV volume and LV ejection fraction. Regional function, ie, both peak systolic anterior and posterior wall tissue velocity, as well as strain and strain rate imaging, were measured by tissue Doppler imaging from a short-axis view. At 24 hours, a significant reduction in transaortic mean pressure gradient (from 46Ϯ15 to 8Ϯ3 mm Hg; PϽ0.0001) was accompanied by an increase in aortic valve area (from 0.59Ϯ0.11 to 1.69Ϯ0.11 cm 2 ; PϽ0.0001). LV end-diastolic volume remained unchanged (102Ϯ36 to 101Ϯ12 mL; PϭNS), whereas LV ejection fraction increased (48Ϯ18% to 57Ϯ12%; PϽ0.01). Improvement in posterior wall displacement (posterior wall tissue velocity increased from 2.2Ϯ0.5 to 4.4Ϯ1.0 cm/s

Percutaneous heart valve implantation is feasible in inoperable patients with end-stage AS leading to hemodynamic and clinical improvement. Continued advances and improved patient selection should decrease adverse events in the near future.

SummaryBackground: Central anthropometric indexes are better than the body mass index to discriminate elevated coronary risk. However, the Body Mass Index (BMI) is still the most frequently studied anthropometric index on outcomes of patients undergoing percutaneous coronary angioplasty (PCI).

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Forty-four consecutive pregnant patients with mitral stenosis were submitted to percutaneous mitral valvuloplasty (PMV) over a period of 12 years. The mean age was 28 +/- 6 years and the mean gestational age was 23 +/- 6 weeks. The mean mitral valve area had a significant increase from 1.17 +/- 0.26 to 2.06 +/- 0.41 cm(2) (P = 0.0000). The mean mitral valve gradient decreased from 16.22 +/- 5.55 to 7.94 +/- 3.75 mm Hg (P = 0.0001). The procedure was performed successfully in 95% of the patients and there were no major complications. Concerning labor and delivery, we evaluated 37 patients. Thirty patients (81%) reached term and delivered normal infants. Seven patients (18.9%) delivered prematurely, resulting in two fetal death; one patient delivered a stillborn. We concluded that PMV is a safe procedure for the treatment of mitral stenosis in pregnant patients, providing significant symptomatic relief and better clinical conditions for labor and delivery.