Summary: Anticoagulation instability due to a change in intake of vitamin K after dietary modification was observed in 2 patients on long-term oral anticoagulants. One patient developed diffuse bruises treated conservatively with fresh frozen plasma transfusion and the other had a thrombosed aortic prosthesis which required emergency operation. To prevent such complications, dietary modification especially with food rich in vitamin K should be undertaken with care in patients on long-term oral anticoagulants.

Nine patients with atrial myxoma in whom selective coronary arteriography had been performed were studied. The angiographic sign of 'tumour vascularity' was found to be present in three patients with highly vascularized atrial myxoma. The clinical significance of the angiographic sign is unknown although highly vascularized myxomata appear to have a greater propensity to bleeding into the tumour, resulting in an acute worsening of clinical symptoms. The angiographic sign of 'tumour vascularity' is not specific but useful to complement the diagnosis of an atrial myxoma. The indication for selective coronary arteriography in patients with atrial myxoma remains the detection of coronary artery disease, thus concomitant coronary artery bypass surgery could be planned preoperatively.

The results and follow-up data for 11 patients with recurrent pericardial effusion due to various etiologies who underwent balloon pericardiotomy with the Inoue balloon catheter between May 1992 and July 1994 are described. Inoue balloon pericardiotomy was successful in 10 patients (91%), who remained free of pericardial effusion at a mean follow-up duration of 4.2 months. All patients tolerated the procedure well with minimal discomfort and with no complications. Despite good symptomatic relief, 9 patients (82%) eventually succumbed to disease dissemination, with a mean survival time of 1.4 months. It is concluded that Inoue balloon pericardiotomy is a safe and useful alternative to surgical pericardial windowing for the symptomatic treatment of recurrent pericardial effusion.

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Two patients in whom a proximal balloon tear accompanied by a unique angiographic appearance occurred during percutaneous balloon mitral valvotomy using the Inoue balloon catheter are described.