Patel A A, Hatle L, Mimish L
King Faisal Specialist Hospital and Research Center, Department of Cardiovascular Diseases, Riyadh, Saudi Arabia.
J Heart Valve Dis. 1999 May;8(3):307-11.
A 15-year-old boy with severe pulmonary stenosis associated with severe right and left ventricular systolic dysfunction is reported. After successful percutaneous pulmonary valvuloplasty, there was an initial and early improvement in right ventricular (RV) function, followed by a delayed and more gradual improvement in left ventricular (LV) function. At long-term follow up, both RV and LV systolic functions were nearly normalized. Several mechanisms may be implicated, including ventricular interdependence, geometric factors, altered compliance and intrinsic alteration in the LV muscle. A delayed, but sustained, improvement in LV systolic function following relief of RV pressure overload suggests that the latter mechanism must have played an important role in the genesis of the LV dysfunction. Pulmonary stenosis associated with severe biventricular dysfunction may be treated primarily by percutaneous pulmonary balloon valvuloplasty with near-total recovery of the ventricular function.
报道了一名15岁男孩，患有严重的肺动脉狭窄并伴有严重的右心室和左心室收缩功能障碍。在成功进行经皮肺动脉瓣成形术后，右心室（RV）功能最初出现早期改善，随后左心室（LV）功能出现延迟且更渐进的改善。在长期随访中，RV和LV收缩功能几乎恢复正常。可能涉及多种机制，包括心室相互依存、几何因素、顺应性改变以及LV心肌的内在改变。RV压力过载解除后LV收缩功能出现延迟但持续的改善表明，后一种机制在LV功能障碍的发生中一定起到了重要作用。伴有严重双心室功能障碍的肺动脉狭窄可能主要通过经皮肺动脉球囊瓣成形术进行治疗，心室功能可近乎完全恢复。
