Lekkerkerker J C, Walhout R J, Hutter P A, Sreeram N, Bennink G B, Meijboom E J
Afd. Kinderhartcentrum, Universitair Medisch Centrum Utrecht, Utrecht.
Ned Tijdschr Geneeskd. 2000 Oct 21;144(43):2057-61.
Evaluation of the results of balloon dilatation in coarctation of the aorta in children.
Retrospective.
In the years 1990-1999 30 patients with a congenital coarctation of the aorta were treated with balloon angioplasty in the Children's Heart Centre of Utrecht University Medical Centre, the Netherlands. The group comprised 5 girls and 25 boys, with a mean age of 4.8 years (range 1 month-16 years) without severe associated congenital heart defects or a long segment coarctation. Follow-up included Doppler echocardiography and MRI within the first 6 years after the procedure. The fall of the pressure gradient was assessed with Student's t-test for paired observations and the reintervention period was calculated by the Kaplan-Meier method.
No children died. Of 30 procedures performed, 28 (93%) were considered successful. Mean pressure gradient was reduced from 36.2 mmHg (SD: 12.7) to 13.1 mmHg (SD: 9.3) (p < 0.001). Mean follow-up was 4.1 years; the follow-up of 11 patients was longer than 5 years. Four patients (13%) developed a recoarctation. No aneurysm formation was encountered (n = 14).
Balloon angioplasty for the treatment of native coarctation of the aorta in children may be an efficient and not very damaging solution for this selected group of patients.
评估儿童主动脉缩窄球囊扩张术的结果。
回顾性研究。
1990年至1999年期间，荷兰乌得勒支大学医学中心儿童心脏中心对30例先天性主动脉缩窄患儿进行了球囊血管成形术治疗。该组包括5名女孩和25名男孩，平均年龄4.8岁（范围1个月至16岁），无严重相关先天性心脏缺陷或长节段缩窄。随访包括术后前6年内的多普勒超声心动图和磁共振成像。采用配对观察的学生t检验评估压力梯度下降情况，采用Kaplan-Meier方法计算再次干预时间。
无患儿死亡。在进行的30例手术中，28例（93%）被认为成功。平均压力梯度从36.2 mmHg（标准差：12.7）降至13.1 mmHg（标准差：9.3）（p < 0.001）。平均随访4.1年；11例患者的随访时间超过5年。4例患者（13%）出现再缩窄。未发现动脉瘤形成（n = 14）。
对于这组选定的患儿，球囊血管成形术治疗先天性主动脉缩窄可能是一种有效且损伤较小的解决方案。
