Alekian B G, Petrosian Iu S, Il'in V I, Nikoliuk A P, Vinokurov A V, Suturin S A
Grud Serdechnososudistaia Khir. 1992(9-10):22-6.
Balloon valvuloplasty was performed in 14 patients with congenital valvular aortic stenosis. Their age was 28 days to 12 months. All the patients had severe heart failure. Balloon valvuloplasty was successfully conducted in 8 patients. The systolic pressure gradient between the aorta and the left ventricle decreased, on the average, from 81.2 +/- 21.4 to 31.3 +/- 8.2 mm Hg, i.e. by 61.5%. Only 2 patients developed moderate aortic insufficiency after balloon valvuloplasty. The left ventricle could not be catheterised in 6 infants: in 4 patients due to critical valvular stenosis, in 2 due to a. lusoria. One of them died when the guide was attempted to be introduced through the narrowed aortic valve, which resulted in aortic sinus perforation. Long-term results were studied in 4 patients 3 to 24 months after surgery. Their clinical condition improved. The systolic pressure gradient between the left ventricle and the aorta was in agreement with the values obtained just after transluminal balloon valvuloplasty. Transluminal balloon valvuloplasty can be successfully performed in 1-year-old infants with congenital critical aortic valvular stenosis and yields good immediate results. A further accumulation of clinical findings, development of procedures for transluminal balloon valvuloplasty and study of long-term results will allow indications for this tool to be worked out in this group of patients.
对14例先天性瓣膜性主动脉狭窄患者实施了球囊瓣膜成形术。他们的年龄为28天至12个月。所有患者均患有严重心力衰竭。8例患者球囊瓣膜成形术成功实施。主动脉与左心室之间的收缩压梯度平均从81.2±21.4降至31.3±8.2 mmHg，即降低了61.5%。球囊瓣膜成形术后仅2例患者出现中度主动脉瓣关闭不全。6例婴儿无法进行左心室插管：4例因严重瓣膜狭窄，2例因迷走主动脉。其中1例在试图将导管经狭窄的主动脉瓣插入时死亡，导致主动脉窦穿孔。对4例患者术后3至24个月的长期结果进行了研究。他们的临床状况有所改善。左心室与主动脉之间的收缩压梯度与经腔球囊瓣膜成形术后即刻获得的值相符。经腔球囊瓣膜成形术可成功应用于1岁先天性严重主动脉瓣狭窄婴儿，且能取得良好的即刻效果。进一步积累临床资料、完善经腔球囊瓣膜成形术操作方法并研究长期结果，将有助于明确该治疗手段在这组患者中的适应证。
