Fawzy Mohamed Eid, Awad Mahmoud, Hassan Walid, Al Kadhi Yusuf, Shoukri Mohamed, Fadley Fadel
Department of Cardiovascular Diseases (MBC-16), King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia.
J Am Coll Cardiol. 2004 Mar 17;43(6):1062-7. doi: 10.1016/j.jacc.2003.10.040.
This study evaluated the long-term follow-up results of balloon angioplasty (BA) in adolescent and adult patients with discrete coarctation of the aorta.
Although the immediate and intermediate term results of BA for patients with aortic coarctation (AC) have been encouraging, there is a paucity of data on long-term follow-up results.
This basis of this study was follow-up of 49 patients (mean age, 22 +/- 7 years) undergoing BA for discrete AC at median interval of 10.2 years, including cardiac catheterization, magnetic resonance imaging, and Doppler echocardiography.
No early or late deaths occurred. Balloon angioplasty produced a reduction in peak AC gradient from 66 +/- 23 mm Hg (95% confidence interval [CI]: 59.5 to 72.7) to 10.8 +/- 7 mm Hg (95% CI: 8.8 to 12.5) (p < 0.0001). Follow-up catheterization 12 months later revealed a residual gradient of 6.2 +/- 6 mm Hg (95% CI: 4.4 to 7.9) (p < 0.001). Four patients (7.5%) with suboptimal initial outcome with peak gradient >20 mm Hg had successful repeat angioplasty. Aneurysm developed at the site of dilation in four patients (7.5%). Magnetic resonance imaging follow-up results revealed no new aneurysm or appreciable changes in the size of pre-existing aneurysms, and no recoarctation was observed. Also, no appreciable changes in the Doppler gradient across the AC site were noted. The blood pressure had normalized without medication in 31 (63%) of the 49 patients.
Long-term results of BA for discrete AC are excellent and should be considered as first option for treatment of this disease.
本研究评估了球囊血管成形术（BA）治疗青少年和成年单纯性主动脉缩窄患者的长期随访结果。
尽管BA治疗主动脉缩窄（AC）患者的近期和中期结果令人鼓舞，但长期随访结果的数据却很少。
本研究基于对49例（平均年龄22±7岁）接受BA治疗单纯性AC患者的随访，随访中位间隔时间为10.2年，包括心脏导管检查、磁共振成像和多普勒超声心动图检查。
无早期或晚期死亡病例。球囊血管成形术使AC峰值压差从66±23 mmHg（95%置信区间[CI]：59.5至72.7）降至10.8±7 mmHg（95%CI：8.8至12.5）（p<0.0001）。12个月后的随访导管检查显示残余压差为6.2±6 mmHg（95%CI：4.4至7.9）（p<0.001）。4例（7.�%）初始结果欠佳、峰值压差>20 mmHg的患者成功进行了重复血管成形术。4例（7.5%）患者在扩张部位出现动脉瘤。磁共振成像随访结果显示无新的动脉瘤形成，已存在的动脉瘤大小无明显变化，未观察到再缩窄。此外，AC部位的多普勒压差也无明显变化。49例患者中有31例（63%）血压未经药物治疗已恢复正常。
BA治疗单纯性AC的长期效果极佳，应被视为该病治疗的首选方法。
