Ledesma Velasco M, Acosta Valdes J L, Munayer Calderón J, Salgado Escobar J L, Arias Monroy L, Soberanis Torruco C N
Departamento de Hemodinamia y Fisiología Pulmonar, Hospital General Centro Médico la Raza, México, D.F.
Arch Inst Cardiol Mex. 1991 Jan-Feb;61(1):53-8.
Percutaneous transluminal angioplasty (PTA) was performed in 34 patients with aortic coarctation (Ao Co). One of them with coarctation after surgical correction, the rest were native Ao Co. We used one balloon in 28 patients and two balloons simultaneously in 6. They were separated in three groups according to the degree of aortic arc hypoplasia. Group I (mild to moderate hypoplasia N = 9) the gradient dropped 39% with angiographic improvement of 48% during the follow-up (m = 13.1 months). Three cases with restenosis, 2 were satisfactory dilated and one was sent to surgery. In Group II (severe hypoplasia N = 4) the gradient dropped 31% with angiographic improvement of 30% (follow-up 16.3 months). Two cases with recoarctation were sent to surgery. In Group III (without hypoplasia N = 21) we obtained dropped of gradient of 71% with angiographic improvement of 60% (follow-up 18.5 months). Two cases were redilated successfully. The complications were: cerebral hemorrhage with death due to hypertensive crisis, (1) cerebral embolism, (1) thrombosis in the puncture site 1 and small aneurysm in dilated zone. (1) We think PTA is a good choice to conventional surgery with low rate of morbidity-mortality. The results depend basically on the anatomic type of coarctation and degree of aortic arch hypoplasia.
对34例主动脉缩窄（Ao Co）患者进行了经皮腔内血管成形术（PTA）。其中1例为手术矫正后的缩窄，其余为原发性Ao Co。28例患者使用一个球囊，6例同时使用两个球囊。根据主动脉弓发育不全的程度将他们分为三组。I组（轻度至中度发育不全，N = 9）在随访期间（平均13.1个月）梯度下降39%，血管造影改善48%。3例再狭窄患者中，2例扩张效果满意，1例接受手术。II组（重度发育不全，N = 4）梯度下降31%，血管造影改善30%（随访16.3个月）。2例再缩窄患者接受手术。III组（无发育不全，N = 21）梯度下降71%，血管造影改善60%（随访18.5个月）。2例成功再次扩张。并发症包括：因高血压危象导致脑出血死亡（1例）、脑栓塞（1例）、穿刺部位1血栓形成和扩张区小动脉瘤（1例）。我们认为PTA相对于传统手术是一个不错的选择，发病率和死亡率较低。结果基本取决于缩窄的解剖类型和主动脉弓发育不全的程度。
