Jabbour Richard J, Dick Ron, Walton Anthony S
Epworth Hospital, Level 6, 89 Bridge Road, Richmond 3121, Victoria, Australia.
Heart Lung Circ. 2008;17 Suppl 4:S73-81. doi: 10.1016/j.hlc.2008.09.009. Epub 2008 Nov 14.
Aortic balloon valvuloplasty (BAV) was initially devised in the 1980s as an alternative procedure to the surgical treatment of aortic stenosis, with the theory behind it being both minimally invasive as well as having a lower complication rate [Hara H, et al. Percutaneous balloon aortic valvuloplasty revisited: time for a renaissance? Circulation 2007 March;115(12):e334-8]. In practice however, the procedure was found to have a higher complication rate with only a modest haemodynamic improvement compared to the surgical approach. Most important of all it had an unacceptably high restenosis rate as a substitute for surgery [Otto CM, et al. 3-year outcome after balloon aortic balloon valvuloplasty: insights into prognosis of valvular aortic stenosis. Circulation 1994;89:642-50]. As a result, the procedure has fallen out of favour and has been abandoned at many health care facilities [Hara H, et al. Percutaneous balloon aortic valvuloplasty revisited: time for a renaissance? Circulation 2007 March;115(12):e334-8]. This article will review the management of patients with severe aortic stenosis that are unsuitable to undergo surgery.
主动脉球囊瓣膜成形术（BAV）最初于20世纪80年代被设计出来，作为主动脉瓣狭窄外科治疗的替代手术，其背后的理论是该手术既微创又具有较低的并发症发生率[原田浩等人。经皮主动脉球囊瓣膜成形术再探讨：复兴的时候到了？《循环》2007年3月；115(12):e334 - 8]。然而在实际应用中，与手术方法相比，该手术被发现并发症发生率更高，血流动力学改善却很有限。最重要的是，作为手术替代方法，其再狭窄率高得令人难以接受[奥托·C·M等人。主动脉球囊瓣膜成形术后3年的结果：对瓣膜性主动脉狭窄预后的见解。《循环》1994年；89:642 - 50]。因此，该手术已失宠，许多医疗机构已不再采用[原田浩等人。经皮主动脉球囊瓣膜成形术再探讨：复兴的时候到了？《循环》2007年3月；115(12):e334 - 8]。本文将综述不适于接受手术的重度主动脉瓣狭窄患者的治疗。
