Leithe M E, Harrison J K, Davidson C J, Rankin J S, Pierce C, Kisslo K B, Bashore T M
Duke University Medical Center, Cardiac Catheterization Laboratory, Durham, NC 27710.
Cathet Cardiovasc Diagn. 1991 Sep;24(1):16-21. doi: 10.1002/ccd.1810240105.
Valve repair and calcium debridement in patients with calcific aortic stenosis, using the Cavitron Ultrasonic Surgical Aspirator (CUSA), results in a reduction in the aortic valve gradient while potentially avoiding long-term problems inherent to prosthetic valves. Invasive followup data in these patients has not previously been reported. Ten patients in whom CUSA debridement was performed underwent cardiac catheterization prior to and 8.0 +/- 2.5 months following the procedure. Compared to baseline, the aortic valve area significantly increased from 0.75 +/- 0.2 to 1.1 +/- 0.3 cm2 (p = 0.009) and the mean gradient was significantly reduced from 54 +/- 21 to 27 +/- 21 mmHg (p = 0.02) at followup. No significant change was noted in cardiac output, ejection fraction, left ventricular end systolic or diastolic volumes or left ventricular end diastolic pressure. However, 6 patients were found to have at least one grade worsening of aortic regurgitation. The development of increased aortic insufficiency in many patients after CUSA aortic valve debridement will likely limit this procedure's clinical utility.
使用超声外科吸引器（CUSA）对钙化性主动脉瓣狭窄患者进行瓣膜修复和钙化清除，可降低主动脉瓣压差，同时可能避免人工瓣膜固有的长期问题。此前尚未报道过这些患者的侵入性随访数据。10例行CUSA清除术的患者在术前及术后8.0±2.5个月接受了心导管检查。与基线相比，随访时主动脉瓣面积从0.75±0.2显著增加至1.1±0.3 cm²（p = 0.009），平均压差从54±21显著降低至27±21 mmHg（p = 0.02）。心输出量、射血分数、左心室收缩末期或舒张末期容积以及左心室舒张末期压力均未发现显著变化。然而，发现6例患者至少有一级主动脉瓣反流恶化。CUSA主动脉瓣清除术后许多患者主动脉瓣关闭不全加重，这可能会限制该手术的临床应用。
