Division of Cardiology, Angiogenesis Research Center and Interventional Cardiology Section, BIDMC/Harvard Medical School, Boston, Massachusetts, USA.
Catheter Cardiovasc Interv. 2011 Mar 1;77(4):589-92. doi: 10.1002/ccd.22816.
Calcific aortic stenosis remains a major cause of mortality and morbidity in the aging population. Surgical replacement remains the treatment of choice for this disease. Balloon aortic valvuloplasty was introduced as a palliative procedure for these patients, but was tempered by a high rate of recurrence, which has limited its usefulness. However, the introduction of smaller-profile balloons, rapid pacing, and closure devices have brought it back as an alternative treatment strategy in selected patients who are at too high risk for surgery with repeat valvuloplasty as needed for recurrences. We report a case of prosthetic aortic valve stenosis treated with valvuloplasty with intracardiac and fluoroscopic guidance with recurrence treated with repeat valvuloplasty with promising intermediate-term outcome and describe the growing valve in valve procedures.
钙化性主动脉瓣狭窄仍然是老龄化人口中主要的死亡和发病原因。对于这种疾病,外科瓣膜置换仍然是首选的治疗方法。球囊主动脉瓣成形术作为一种姑息性手术被引入,但由于高复发率,其应用受到限制。然而,较小口径球囊、快速起搏和闭合装置的引入使它在某些高手术风险的患者中又成为一种替代治疗策略,对于这些患者,可以在需要时重复进行瓣成形术以治疗复发。我们报告了一例在心脏内和荧光透视引导下进行的瓣成形术治疗人工主动脉瓣狭窄的病例,复发后再次进行瓣成形术,中期结果有希望,并描述了正在发展的瓣中瓣手术。