Hartmann A, Rosenbohm G J, Keul H G, Kober G, Satter P, Kaltenbach M
Abteilung für Kardiologie, J.-W.-Goethe-Universität, Frankfurt am Main.
Z Kardiol. 1990 Sep;79(9):610-4.
To determine if electromagnetically generated shock-wave lithotripsy has potential application for treatment of stenotic, calcified aortic valves, 38 cusps of surgically excised human aortic valves were studied. Valves were weighed, photographed, and calcium deposition was determined by x-ray. Stiffness was determined by palpation and by measuring the pressure gradient generated in a perfusion system. Valves were exposed to shock waves at 16 or 18 kV with 200 or 400 impulses each. Twenty valves reacted to exposure to shock waves with a reduction in pressure gradient of 1.9 +/- 2 cm H2O. Calcified valve area was reduced by 3.5 +/- 1.3 mm2. Valves without changes in pressure gradient showed a reduction of 7.1 +/- 2 mm2 of calcified valve area. There was no significant difference in weight loss. Using a small focus (4 mm) there was a significant reduction in pressure gradient and calcified valve area, but not in weight; with a large focus (8 mm) reduction in calcified valve area, gradient, and weight was significant (p less than 0.05). Changes in valve stiffness were independent of weight loss and reduction in calcified valve area. In conclusion, shock-wave lithotripsy is capable of reducing stiffness of calcified aortic valves, presumably by fragmentation of tissue calcium deposits.
为了确定电磁产生的冲击波碎石术是否具有治疗狭窄、钙化主动脉瓣的潜在应用价值，对38个手术切除的人主动脉瓣尖进行了研究。称取瓣膜重量、拍照，并通过X射线测定钙沉积情况。通过触诊和测量灌注系统中产生的压力梯度来确定硬度。将瓣膜分别暴露于16 kV或18 kV的冲击波下，每次200或400次脉冲。20个瓣膜在暴露于冲击波后压力梯度降低了1.9±2 cmH₂O。钙化瓣膜面积减少了3.5±1.3 mm²。压力梯度无变化的瓣膜钙化瓣膜面积减少了7.1±2 mm²。重量减轻无显著差异。使用小焦点（4 mm）时，压力梯度和钙化瓣膜面积显著降低，但重量无变化；使用大焦点（8 mm）时，钙化瓣膜面积、梯度和重量的降低均显著（p<0.05）。瓣膜硬度的变化与重量减轻和钙化瓣膜面积减少无关。总之，冲击波碎石术能够降低钙化主动脉瓣的硬度，推测是通过破碎组织中的钙沉积物实现的。
