Friedli B, Meier B
Unité de cardiologie pédiatrique, Hôpital cantonal universitaire, Genève.
Schweiz Med Wochenschr. 1990 Jun 9;120(23):870-3.
The treatment of heart defects by interventional catheterization started in 1982, when the first report on balloon dilatation of pulmonary valve stenosis was published. Similar techniques have since been extended to many other lesions. Presently, two types of catheter intervention have come into use. The first is dilatation of stenotic lesions by inflatable balloons: the main defects treated include pulmonary valve stenoses, aortic valve stenoses, coarctation of the aorta and peripheral pulmonary artery stenoses. Second, it is now possible to close defects and unwanted vessels, such as a persistent ductus arteriosus, with umbrella-like devices introduced through catheters. While balloon dilatation has clearly become the treatment of choice for pulmonary valve stenosis, other applications remain either controversial (e.g. balloon dilatation of coarctation) or experimental (e.g. closure of atrial or ventricular septal defects). Time will tell what is the exact role of interventional cardiology, keeping in mind that surgery provides excellent results with minimal morbidity and mortality in these lesions.
介入导管治疗心脏缺陷始于1982年，当时发表了关于肺动脉瓣狭窄球囊扩张术的首篇报告。自那时起，类似技术已扩展至许多其他病变。目前，两种类型的导管介入治疗已开始应用。第一种是通过可充气球囊扩张狭窄病变：主要治疗的缺陷包括肺动脉瓣狭窄、主动脉瓣狭窄、主动脉缩窄和外周肺动脉狭窄。第二种是现在可以使用通过导管引入的伞状装置来闭合缺损和不需要的血管，如动脉导管未闭。虽然球囊扩张术显然已成为肺动脉瓣狭窄的首选治疗方法，但其他应用仍存在争议（如主动脉缩窄的球囊扩张术）或仍处于实验阶段（如房间隔或室间隔缺损的闭合）。随着时间的推移，介入心脏病学的确切作用将会明了，要记住在这些病变中手术能以最低的发病率和死亡率提供优异的治疗效果。
