Vogel M, Benson L N, Burrows P, Smallhorn J F, Freedom R M
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Br Heart J. 1989 Aug;62(2):148-53. doi: 10.1136/hrt.62.2.148.
Percutaneous balloon dilatation of the aortic valve was attempted in 25 consecutive patients with stenosis. The aortic valve diameters were normal for age. The balloon catheters were placed retrogradely, and their diameters were within 1-2 mm of the valve diameter and 3 (13 patients) or 6 cm (recent 12 patients) long. After dilatation the pressure gradients across the aortic valve were reduced significantly and the valve areas, measured in 10 patients, increased. Aortic regurgitation was detected in six patients before (grade I) the procedure and in 15 patients (6 grade I, 6 grade II, 3 grade III) after the procedure. In one patient the aortic valve could not be crossed and in three there was no reduction in the pressure drop. Nine patients have a sustained reduction in Doppler assessed gradients. There were vascular complications in 12 and these required surgical intervention in three patients. Balloon dilatation seems to be an effective short term palliative procedure in patients with congenital stenosis of the aortic valve.
对25例连续性主动脉瓣狭窄患者尝试进行经皮球囊主动脉瓣扩张术。主动脉瓣直径与年龄相符。球囊导管逆行置入，其直径比瓣膜直径小1 - 2毫米，长度为3厘米（13例患者）或6厘米（最近12例患者）。扩张后，主动脉瓣两端的压力阶差显著降低，在10例患者中测量的瓣膜面积增加。6例患者在手术前检测到主动脉瓣反流（I级），15例患者在手术后检测到主动脉瓣反流（6例I级，6例II级，3例III级）。1例患者球囊无法穿过主动脉瓣，3例患者压力降未降低。9例患者经多普勒评估的压力阶差持续降低。12例出现血管并发症，其中3例需要手术干预。球囊扩张术似乎是先天性主动脉瓣狭窄患者有效的短期姑息治疗方法。
