Letac B, Cribier A, Koning R
Service de cardiologie, Hôpital Charles-Nicolle, Rouen.
Arch Mal Coeur Vaiss. 1989 Jan;82(1):17-25.
In our department, percutaneous balloon valvuloplasty has become the routine treatment of aortic valve stenosis in adults. We report here the results obtained in 245 consecutive patients. The patients' age varied between 30 and 98 years (mean 74 +/- 11 years), 77 of them (31 p. 100) being 80 years' old or older. The initial peak to peak ventriculo-aortic gradient was 72 +/- 25 mmHg and the aortic valve area was 0.53 +/- 0.17 cm2. After dilatation the gradient was reduced to 29 +/- 14 mmHg (p less than 0.001) and the aortic valve area was increased to 0.95 +/- 0.33 cm2 (p less than 0.0001). The aortic valve area was increased by 100 p. 100 or more in 83 patients (34 p. 100) and by less than 25 p. 100 in only 17 patients (7 p. 100). The ventricular ejection fraction rose slightly but significantly from 48 +/- 18 p. 100 to 51 +/- 17 p. 100 (p less than 0.01). One patient developed massive regurgitation and had to undergo semi-emergency surgery. The experience acquired and the use of better catheters enabled us to improve these results by almost doubling the number of patients whose aortic valve area became 1 cm2 or more and by reducing by half those whose aortic valve area remained 0.7 cm2 or less. Three patients aged 82, 91 and 98 respectively died, and there was one cerebral vascular accident in the catheterization room. Nine patients (4 p. 100) died in hospital during the following days.(ABSTRACT TRUNCATED AT 250 WORDS)
在我们科室，经皮球囊瓣膜成形术已成为成人主动脉瓣狭窄的常规治疗方法。我们在此报告连续245例患者的治疗结果。患者年龄在30至98岁之间（平均74±11岁），其中77例（31%）年龄在80岁及以上。最初的心室-主动脉峰峰值压差为72±25 mmHg，主动脉瓣面积为0.53±0.17 cm²。扩张后压差降至29±14 mmHg（p<0.001），主动脉瓣面积增加至0.95±0.33 cm²（p<0.0001）。83例患者（34%）的主动脉瓣面积增加了100%或更多，仅17例患者（7%）的增加幅度小于25%。心室射血分数从48±18%略有但显著地升至51±17%（p<0.01）。1例患者出现大量反流，不得不接受半急诊手术。所积累的经验以及使用更好的导管使我们能够改善这些结果，使主动脉瓣面积达到1 cm²或更大的患者数量几乎翻倍，使主动脉瓣面积仍小于或等于0.7 cm²的患者数量减半。分别为82岁、91岁和98岁的3例患者死亡，在导管室发生了1例脑血管意外。9例患者（4%）在随后的几天内死于医院。（摘要截取自250字）
