Burrows P E, Benson L N, Moes C A, Freedom R M
Department of Radiology, Hospital for Sick Children, Toronto, Ontario, Canada.
Cardiovasc Intervent Radiol. 1989 Jan-Feb;12(1):38-42. doi: 10.1007/BF02577125.
Tears involving the anterior supravalvar annulus developed in 2 children and an infant following percutaneous balloon pulmonary valvotomy using oversized balloons. The 3 patients had angiographic features of three different types of stenotic valves: usual pulmonary valve stenosis in 1, a form of dysplastic pulmonary valve with supravalvar narrowing in a second, and a doming valve in a neonate. All had a successful reduction in right ventricular outflow tract gradient following the procedure. The pulmonary arterial tears were not associated with balloon rupture or clinical symptoms. It is postulated that the relative deficiency of elastic fibers in the supravalvar commissure makes this site relatively vulnerable to intimal tearing.
在2名儿童和1名婴儿接受使用超大球囊的经皮球囊肺动脉瓣切开术后，出现了累及瓣膜上方前部瓣环的撕裂。这3例患者具有三种不同类型狭窄瓣膜的血管造影特征：1例为常见的肺动脉瓣狭窄，第2例为伴有瓣膜上方狭窄的发育异常型肺动脉瓣，1例新生儿为圆顶状瓣膜。术后所有患者右心室流出道压力阶差均成功降低。肺动脉撕裂与球囊破裂或临床症状无关。据推测，瓣膜上方联合处弹性纤维相对缺乏使该部位相对易发生内膜撕裂。
