Marçon F, Worms A M, Pernot C
Clinique des maladies cardio-vasculaires et service de cardiologie infantile du CHU de Nancy, Brabois, Vandoeuvre.
Arch Mal Coeur Vaiss. 1989 May;82(5):761-7.
Between January 1986 and October 1988, 11 young patients aged from 3 months to 29 years (10.6 years) underwent percutaneous transluminal angioplasty for recoarctation of the aorta. The procedure was performed 3 months to 21 years (6.7 years) after the initial operation for coarctation (9 cases: 8 terminoterminal sutures and 1 Waldhausen operation) or for complete interruption of the aortic arch (2 cases: direct terminoterminal suture with banding of the pulmonary artery in 1 case and closure of an aorto-pulmonary fistula in the other case). The diameter of the balloon selected was at most 1 to 1.5 mm wider than that of the smallest diameter of the aorta upstream or downstream of the stenosis, as measured by prior aortography. Adverse events recorded were thrombosis of the femoral artery in a 1-year old child, transient subendocardial lesion wave during dilatation in another child, and regressive left bundle branch block in a third patient. In one patient a small aneurysm developed at the site of dilatation: it was perfectly stable after 8 months. A satisfactory result was obtained in 4 cases, with a 52 to 95% increase in diameter of the stenosis and reduction of the gradient which fell from 56 mmHg on average to 18.25 mmHg. One child was lost sight of; in the remaining 3 patients the result remained stable after 6 to 20 months. A partial result (widening of the stenosis without change in gradient) was obtained in 2 cases. Five of the 11 cases were failures.(ABSTRACT TRUNCATED AT 250 WORDS)
1986年1月至1988年10月期间,11名年龄在3个月至29岁(平均10.6岁)的年轻患者接受了经皮腔内血管成形术治疗主动脉缩窄复发。该手术在最初的缩窄手术(9例:8例端端吻合和1例Waldhausen手术)或主动脉弓完全中断手术(2例:1例为直接端端吻合并结扎肺动脉,另1例为闭合主肺动脉瘘)后3个月至21年(平均6.7年)进行。根据术前主动脉造影测量,所选球囊的直径比狭窄部位上游或下游主动脉最小直径最多宽1至1.5毫米。记录的不良事件包括1名1岁儿童股动脉血栓形成、另1名儿童扩张期间短暂的心内膜下损伤波以及第3名患者的进行性左束支传导阻滞。1例患者在扩张部位出现小动脉瘤:8个月后完全稳定。4例患者取得了满意的结果,狭窄部位直径增加了52%至95%,压力阶差降低,平均从56 mmHg降至18.25 mmHg。1名儿童失访;其余3例患者在6至20个月后结果保持稳定。2例患者取得了部分结果(狭窄增宽但压力阶差无变化)。11例中有5例手术失败。(摘要截短于250字)