Petrosian Iu S, Alekian B G, Sarkisova T N, Arzhanukhina S Iu
Vestn Akad Med Nauk SSSR. 1989(10):40-6.
The authors' experience in endovascular treatment of such congenital heart defects as pulmonary valvular stenosis (PVS), aortic valvular stenosis (AVS), and aortic coarctation (AC) is presented. Transluminal balloon dilatation was performed in 46 patients: in 30 patients with PVS, 11 patients with CA, and 4 patients with AVS, the patients' age ranging from 7 months to 45 years. Transluminal balloon valvuloplasty was performed using 'Schneider-Medintag' catheters (Switzerland). In PVS patients, the systolic pressure in the right ventricle (RV) was reduced after the procedure from 129 +/- 10.4 to 58 +/- 3.5 mm Hg, the systolic pressure gradient (SPG) between the right ventricle and pulmonary artery fell from 111 +/- 10.6 to 35 +/- 3.8 mm Hg, and the pulmonary valve opening was enlarged from 13.4 +/- 1.5 to 69 +/- 3.9 mm2. Late (6-18-month) results were studied in 5 patients. In CA and reversed CA patients, the SPG between the ascending and descending aorta was reduced from 47.0 +/- 1.7 to 16.0 +/- 3.7 mm Hg, the coarctation diameter increased from 4.5 +/- 0.6 to 8.2 +/- 2.3 mm. In congenital AVS patients, the SPG between the left ventricle and aorta was reduced from 106.5 +/- 35.1 to 39.5 +/- 8.1 mm Hg. Thus, the transluminal balloon valvuloplasty is an effective therapeutic intervention and might be an alternative to surgical treatment. Further experience will allow one to specify indications to its performance in congenital heart disease.
本文介绍了作者对诸如肺动脉瓣狭窄(PVS)、主动脉瓣狭窄(AVS)和主动脉缩窄(AC)等先天性心脏缺陷进行血管内治疗的经验。对46例患者进行了经腔球囊扩张术:30例PVS患者、11例CA患者和4例AVS患者,患者年龄从7个月至45岁不等。使用“Schneider-Medintag”导管(瑞士)进行经腔球囊瓣膜成形术。在PVS患者中,术后右心室(RV)收缩压从129±10.4降至58±3.5 mmHg,右心室与肺动脉之间的收缩压梯度(SPG)从111±10.6降至35±3.8 mmHg,肺动脉瓣开口面积从13.4±1.5扩大至69±3.9 mm²。对5例患者进行了晚期(6 - 18个月)结果研究。在CA和反向CA患者中,升主动脉和降主动脉之间的SPG从47.0±1.7降至16.0±3.7 mmHg,缩窄直径从4.5±0.6增加至8.2±2.3 mm。在先天性AVS患者中,左心室与主动脉之间的SPG从106.5±35.1降至39.5±8.1 mmHg。因此,经腔球囊瓣膜成形术是一种有效的治疗干预措施,可能是手术治疗的替代方法。进一步的经验将有助于明确其在先天性心脏病治疗中的应用指征。