Arora R, Jolly N, Bhat A, Tyagi S, Kaul U A, Khanna S K, Khalilullah M
Indian Heart J. 1989 Sep-Oct;41(5):314-7.
Percutaneous Balloon Valvuloplasty was performed in 25 patients with severe aortic stenosis (Aortic valve area index: 0.23 to 0.70, mean 0.36 +/- 0.11 cm2/m2). The mean age was 23 +/- 15 (range 6-66) years, and majority (n = 18) had noncalcific valves. Valve morphology was bicuspid in 14, tricuspid in 6 and indeterminate in 5. Valvuloplasty resulted in a fall of peak systolic gradient (PSG) from 112 +/- 35 to 34 +/- 16 mmHg (p less than 0.001), and an increase in aortic valve area (index) (AVAI) from 0.36 +/- 0.11 to 0.82 +/- 0.43 cm2/m2 (p less than 0.001). Follow-up data at 16 +/- 6 months were available for 18 patients, 80 per cent of whom registered symptomatic improvement. Repeat catheterization, performed in 12 cases, showed increase of PSG to 53 +/- 22 mmHg and a fall in AVA (1) to 0.62 +/- 0.24 cm2/m2, as compared to the results immediately following the procedure. In addition, 3 patients had their valve areas estimated by doppler echocardiography. Forty-six per cent of these 15 patients (n = 7) showed evidence of restenosis. Four out of these 7 cases had calcific valves, whereas none of the patients who had sustained improvement had calcification. Tricuspid morphology was present in 50 per cent of the group with sustained improvement, as compared to 20 per cent of the group that restenosed. Our preliminary data shows sustained hemodynamic improvement after balloon dilatation in young patients with severe aortic stenosis with noncalcific and tricuspid aortic valve.
对25例重度主动脉瓣狭窄患者（主动脉瓣面积指数：0.23至0.70，平均0.36±0.11cm²/m²）进行了经皮球囊瓣膜成形术。平均年龄为23±15（范围6 - 66）岁，大多数（n = 18）患者的瓣膜无钙化。瓣膜形态为二叶式14例，三叶式6例，形态不确定5例。瓣膜成形术后，收缩期峰值梯度（PSG）从112±35降至34±16mmHg（p＜0.001），主动脉瓣面积（指数）（AVAI）从0.36±0.11增加至0.82±0.43cm²/m²（p＜0.001）。18例患者获得了16±6个月的随访数据，其中80%的患者症状有所改善。12例患者进行了重复心导管检查，结果显示与术后即刻相比，PSG升高至53±22mmHg，主动脉瓣面积（AVA）（1）降至0.62±0.24cm²/m²。此外，3例患者通过多普勒超声心动图评估了瓣膜面积。这15例患者中有46%（n = 7）出现再狭窄迹象。这7例患者中有4例瓣膜有钙化，而症状持续改善的患者均无钙化。持续改善组中有50%的患者为三叶式瓣膜形态，而再狭窄组中这一比例为20%。我们的初步数据显示，对于患有非钙化三叶式主动脉瓣的重度主动脉瓣狭窄年轻患者，球囊扩张术后血流动力学可获得持续改善。
