de Menezes I C, Telo M, Martins F M
Rev Port Cardiol. 1989 Dec;8(12):863-5.
The case of a six years-old girl with Ductus Arterious, Pulmonary Hypertension, Aortic Stenosis and poor left ventricular function is presented. No aortic valvular gradient could be found on a simple aortic and left ventricular pressure measurement, but it could be recorded when transvalvular aortic flow was increased while the Ductus Arteriosus was occluded with a balloon. This manoeuver forced an increase in pulmonary blood flow by avoiding right-to-left ductal shunting, thus increasing the venous return to the left heart and across the aortic valve. The aortic valve stenosis was subsequently relieved by percutaneous balloon valvuloplasty performed in two separate instances. This was thought to be particularly indicated in this case, considering the high risks of open-heart surgery.
本文介绍了一名六岁女童的病例，她患有动脉导管未闭、肺动脉高压、主动脉狭窄且左心室功能不佳。在简单测量主动脉和左心室压力时未发现主动脉瓣压差，但当用球囊封堵动脉导管以增加经主动脉瓣血流时可记录到该压差。此操作通过避免右向左的导管分流来促使肺血流量增加，从而增加了回流入左心并通过主动脉瓣的静脉血。随后在两个不同时间进行了经皮球囊瓣膜成形术，主动脉瓣狭窄得以缓解。考虑到心脏直视手术的高风险，认为此病例特别适合进行该手术。
