Fiszer Roland, Szkutnik Małgorzata, Litwin Linda, Smerdziński Sebastian, Chodór Beata, Białkowski Jacek
Department of Congenital Heart Diseases and Pediatric Cardiology, Silesian Center for Heart Diseases, Zabrze, Poland.
Department of Congenital Heart Defects and Pediatric Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
Postepy Kardiol Interwencyjnej. 2016;12(3):231-7. doi: 10.5114/aic.2016.61645. Epub 2016 Aug 19.
Balloon angioplasty (BAP) and aortic or pulmonary balloon valvuloplasty (BAV, BPV) are well-established treatment options in congenital heart defects. Recently, significant technological progress has been made and new catheters have been implemented in clinical practice.
To analyze the results of BAP, BAV and BPV with the new balloon catheter Valver and its second generation Valver II, which the company Balton (Poland) launched and developed. These catheters have not been clinically evaluated yet.
We performed 64 interventions with Valver I and Valver II. With Valver I the following procedures were performed: 17 BPV (including 9 in tetralogy of Fallot - TOF), 10 BAV and 27 BAP in coarctations of the aorta (CoA) - including 9 native and 18 after surgery. With Valver II ten interventions were done - 3 BPV, 2 pulmonary supravalvular BAP (after switch operations), 2 BAP of recoarctations and 3 other BAP. Age of the patients ranged from a few days to 40 years.
All procedures were completed successfully, without rupture of any balloon catheters. The pressure gradient drop was statistically significant in all groups: BPV in isolated pulmonary valvular stenosis 28.1 mm Hg (mean), BPV in TOF 18.7 mm Hg, BAV 32.8 mm Hg, BAP in native CoA 15.4 mm Hg and in recoarctations 18.6 mm Hg. In 3 cases during rapid deflation of Valver I, wrinkles of the balloons made it impossible to insert the whole balloon into the vascular sheath (all were removed surgically from the groin). No such complication occured with Valver II.
Valver balloon catheters are an effective treatment modality in different valvular and vascular stenoses.
球囊血管成形术（BAP）以及主动脉或肺动脉球囊瓣膜成形术（BAV、BPV）是先天性心脏缺陷中已确立的治疗选择。最近，取得了重大技术进展，新导管已应用于临床实践。
分析使用新型球囊导管Valver及其第二代产品Valver II进行BAP、BAV和BPV的结果，这两款导管由波兰的Balton公司推出并研发。这些导管尚未进行临床评估。
我们使用Valver I和Valver II进行了64例干预操作。使用Valver I进行了以下操作：17例BPV（包括9例法洛四联症 - TOF）、10例BAV以及27例主动脉缩窄（CoA）的BAP - 包括9例原发性和18例术后病例。使用Valver II进行了10例干预操作 - 3例BPV、2例肺动脉瓣上BAP（转换手术后）、2例再狭窄的BAP以及3例其他BAP。患者年龄从几天到40岁不等。
所有操作均成功完成，无任何球囊导管破裂。所有组的压力阶差下降均具有统计学意义：孤立性肺动脉瓣狭窄的BPV为28.1毫米汞柱（均值），TOF的BPV为18.7毫米汞柱，BAV为32.8毫米汞柱，原发性CoA的BAP为15.4毫米汞柱，再狭窄的BAP为18.6毫米汞柱。在3例使用Valver I快速放气过程中，球囊出现褶皱，导致无法将整个球囊插入血管鞘（所有均通过手术从腹股沟取出）。使用Valver II未发生此类并发症。
Valver球囊导管是治疗不同瓣膜和血管狭窄的有效治疗方式。
