Sinha Santosh Kumar, Mishra Vikas, Razi Mahmadula, Jha Mukesh Jitendra
Department of Cardiology, LPS institute of Cardiology, Kanpur, Uttar Pradesh, India.
Department of Cardiology and Cardiac Surgery, LPS Institute of Cardiology, Kanpur, Uttar Pradesh, India.
BMJ Case Rep. 2017 Oct 4;2017:bcr-2017-221533. doi: 10.1136/bcr-2017-221533.
Transcatheter therapy of valvular pulmonary stenosis is one of first catheter interventions facilitating its application in field of structural heart disease and now treatment of choice for significant pulmonary stenosis. Myriads of balloon catheter have been used for this purpose starting from Diamond (Boston Scientific,Natick, MA USA), Marshal (Medi-Tech,Watertown MAUSA), Innoue balloon, Tyshak I and currently Tyshak II. Diameter and length of balloon depend on size of annulus and age group, respectively. Problem with shorter balloon is difficulty in keeping it across the annulus while inflation as it tends to slip distally whereas with longer balloon, potential of tricuspid leak or conduction block as it may impinge on adjacent structures. Potential advantage of Accura balloon over Tyshak balloon lies in its peculiar shape while inflation and variable diameter, making stepwise dilatation possible. Here, we report a case of successful balloon pulmonary valvuloplasty using Accura balloon (Vascular Concept, UK) with little modification of conventional technique.
经导管治疗瓣膜性肺动脉狭窄是最早的导管介入治疗之一,这促进了其在结构性心脏病领域的应用,目前已成为重度肺动脉狭窄的首选治疗方法。从戴蒙德球囊(美国马萨诸塞州纳蒂克市波士顿科学公司)、马歇尔球囊(美国马萨诸塞州沃特敦市美迪泰克公司)、井上球囊、泰沙克I型球囊,到目前的泰沙克II型球囊,无数的球囊导管都被用于此目的。球囊的直径和长度分别取决于瓣环大小和年龄组。较短球囊的问题在于充气时难以使其跨过瓣环,因为它容易向远端滑动;而较长球囊则存在三尖瓣反流或传导阻滞的风险,因为它可能会压迫相邻结构。与泰沙克球囊相比,Accura球囊的潜在优势在于其充气时独特的形状和可变直径,使得逐步扩张成为可能。在此,我们报告一例使用Accura球囊(英国血管概念公司)成功进行球囊肺动脉瓣成形术的病例,该操作对传统技术改动很小。