Sullivan I D, Robinson P J, Macartney F J, Taylor J F, Rees P G, Bull C, Deanfield J E
Br Heart J. 1985 Oct;54(4):435-41. doi: 10.1136/hrt.54.4.435.
Pulmonary valve stenosis was relieved by balloon dilatation during cardiac catheterisation on 27 occasions in 23 infants and children aged 7 days to 12 years, median 31 months (three aged less than 2 weeks). Pulmonary valve diameter was estimated by cross sectional echocardiography to assist in the choice of balloon size. Before dilatation the right ventricular systolic pressure ranged from 41 to 190 (median 92) mm Hg and was suprasystemic in 10 patients. There were significant reductions in the ratio of right ventricular to systemic systolic pressure and pulmonary systolic pressure gradients immediately after balloon dilatation. Twelve patients underwent recatheterisation (11 at six months and one at one week after balloon dilatation), which showed further improvement with significant reductions in right ventricular pressure or pulmonary valve gradient or both, particularly in the patients with the least satisfactory initial results. This improvement was attributed to resolution of the obstruction at infundibular level. Repeat pulmonary valve dilatation was successfully performed in four patients who had poor results after initial dilatation. Balloon pulmonary valvotomy appears to provide good short term and medium term relief of pulmonary valve stenosis and may obviate the need for surgery in many cases. An apparently poor immediate haemodynamic result does not preclude a good longer term result.
在23例年龄从7天至12岁（中位年龄31个月，3例年龄小于2周）的婴幼儿和儿童中，通过心导管插入术进行球囊扩张术解除肺动脉瓣狭窄27次。通过横断面超声心动图估计肺动脉瓣直径，以协助选择球囊大小。扩张前右心室收缩压范围为41至190（中位值92）mmHg，10例患者的右心室收缩压高于体循环收缩压。球囊扩张术后，右心室与体循环收缩压之比以及肺动脉收缩压梯度立即显著降低。12例患者接受了再次心导管检查（11例在球囊扩张术后6个月，1例在1周后），结果显示进一步改善，右心室压力或肺动脉瓣梯度或两者均显著降低，尤其是初始结果最不理想的患者。这种改善归因于漏斗部水平梗阻的解除。4例初次扩张效果不佳的患者成功进行了重复肺动脉瓣扩张术。球囊肺动脉瓣切开术似乎能在短期和中期有效缓解肺动脉瓣狭窄，并且在许多情况下可能无需进行手术。即时血流动力学结果看似不佳并不排除长期效果良好。
