Bussmann W D, Sievert H, Reifart N, Kober G, Satter P, Kaltenbach M
Z Kardiol. 1985 Dec;74(12):718-21.
Five patients (aged between 11 and 59 years) with valvular pulmonary artery stenosis and pressure gradients between 60 and 143 mm Hg underwent percutaneous transluminal balloon valvuloplasty. Selection of the appropriate balloon size was based on the measurement of the dimension of the value anulus as a determinant from the angiogram. Balloon catheters were used with a diameter of 18 to 20 mm. After placement in the stenotic valve the balloon was filled with diluted contrast material for 10-20 s. The balloon indention by the stenotic valve disappeared suddenly during expansion with one to three atmospheres. The pressure gradient in individual patients decreased from 60 to 25, from 143 to 60, 100 to 55, 143 to 60, and 60 to 37 mm Hg, in the mean from 101 to 52 mm Hg. All patients were discharged two to four days after the procedure. During follow-up with recatheterization after three to nine months (four patients) the gradients decreased as compared to the value immediately after valvuloplasty. The exercise capacity increased in all patients. No complications were observed. Balloon valvuloplasty of pulmonary valvular stenosis seems to be an alternative to the operative procedure.
5例(年龄在11至59岁之间)患有瓣膜性肺动脉狭窄且压力阶差在60至143mmHg之间的患者接受了经皮腔内球囊瓣膜成形术。合适球囊大小的选择基于对瓣膜环尺寸的测量,该尺寸通过血管造影确定为决定因素。使用直径为18至20mm的球囊导管。将球囊置于狭窄瓣膜后,用稀释的造影剂充盈10至20秒。在1至3个大气压扩张过程中,狭窄瓣膜造成的球囊压痕突然消失。个别患者的压力阶差分别从60降至25、从143降至60、从100降至55、从143降至60以及从60降至37mmHg,平均从101降至52mmHg。所有患者在术后2至4天出院。在术后3至9个月对4例患者进行再导管检查的随访期间,与瓣膜成形术后即刻的值相比,压力阶差降低。所有患者的运动能力均有所提高。未观察到并发症。肺动脉瓣狭窄的球囊瓣膜成形术似乎是手术治疗的一种替代方法。