Stenberg R G, Fixler D E, Taylor A L, Corbett J R, Firth B G
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235.
Am J Med. 1988 Jan;84(1):157-61. doi: 10.1016/0002-9343(88)90026-5.
Left ventricular dysfunction due to chronic right ventricular pressure overload is well documented in experimental animals, but is controversial in humans. Whether left ventricular dysfunction resolves following the relief of chronic right ventricular pressure overload has not been studied. In this report, rapid improvement in both right and left ventricular function following successful percutaneous balloon valvuloplasty is described in a patient with severe isolated valvular pulmonic stenosis and biventricular dysfunction. It appears that: (1) geometric distortion played a major role in his reversible left ventricular dysfunction, and (2) severe biventricular dysfunction should not be a contraindication to valvuloplasty for valvular pulmonic stenosis.
慢性右心室压力负荷过重导致的左心室功能障碍在实验动物中已有充分记录，但在人类中存在争议。慢性右心室压力负荷过重缓解后左心室功能障碍是否会消退尚未得到研究。在本报告中，描述了一名患有严重孤立性瓣膜性肺动脉狭窄和双心室功能障碍的患者在成功进行经皮球囊瓣膜成形术后右心室和左心室功能迅速改善的情况。似乎：（1）几何变形在其可逆性左心室功能障碍中起主要作用，（2）严重双心室功能障碍不应成为瓣膜性肺动脉狭窄瓣膜成形术的禁忌证。
