Ben-Shachar G, Cohen M H, Sivakoff M C, Portman M A, Riemenschneider T A, Van Heeckeren D W
J Am Coll Cardiol. 1985 Mar;5(3):754-6. doi: 10.1016/s0735-1097(85)80407-1.
A 14 month old boy with suprasystemic right ventricular pressure secondary to pulmonary valvular stenosis and anular size of 10 mm underwent percutaneous balloon valvuloplasty with a 12 mm balloon. Right ventricular pressure almost doubled after valvuloplasty and the electrocardiogram revealed development of severe right ventricular strain. Both findings persisted on the following day. A postvalvuloplasty right ventriculogram demonstrated a severe systolic infundibular obstruction not present before. The patient underwent surgical relief of infundibular obstruction; successful opening of the pulmonary valve by the balloon valvuloplasty was observed. It is concluded that a balloon size 20% larger than anular size can be safe in human subjects and that infundibular obstruction may appear or even worsen after balloon valvuloplasty. Such an obstruction may be related to the severity of pulmonary valvular obstruction and a hypercontractile infundibulum.
一名14个月大的男孩，因肺动脉瓣狭窄导致右心室压力超过体循环压力，瓣环大小为10毫米，使用12毫米球囊进行了经皮球囊瓣膜成形术。瓣膜成形术后右心室压力几乎翻倍，心电图显示出现严重右心室劳损。这两个发现第二天仍持续存在。瓣膜成形术后的右心室造影显示出之前不存在的严重收缩期漏斗部梗阻。该患者接受了漏斗部梗阻的手术解除；观察到球囊瓣膜成形术成功打开了肺动脉瓣。得出的结论是，球囊尺寸比瓣环尺寸大20%在人体中可能是安全的，并且漏斗部梗阻可能在球囊瓣膜成形术后出现甚至加重。这种梗阻可能与肺动脉瓣梗阻的严重程度和漏斗部过度收缩有关。
