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婴儿和新生儿重度肺动脉瓣狭窄球囊瓣膜成形术后右心室的生长与功能

Right Ventricular Growth and Function After Balloon Valvuloplasty for Critical Pulmonary Valve Stenosis in Infants and Neonates.

作者信息

Agha Hala, El-Saeidi Sonia, Abou Seif Hassan, Abd El-Salam Mohamed, El Amrousy Doaa

机构信息

Pediatric Department, Cairo University, Cairo, Egypt.

Pediatric Department, Al-Azhar University, Cairo, Egypt.

出版信息

Pediatr Cardiol. 2020 Apr;41(4):795-800. doi: 10.1007/s00246-020-02314-1. Epub 2020 Feb 17.

DOI:10.1007/s00246-020-02314-1
PMID:32065250
Abstract

Little data are published about right ventricular (RV) growth and function in infants and neonates after balloon pulmonary valvuloplasty (BPV) for critical valvular pulmonary stenosis (PS). We aimed to assess the RV growth and function during 1 year after BPV for critical valvular PS in neonates and infants. A total of 41 infants and neonates with isolated critical valvular PS who underwent BPV from August 2016 to Sep 2018 were enrolled in the study. Complete Echocardiographic examination was performed to all infants before, 1 week, 1 month, 3 months, 6 months, and 1 year after BPV. The RV systolic pressure and transvalvular pulmonary pressure gradient significantly decreased 1 week after BPV and continue to decrease more slowly during the period of follow-up. During follow-up, RV end-diastolic dimension increased significantly, whereas RV anterior wall thickness significantly decreased. The mean diameters of pulmonary valve annulus and tricuspid valve annulus significantly increased after BPV over the period of follow-up. RV systolic and diastolic dysfunction improved significantly as reported by reduced RV Tei index and tricuspid annular systolic velocity and increased RV E/A ratio. RV growth and function were significantly improved after BPV for critical PS in infants and neonates and catch-up growth of right ventricular structures occurred after 6 months of BPV.

摘要

关于婴儿和新生儿在接受球囊肺动脉瓣成形术(BPV)治疗重度瓣膜性肺动脉狭窄(PS)后右心室(RV)的生长和功能,发表的数据很少。我们旨在评估新生儿和婴儿在接受BPV治疗重度瓣膜性PS后1年内的RV生长和功能。本研究纳入了2016年8月至2018年9月期间接受BPV治疗的41例孤立性重度瓣膜性PS的婴儿和新生儿。在BPV前、BPV后1周、1个月、3个月、6个月和1年对所有婴儿进行了完整的超声心动图检查。BPV后1周,RV收缩压和跨瓣膜肺动脉压力梯度显著降低,且在随访期间继续缓慢下降。随访期间,RV舒张末期内径显著增加,而RV前壁厚度显著降低。随访期间,BPV后肺动脉瓣环和三尖瓣环的平均直径显著增加。如RV Tei指数降低、三尖瓣环收缩速度降低和RV E/A比值增加所示,RV收缩和舒张功能障碍显著改善。婴儿和新生儿在接受BPV治疗重度PS后,RV生长和功能显著改善,且在BPV 6个月后右心室结构出现追赶性生长。

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