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先天性肺动脉瓣狭窄球囊成形术的即刻结果。

Immediate results of balloon valvuloplasty in congenital pulmonary valve stenosis.

出版信息

Tunis Med. 2021 Feb;99(2):291-297.

Abstract

INTRODUCTION

Balloon Valvuloplasty is the first-line treatment for congenital valve pulmonary stenosis (PS) in children and adults.

METHODS

We reported immediate results of balloon valvuloplasty in congenital pulmonary stenosis from 2014 to 2019.

RESULTS

BPV was performed in 40 patients, the diagnosis was based on cardiac ultrasound data showing valvular dysplasia in 92% of cases, the main associated anomaly is FOP in 22.5% of cases,  immediate success (defined by a peak-to-peak gradient after the DPPC of less than 50mmHg) was found in 88% of cases, allowing a significant reduction in mean  peak to peak pressure among pulmonary valve  from 69.65mmHg to 30.19mmHg. After BV 11% of patients maintained a high gradient, the independent predictive factors were valvular dysplasia and the small diameter of the ring an immediate post procedural infundibular reaction was noted in 25% of cases mainly related to valvular dysplasia. The mortality of the procedure was zero and morbidity was low. mild pulmonary regurgitation was found in all patients.

CONCLUSION

PV has been established as the treatment of choice for valvular PR with few complications. Following its satisfactory immediate results, the indications quickly extended to critical pulmonary stenosis in newborns and late discovery forms in adults.

摘要

介绍

球囊瓣膜成形术是儿童和成人先天性瓣膜性肺动脉瓣狭窄(PS)的一线治疗方法。

方法

我们报告了 2014 年至 2019 年期间先天性肺动脉瓣狭窄球囊瓣膜成形术的即刻结果。

结果

对 40 例患者进行了 BPV,诊断基于心脏超声数据,92%的病例显示瓣膜发育不良,22.5%的病例主要伴发法洛四联症。88%的病例即刻成功(定义为 DPPC 后峰-峰值梯度小于 50mmHg),允许肺动脉瓣平均峰值压力显著降低,从 69.65mmHg 降至 30.19mmHg。BV 后 11%的患者保持高梯度,独立预测因素为瓣膜发育不良和环的小直径,即刻出现瓣下反应在 25%的病例中,主要与瓣膜发育不良有关。该手术的死亡率为零,发病率较低。所有患者均发现轻度肺动脉瓣反流。

结论

PV 已确立为瓣膜性 PR 的首选治疗方法,并发症较少。在即刻结果令人满意后,其适应证迅速扩展到新生儿的严重肺动脉瓣狭窄和成人的晚期发现形式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/682c/8715795/ee7ba218ee75/fig1.jpg

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