Beekman R H, Rocchini A P, Crowley D C, Snider A R, Serwer G A, Dick M, Rosenthal A
Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor 48109-0204.
J Am Coll Cardiol. 1988 Aug;12(2):480-5. doi: 10.1016/0735-1097(88)90423-8.
To compare the effectiveness of the single and double balloon techniques, the short-term results of percutaneous balloon valvuloplasty were assessed in two consecutive groups of children with valvular aortic stenosis. In 16 children (aged 3 months to 17 years) the single balloon technique was utilized; the ratio of balloon diameter to valve anulus diameter was 0.96 +/- 0.03 (mean +/- SEM). In 11 children (aged 3 months to 21 years) the double balloon technique was utilized in which two balloons are positioned across the valve and inflated simultaneously; the ratio of the balloon diameter sum to valve anulus diameter was 1.32 +/- 0.05. The groups were similar in age, weight, cardiac output, prevalvuloplasty gradient and valve anulus diameter. Overall, valvuloplasty reduced the peak systolic gradient by 53% from 80 +/- 4 to 38 +/- 3 mm Hg (p less than 0.0001). In the single balloon group the gradient decreased from 82 +/- 6 to 46 +/- 4 mm Hg (p less than 0.0001), whereas in the double balloon group the gradient decreased from 76 +/- 5 to 26 +/- 4 mm Hg (p less than 0.0001). The peak systolic gradient after valvuloplasty was 43% lower in the double balloon group (p less than 0.01). Furthermore, the single balloon technique reduced the gradient by an average of 43% compared with a 67% reduction with the double balloon technique (p less than 0.001). The short-term complications of valvuloplasty were similar, with an increase in aortic insufficiency occurring in three children in each group.(ABSTRACT TRUNCATED AT 250 WORDS)
为比较单球囊技术和双球囊技术的有效性，对两组连续性的瓣膜性主动脉狭窄患儿经皮球囊瓣膜成形术的短期结果进行了评估。16名患儿（年龄3个月至17岁）采用单球囊技术，球囊直径与瓣环直径之比为0.96±0.03（均值±标准误）。11名患儿（年龄3个月至21岁）采用双球囊技术，即两个球囊横跨瓣膜并同时充气，球囊直径之和与瓣环直径之比为1.32±0.05。两组在年龄、体重、心输出量、成形术前压力阶差和瓣环直径方面相似。总体而言，瓣膜成形术使收缩期峰值压力阶差从80±4 mmHg降至38±3 mmHg，降幅为53%（p<0.0001）。单球囊组压力阶差从82±6 mmHg降至46±4 mmHg（p<0.0001），而双球囊组压力阶差从76±5 mmHg降至26±4 mmHg（p<0.0001）。瓣膜成形术后双球囊组的收缩期峰值压力阶差低43%（p<0.01）。此外，单球囊技术使压力阶差平均降低43%，而双球囊技术降低67%（p<0.001）。瓣膜成形术的短期并发症相似，每组均有3名患儿出现主动脉瓣关闭不全加重。（摘要截选至250词）
