Midei M G, Brennan M, Walford G D, Aversano T, Gottlieb S O, Brinker J A
Department of Medicine, Johns Hopkins Medical Institutions, Baltimore.
Chest. 1988 Aug;94(2):245-50. doi: 10.1378/chest.94.2.245.
Percutaneous aortic valvuloplasty using a single dilating balloon has been associated with significant but modest reduction in transvalvular pressure gradient and increase in valve area. The balloon diameter is usually 20 mm or smaller to avoid disruption of aortic root structure and to permit forward blood flow during inflation. To evaluate the safety and efficacy of valvuloplasty using a combination of balloons with larger maximum inflated diameters, we compared results of aortic valvuloplasty in 21 patients using either the single or double balloon technique. Mean maximum inflated balloon diameter was 19.4 mm +/- 1.4 for the single balloon technique, while the mean sum of diameters for the simultaneous double balloon technique was 36.3 mm +/- 3.9. The mean age, aortic annulus diameter, and predilatation aortic valve area were not different among groups. Mean aortic transvalvular gradient reduction and mean aortic valve area increase were greater for the double balloon technique. The procedure was well tolerated with no major complications. No change in the degree of aortic regurgitation was noted. The double balloon technique for aortic valvuloplasty is safe and more effective at improving aortic valve area and transvalvular gradient than the conventional single balloon technique.
使用单个扩张球囊进行经皮主动脉瓣成形术已使跨瓣压差显著但适度降低，瓣膜面积增加。球囊直径通常为20毫米或更小，以避免破坏主动脉根部结构，并在球囊充盈时允许血液向前流动。为了评估使用最大充盈直径更大的球囊组合进行瓣膜成形术的安全性和有效性，我们比较了21例采用单球囊或双球囊技术进行主动脉瓣成形术的结果。单球囊技术的平均最大充盈球囊直径为19.4毫米±1.4，而同步双球囊技术的直径总和平均为36.3毫米±3.9。各组之间的平均年龄、主动脉瓣环直径和预扩张主动脉瓣面积无差异。双球囊技术使平均主动脉跨瓣压差降低幅度更大，平均主动脉瓣面积增加幅度更大。该手术耐受性良好，无重大并发症。未观察到主动脉瓣反流程度的变化。与传统的单球囊技术相比，双球囊技术用于主动脉瓣成形术在改善主动脉瓣面积和跨瓣压差方面更安全、更有效。
