Block P C, Palacios I F
Department of Medicine, Massachusetts General Hospital, Boston 02114.
Am J Cardiol. 1988 Oct 1;62(10 Pt 1):760-3. doi: 10.1016/0002-9149(88)91218-0.
This study reports clinical (84 patients) and catheterization (15 patients) follow-up of the first 90 patients who underwent percutaneous balloon aortic valvuloplasty (PBAV) at Massachusetts General Hospital. Eight patients died within 1 week in-hospital; 1 patient was lost to follow-up. Mean age of the group was 79 +/- 1 year (range 52 to 95). Before PBAV 25% of the patients were in New York Heart Association class III and 73% were in class IV. Endpoints were aortic valve surgery, death, second PBAV or interview. Mean follow-up was 5.5 +/- 0.3 months after PBAV. Although all patients improved symptomatically immediately after PBAV, at follow-up 16% were in New York Heart Association class I, 20% were in class II, 11% were in class III and 25% were in class IV. Twenty-three (28%) patients died during the follow-up period. A second PBAV was performed in 15 patients who had repeat catheterization. All had restenosis but only 13 of 15 had recurrent symptoms. Repeat PBAV produced results similar to the first PBAV despite the use of larger or double balloons. Although PBAV improves most patients' symptoms, recurrence of clinical symptoms and a high mortality within 6 months should limit the procedure to selected patients.
本研究报告了在马萨诸塞州综合医院接受经皮球囊主动脉瓣成形术（PBAV）的首批90例患者的临床（84例患者）和导管插入术（15例患者）随访情况。8例患者在住院1周内死亡；1例患者失访。该组患者的平均年龄为79±1岁（范围52至95岁）。在PBAV之前，25%的患者属于纽约心脏协会III级，73%属于IV级。观察终点为主动脉瓣手术、死亡、二次PBAV或随访访谈。PBAV后平均随访时间为5.5±0.3个月。尽管所有患者在PBAV后症状立即得到改善，但在随访时，16%的患者属于纽约心脏协会I级，20%属于II级，11%属于III级，25%属于IV级。23例（28%）患者在随访期间死亡。15例接受重复导管插入术的患者进行了二次PBAV。所有患者均有再狭窄，但15例中只有13例有复发症状。尽管使用了更大的或双球囊，重复PBAV产生的结果与首次PBAV相似。尽管PBAV可改善大多数患者的症状，但临床症状的复发和6个月内的高死亡率应将该手术限制在特定患者中。
