Cooke J P, Seward J B, Holmes D R
Mayo Clin Proc. 1987 Apr;62(4):306-11. doi: 10.1016/s0025-6196(12)61908-9.
Transluminal balloon valvotomy has become a widely used nonsurgical approach to treatment of certain valvular lesions in children. In adults, however, experience with this technique is limited. We performed balloon valvotomy in a 61-year-old woman who had pulmonic stenosis. Four months after the procedure, her exercise tolerance had increased and she no longer had exertional dyspnea. Among the few reported cases of balloon valvotomy in adult patients with pulmonary stenosis, the systolic pressure gradient and the peak systolic ventricular pressure have been considerably reduced. Possible mechanisms by which transluminal balloon valvotomy relieves obstruction are tearing or deformation of the valve cusps, separation of fused commissures, fracture of valvular calcification, dilation of the annulus, or some combination of these factors. Balloon valvotomy seems to be an appropriate therapeutic choice for pulmonic stenosis in adult patients.
经腔球囊瓣膜切开术已成为治疗儿童某些瓣膜病变广泛应用的非手术方法。然而，在成人中，该技术的经验有限。我们对一名患有肺动脉瓣狭窄的61岁女性进行了球囊瓣膜切开术。术后四个月，她的运动耐量增加，不再有劳力性呼吸困难。在少数报道的成年肺动脉瓣狭窄患者球囊瓣膜切开术病例中，收缩压梯度和收缩期心室峰值压力已大幅降低。经腔球囊瓣膜切开术缓解梗阻的可能机制是瓣膜叶撕裂或变形、融合瓣叶分离、瓣膜钙化骨折、瓣环扩张或这些因素的某种组合。球囊瓣膜切开术似乎是成年肺动脉瓣狭窄患者合适的治疗选择。
