Vogt J, de Vivie E R, Koncz J, Beuren A J
Eur Heart J. 1986 Jun;7(6):501-8. doi: 10.1093/oxfordjournals.eurheartj.a062097.
Aortoventriculoplasty (AVP) is an established operative procedure for the enlargement of different types of severe left ventricular outflow tract obstruction. Between 1974 and 1985 75 aortoventriculoplasties were carried out in 72 patients ranging from 5 to 34 years of age. Three patients had to be reoperated upon due to significant right ventricular outflow tract obstruction, outgrown prosthesis, and dissecting aortic aneurysm. There were 7 early deaths (mortality rate 9.3%) and one late death (1.3%) following AVP. Out of the last 55 patients only 2 died (3.6%). In contrast to the unsatisfactory haemodynamic results of previous conventional operations. AVP reduced the mean residual gradient at rest across the left ventricular outflow tract from 84 +/- 23 mmHg (range 50-160 mmHg) to 12 +/- 12 mmHg (range 0-65 mmHg). Except in 2 patients, no gradient increased more than 15 mmHg with isoproterenol. In the cross-sectional echocardiogram, the left ventricular outflow tract was enlarged from 1.9 +/- 0.42 to 3.1 +/- 0.39 cm after AVP, whereas the aortic annulus had been expanded from 2.4 +/- 0.36 to 3.2 +/- 0.35 cm (n = 17). The mean length of the inner patch covering the septal incision measured 2.1 cm +/- 0.4 cm (n = 37). Our recatheterization studies after AVP revealed equally good haemodynamic results in all types of left ventricular outflow tract obstruction which cannot be relieved by conventional surgery.
主动脉心室成形术（AVP）是一种用于扩大不同类型严重左心室流出道梗阻的既定手术方法。1974年至1985年间，对72例年龄在5岁至34岁之间的患者进行了75次主动脉心室成形术。3例患者因严重的右心室流出道梗阻、人工瓣膜长大后出现问题以及主动脉夹层动脉瘤而需要再次手术。主动脉心室成形术后有7例早期死亡（死亡率9.3%）和1例晚期死亡（1.3%）。在最后55例患者中，仅有2例死亡（3.6%）。与以往传统手术不尽人意的血液动力学结果形成对比的是，主动脉心室成形术将左心室流出道静息时的平均残余压差从84±23 mmHg（范围50 - 160 mmHg）降至12±12 mmHg（范围0 - 65 mmHg）。除2例患者外，使用异丙肾上腺素后压差增加不超过15 mmHg。在横断面超声心动图中，主动脉心室成形术后左心室流出道从1.9±0.42 cm扩大至3.1±0.39 cm，而主动脉瓣环从2.4±0.36 cm扩大至3.2±0.35 cm（n = 17）。覆盖室间隔切口的内部补片平均长度为2.1 cm±0.4 cm（n = 37）。我们对主动脉心室成形术后的再导管检查研究表明，在所有传统手术无法缓解的左心室流出道梗阻类型中，血液动力学结果同样良好。
