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双球囊技术用于球囊主动脉瓣切开术的中期结果:来自印度一家三级医疗中心的经验。

Mid-term outcomes of double-balloon technique for balloon aortic valvotomy: Experience from a tertiary care center in India.

作者信息

Yenduri Naimisha, Sasikumar Navaneetha, Patel Asha, Kumar Raman Krishna

机构信息

Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.

出版信息

Ann Pediatr Cardiol. 2024 Jul-Aug;17(4):277-280. doi: 10.4103/apc.apc_103_24. Epub 2024 Nov 15.

Abstract

We hypothesized that a double-balloon technique would be associated with a lower likelihood of aortic regurgitation (AR) following balloon aortic valvotomy (BAV). We present the short- and mid-term outcomes of the double-balloon technique for BAV. Fifty consecutive patients (median age: 6.5 years; interquartile range (IQR): 3.8-13.2) underwent BAV using double balloons. Prior AR was present in 17 (34%). Following BAV, the peak-to-peak gradient reduced from 80 (66.5-100) mm Hg to 24 (16-35) mm Hg ( < 0.0001); 10 (20%) had trivial AR, 18 (36%) had mild AR, 10 (20%) had moderate AR and none had severe AR. Four (8%) had transient arterial occlusion requiring anticoagulation. There was no procedure-related mortality or requirement for emergency open-heart surgery. The double-balloon technique offers a safe and effective alternative option for BAV in patients beyond infancy with relatively large annulus sizes. There is a low likelihood of postprocedural severe AR and the need for repeat procedures. Further long-term follow-up of this cohort is needed to ascertain long-term outcomes.

摘要

我们假设,在球囊主动脉瓣切开术(BAV)后,双球囊技术与主动脉瓣反流(AR)可能性较低相关。我们展示了BAV双球囊技术的短期和中期结果。连续50例患者(中位年龄:6.5岁;四分位间距(IQR):3.8 - 13.2)接受了双球囊BAV。17例(34%)术前存在AR。BAV后,跨瓣压差从80(66.5 - 100)mmHg降至24(16 - 35)mmHg(<0.0001);10例(20%)有微量AR,18例(36%)有轻度AR,10例(20%)有中度AR,无重度AR。4例(8%)发生短暂性动脉闭塞,需要抗凝治疗。无手术相关死亡或急诊心脏直视手术需求。双球囊技术为婴儿期后且瓣环相对较大的患者进行BAV提供了一种安全有效的替代选择。术后发生重度AR及需要重复手术的可能性较低。需要对该队列进行进一步长期随访以确定长期结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91cd/11651402/ef07cc94e207/APC-17-277-g001.jpg

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