Hwang B, Chen L Y, Lu J H, Meng C C
Department of Pediatrics, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Angiology. 1995 May;46(5):383-91. doi: 10.1177/000331979504600504.
Percutaneous balloon valvuloplasty (PBVP) was performed in 55 children, aged from four days to twelve years and nine months, with different severity of congenital pulmonary stenosis (PS). To evaluate its efficacy, a quantitative analysis of the structure of right ventricle-pulmonary artery junction was conducted. Significant reductions of peak systolic right ventricular pressure, ratio of peak right-to-left ventricular pressure, and pressure gradients between the right ventricle and pulmonary artery were obtained in 48 children who scored 3 or less (Group I) and 7 children who scored over 3 (Group II) (P < 0.05). After two to forty-six months (M +/- SD = 17.1 +/- 15.5 months) of follow-up study, the residual gradients between right ventricle and pulmonary artery over 36 mmHg were higher in children who scored over 3 than in those who scored 3 or less (71.4% vs 20.8%) (P < 0.01). Repeated percutaneous balloon valvuloplasty was successfully performed in 4 children, 2 each in Group I and Group II. Surgical open pulmonary valvotomy was needed in 1 in Group II because of the dysplastic pulmonary valve and the need for repair of atrial septal defect and in 2 in Group I because of the failure to complete repeated PBVP in the catheterization laboratory or the need for repair of associated atrial septal defect.
对55例年龄从4天至12岁9个月、患有不同严重程度先天性肺动脉狭窄（PS）的儿童进行了经皮球囊瓣膜成形术（PBVP）。为评估其疗效，对右心室-肺动脉连接结构进行了定量分析。48例评分为3分及以下的儿童（I组）和7例评分为3分以上的儿童（II组）的收缩期右心室峰值压力、右心室与左心室峰值压力比值以及右心室与肺动脉之间的压力梯度均显著降低（P<0.05）。经过2至46个月（M±SD = 17.1±15.5个月）的随访研究，评分为3分以上的儿童右心室与肺动脉之间超过36 mmHg的残余梯度高于评分为3分及以下的儿童（71.4%对20.8%）（P<0.01）。4例儿童成功进行了重复经皮球囊瓣膜成形术，I组和II组各2例。II组中有1例因肺动脉瓣发育不良且需要修复房间隔缺损而需要进行外科开放性肺动脉瓣膜切开术，I组中有2例因在导管室未能完成重复PBVP或需要修复相关房间隔缺损而需要进行该手术。
