Eltchaninoff H, Cribier A, Tron C, Anselme F, Koning R, Soyer R, Letac B
Hôpital Charles Nicolle, Vacomed Research Group, Rouen, France.
Eur Heart J. 1995 Aug;16(8):1079-84. doi: 10.1093/oxfordjournals.eurheartj.a061050.
Although aortic valve replacement is undoubtedly the treatment of choice for aortic valve stenosis, balloon aortic valvuloplasty may represent the only possible treatment for some frail elderly patients who may have additional medical problems. We evaluated immediate and 1-year results of balloon aortic valvuloplasty in 86 patients > or = 80 years with severe aortic stenosis. Mean age was 84 +/- 3 years. Forty-four % were 85 years or older. Mean gradient decreased from 68 to 26 mm Hg and valve area increased from 0.53 to 0.96 cm2 (P<0.05). There were two per-procedural deaths. No local vascular complication was observed. During the follow-up (13 +/- 9 months), 27 patients died, four had repeat balloon aortic valvuloplasty and eight underwent aortic valve replacement. Persistent clinical improvement was observed in 78% of the surviving patients. One-year actuarial survival rate was 73%. Balloon aortic valvuloplasty appears to be a safe and valuable technique in cases where surgery cannot be performed or carries a very high risk.
尽管主动脉瓣置换术无疑是主动脉瓣狭窄的首选治疗方法，但对于一些可能有其他内科问题的体弱老年患者，球囊主动脉瓣成形术可能是唯一可行的治疗方法。我们评估了86例年龄≥80岁的重度主动脉瓣狭窄患者接受球囊主动脉瓣成形术的即刻及1年结果。平均年龄为84±3岁。44%的患者年龄在85岁及以上。平均压差从68 mmHg降至26 mmHg，瓣膜面积从0.53 cm²增加至0.96 cm²（P<0.05）。围手术期有2例死亡。未观察到局部血管并发症。在随访期间（13±9个月），27例患者死亡，4例接受了重复球囊主动脉瓣成形术，8例接受了主动脉瓣置换术。78%的存活患者观察到持续的临床改善。1年精算生存率为73%。在无法进行手术或手术风险非常高的情况下，球囊主动脉瓣成形术似乎是一种安全且有价值的技术。
