Wang A, Harrison J K, Bashore T M
Division of Cardiology, Duke University Medical Center, Durham, NC 27710, USA.
Prog Cardiovasc Dis. 1997 Jul-Aug;40(1):27-36. doi: 10.1016/s0033-0620(97)80020-5.
Balloon aortic valvuloplasty is a percutaneous, therapeutic option for patients with severe aortic stenosis, yet the effectiveness of this procedure is dependent on the morphology of the stenotic aortic valve and the respective mechanism of dilation. In younger patients with congenital aortic stenosis, acute and intermediate-term results are good. However, in adult patients, in whom degenerative aortic stenosis is the most common cause, the acute clinical and hemodynamic benefits of balloon aortic valvuloplasty are not lasting, as restenosis occurs in most patients within 6 months. Sympatomatic relief for adults undergoing balloon aortic valvuloplasty is only apparent in patients with normal left ventricular function, who generally are also candidates for aortic valve replacement. Furthermore, the long-term survival for adults after balloon aortic valvuloplasty is similar to the natural history of untreated severe aortic stenosis. In this article, the mechanism of balloon aortic valvuloplasty, as well as its clinical and hemodynamic effects, are reviewed in the context of the different morphological types of aortic stenosis. In addition, two large registries of adult patients treated with balloon aortic valvuloplasty provide important information regarding the acute and long-term results of this procedure and are reviewed.
球囊主动脉瓣成形术是重度主动脉瓣狭窄患者的一种经皮治疗选择，然而该手术的有效性取决于狭窄主动脉瓣的形态以及各自的扩张机制。在先天性主动脉瓣狭窄的年轻患者中，急性和中期结果良好。然而，在以退行性主动脉瓣狭窄为最常见病因的成年患者中，球囊主动脉瓣成形术的急性临床和血流动力学益处并不持久，因为大多数患者在6个月内会发生再狭窄。接受球囊主动脉瓣成形术的成年患者的症状缓解仅在左心室功能正常的患者中明显，这些患者通常也是主动脉瓣置换的候选者。此外，成年患者球囊主动脉瓣成形术后的长期生存率与未经治疗的重度主动脉瓣狭窄的自然病程相似。在本文中，结合不同形态类型的主动脉瓣狭窄，对球囊主动脉瓣成形术的机制及其临床和血流动力学效应进行了综述。此外，两个关于接受球囊主动脉瓣成形术治疗的成年患者的大型注册研究提供了有关该手术急性和长期结果的重要信息，并进行了综述。
