球囊肺动脉瓣成形术治疗肺动脉瓣狭窄(附13例报告)

BALLOON VALVULOPLASTY IN THE TREATMENT OF CONGENITAL PULMONARY STENOSIS

对13例先天性肺动脉瓣狭窄病人用球囊肺动脉瓣成形术治疗,治疗前右室和肺动脉的压力阶差为114.7±51.3mmHg,治疗后降至29.9±15.4 mmHg,压差下降84.7±43.2mmHg(72.2±10.7%)(P<0.01)。13例病人中5例行单球囊扩张,8例行双球囊扩张。双球囊直径均较肺动脉瓣环直径大30～40%,治疗结果示双球囊扩张效果更佳。

Percutaneous balloon valvuloplasty(PBV)was attemptedin 13 patients(aged 6 years to 28 years,median 13 years 4 month)with unoperated typical valvular pulmonary stenosis(PS).To achieve anoversized dilation diameter in 8 larger Patients,two balloons were inflatedside by side,their effective dilation diameter was determined by thediameter of the circle with the same area as that of the oval envelopingthe two balloons.A significant reduction of the transvalvular gradient occurred in allPatients(mean±SD=72.2±10.7%).Systolic pressure gradient betweenRV and PA of 114.7±51.3mmHg(mean±SD)fell to 29.9±15.4mmHg(P<0.01),the mean reduction was 72.2±10.7%.The calculatedvalve orifice area increased by an average of 67.6±18.8%.Velocityof blood was decelerated from 4.89m±1.28m/sec.to 2.96±0.65m/sec.It is concluded that PBV with a balloon 20-40% larger than thevalve annulus is the treatment of choice for typical PS.