先天性主动脉缩窄球囊扩张术后疗效的探讨

A STUDY ON THERAPEUTIC EFFECTIVE-NESS OF BALLOON ANGIOPLASTY ONCONGENITAL COARCTATlON OF AORTA

报告１５例先天性主动脉缩窄球囊扩张术后的疗效，男１０例，女５例；年龄６．７±２．９岁。１４例为未经外科手术的先天性主动脉缩窄，其中１０例为局限性，４例为主动脉弓发育不良型，另１例为外科手术后再狭窄。采用的球囊平均直径１０．５±２．６ｍｍ，为缩窄区直径的２．７±０．６倍。术后平均压差（ΔＰ）由７．３±１．８ｋＰａ（５４．８±１３．５ｍｍＨｇ，１ｋＰａ＝７．５ｍｍＨｇ）降至２．３±２．１ｋＰａ，缩窄区直径由３．８±１．１ｍｍ扩大至８．４±２．５ｍｍ。１０例局限性主动脉缩窄及１例外科手术后再狭窄术后ΔＰ≤２．７ｋＰａ，术后平均随访５．６年，９０％病例ΔＰ仍持续下降，造影随访未见动脉瘤发生。４例发育不良型术后ΔＰ＞２．７ｋＰａ，３例进行外科手术。认为球囊扩张术对局限性及外科手术后主动脉缩窄是安全、有效的治疗方法。

allcon angioplasty was applied to 15 patients withcoarctation of aorta (COA) ( 10 boys and 5 girls) , aged2～12 years (mean 6. 3±2. 9) , of whom, 14 patientshadn't had surgical operations. There were 10 caseswith isolated discrete aortic coarctation. 4 with aorticarch hypoplasia and 1 with postoperative aortic coarcta-tion. The mean balloon diameter used was10. 5±2. 6mm, 2. 7 ±0. 6 times the diameter of thecoarctation which was increased from 3. 8± 1. 1mm to8. 4 ±2. 5mm after balloon angioplasty. Follow-upstudy of mean 5. 6 years showed a continuing gradientdecreased in 9 of 10 patients with discrete coarction and1 patient with postoperative restenosis, No aneurysmwas found in all subjects, Since pressure gradient in 4patients with aortic arch hypoplasia still remained over2. 7kpa after dilation, 3 of them had to have surgicalrepair. Our data suggest that ballcon angioplasty is safeand effective for the correction of congenital discreteaortic coarctation and postoperative restenosis of theaortic coarctation.