摘要
Objective To assess the effect of the balloon valvuloplasty for congenital valvular aortic stenosis (AS) in children.Methods A total of 27 (mean age 6.09 years) children with AS accepted the treatment of percutaneous balloon aortic valvuloplasty (PBAV). The ratios of balloon/valve were 0.95 ± 0.08 for 19 cases of typical AS and 1.00 ± 0.11 for 8 cases of hypoplastic AS. The patients were evaluated by the gradients across aotic valves in pre- and post-PBAV and by echocardiogram during the follow-up period.Results Fifteen of 19 (78.9％)cases of typical AS had a batter outcome and the gradient of the remaining 4 cases (26.7％) had increased after follow-up (△P ＞ 50 mm Hg) . Four of 8 (50.0％) cases of hypoplastic AS had satisfactory responses and the gradient of the remaining 3 cases (75.0％) rose. There was no moderate to severe aortic insufficiency (Al).Conclusion The balloon aortic valvuloplasty provides safe and significant hemodynamic and clinical improvement in pediatric patients. The outcome of PBAV for typical AS is better than for hypoplastic AS.
为研究评价先天性主动脉瓣狭窄 (AS)球囊瓣膜成形术 (PBAV)的效果。方法 于 1986年 12月 - 1999年 8月应用PBAV术治疗了 2 7例AS病人 ,年龄 2 .5- 12岁 (平均 6 .0 9± 2 .2 6岁 )。PBAV术球 瓣比值 :发育良好型者 (19例 )为 0 .95± 0 .0 8;发育不良型 (8例 )则为 1.0 0± 0 .11。术前后测定左室和升主动脉压力及跨主动脉瓣压力阶差 (ΔP)。出院后多普勒超声心动图随访以监测跨主动脉瓣ΔP。结果 发育良好型者 15例 (占 78.9% )即刻效果良好 ,随访中有 4例 (2 6 .7% )ΔP回复至 50mmHg以上 ;发育不良型 4例 (占 50 % )效果良好 ,其中随访中有 3例回升 (占 75.0 % )。 2 7例PBAV后无一例有轻度以上主动脉瓣返流及其它并发症结论 PBAV术是一种对AS有效、安全的替代外科瓣膜切开的介入性治疗方法 。
