经皮球囊血管成形术治疗先天性主动脉缩窄中长期疗效观察

Effect and follow up of percutaneous balloon dilatation angioplasty for the treatment of congenital coarctation of the aorta

目的:观察经皮球囊血管成形术对小儿先天性主动脉缩窄(COA)的即刻以及中长期疗效。方法:应用经皮球囊血管成形术,治疗小儿膜型COA7例,选择球囊直径为缩窄处内径的2.4～3倍,以4～6个大气压的压力快速充盈扩张,持续10s,扩张2～3次,每次间隔3min。扩张前、后即刻测压、造影。随访观察血压、缩窄段两端压差的变化。结果:术后即刻缩窄处内径由术前的(3.80±1.23)mm增宽至(6.83±0.98)mm,缩窄段两端压差由术前的(47.50±15.61)mmHg降为(6.50±6.61)mmHg,症状缓解。随访3～7年未发生再狭窄,高血压得到有效控制,无并发症。结论:经皮球囊血管成形术治疗小儿COA即刻以及中、长期疗效可靠,方法简便、安全、术后恢复快。

Objective:To explore the immediate,medium-and long-term effect of percutaneous balloon dilatation angioplasty for the treatment of congenital coarctation of the aorta(membrane type)in children.Methods:Balloon dilatation angioplasty was performed in7children with congenital coarcta-tion of the aorta(membrane type).The diameter of balloon used was2.4～3times than that of the coarctation area.Balloon was filled with4～6atmosphere for10seconds at3min intervals,at all2～3times.The blood pressure measurement and aortic angiography were performed immediately,The blood pressure and the pressure gradient inlesion were followed up for3～7years.Results:After successful procedure,the diameter of the coarctation area was soon increased from(3.80±1.23)mm to(6.83±0.98)mm.The gradient pressure decreased from(47.50±15.61)mmHg to(6.50±6.61)mmHg.And the symptoms disappeared.3～7years after the procedure,no recoarctation was found and the hypertension in all pa-tients was effectively controlled.There was no complication.Conclusion:Using percutaneous balloon dilatation angioplasty to treatment congenital coarctation of the aorta in children was an efficient and safe method for both short and long term.