经皮球囊肺动脉瓣成形术治疗单纯性肺动脉瓣狭窄32例

Percutaneous balloon dilation of pulmonary stenosis

目的 总结1995～2001年我院用经皮球囊肺动脉瓣成形术治疗单纯性肺动脉瓣狭窄32例的经验。方法 本院住院患者32例,单纯性肺动脉瓣狭窄采用经皮球囊肺动脉瓣成形术治疗。结果 本组32例右室收缩压:术前(93.5±28.5)mmHg,术后(42±9.0)mmHg;跨肺动脉瓣压力阶差:术前(76±30)mnHg,术后(24.5±8.5)mmHg;术后跨肺动脉瓣压力阶差<25mmHg达90.6％。结论 经皮球囊肺动脉瓣成形术治疗单纯性肺动脉瓣狭窄是安全有效的,病例和手术方法的选择,精确测定肺动脉瓣直径和选择大小合适的球囊是手术成功的重要环节。

Objective Review our experience of balloon dilation of valvular pulmonary stenosis in 32 cases. Methods Totally 32 cases of pulmonary stenosis admitted from 1995 - 2001 with age of 1. 5-13 yrs mean 6.8), Diagnosis was made by clinical manifestations, EKG, ECHO and angiocardiography. Results Before dilation, the mean systolic pressure of right ventricle was (93. 5±28. 5) mmHg, after the procedure it reduced to (42±9. 0) mmHg. The pressure gradient between right ventricle and pulmonary artery before dilation was (76±30) mmHg and become (24 . 5±8. 5) mmHg after dilation. The gradient pressure after dilation was less than 25 mmHg in 90.6% cases. A case of Noonan syndrome showed no response to balloon dilation and died during valvulectomy from accompanying left ventricular cardiomyopathy. Conclusions Balloon dilation of valvular pulmonary stenosis is effective and safe. The selection of proper diameter of pulmonary valvular rings and sized of the balloon are the major factors.