经皮球囊瓣膜成形术治疗先天性肺动脉瓣狭窄

PERCUTANEOUS BALIOON VALVULOPLASTY FOR CONGENITAL PULMONARY VALVE STENOSIS

对16例肺动脉瓣狭窄施行经皮球囊瓣膜成形术。跨瓣压差平均下降71±12.2％。肺动脉瓣口面积平均增加95±44％。单、双球囊治疗各8例。结果表明:双球囊技术比单球囊技术优越、安全、并发症少。PBPV前后连续式多普勒探测肺动脉瓣最大瞬时压整、平均压差及瓣口面积与心导管相应测值比较相关密切。

Percutaneous balloon valvuloplasty was performed for the treatment of congenital pulmonary valve stenosis in 16 patients. There were significant reductions in right ventricular peak systolic pressure, transvalvular pressure gradient, mean pressure gradient, ratio of right ventricular peak systolic pressure to systemic systolic pressure and resistance in pulmonary orifice immediately after balloon dilatation (p<0.001). Transvalvular pressure gradient decreased from 15.637±6.703 to 4.247±2.602kPa, with a mean reduction of 71.7±12.2％. There was significant increase in pulmonary orifice area from 0.6±0.22 to 1.11±0.36cm^2/m^2, with a mean increase of 95±44%. Dilatation with twoballoon technique was performed in 8 patients with pulmonary valve stenosis and there was no significant decrease in heart rate or systolic arterial pressure as compared with the result of dilatation with single balloon. These data confirm that twoballoon technique is superior and safer than single balloon. Instant peak pressure gradient, mean pressure gradient and area of pulmonary orifice measured before and after PBVP by continuous wave Doppler showed close correlation with those by catheterization.