中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

单纯超声心动图引导下经皮球囊主动脉瓣成形术治疗先天性主动脉瓣狭窄的中期结果

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目的 评价单纯超声心动图引导下经皮球囊主动脉瓣成形术治疗先天性主动脉瓣狭窄的中期结果。 方法 回顾性分析 2016 年 1 月至 2017 年 11 月在我中心接受单纯超声心动图引导下经皮球囊主动脉瓣成形术连续 12 例先天性主动脉瓣狭窄患者的临床资料,其中男 7 例、女 5 例,平均年龄(18.27±15.30)岁。术前平均峰值跨瓣压差 61.8~110.0(80.30±24.50)mm Hg,50% 患者合并主动脉瓣反流。 结果 12 例患者均顺利完成手术。平均主动脉瓣环直径为(18.65±3.17)mm,球囊直径(17.62±3.77)mm,球囊瓣环直径比为 0.92±0.07。术后即刻平均峰值跨瓣压差 16~51(36.72±12.33)mm Hg,与术前差异有统计学意义(P=0.000)。随访期内平均峰值跨瓣压差 21~58(37.06±13.52)mm Hg,与术后即刻差异无统计学意义(P=0.310)。术后即刻和随访期内 58% 患者合并主动脉瓣反流,与术前差异无统计学意义(P=0.682)。 结论 单纯超声心动图引导下经皮球囊主动脉瓣成形术治疗先天性主动脉瓣狭窄安全可行,具有很高的成功率和极低的并发症发生率。

Objective To analyze the midterm outcome of patients with congenital aortic stenosis undergoing percutaneous balloon aortic valvuloplasty (PBAV) by single echocardiographic guidance. Methods The clinical data of 12 patients with congenital aortic stenosis who underwent PBAV by single echocardiographic guidance at Fuwai Hospital from January 2016 to November 2017 were retrospectively analyzed. There were 7 males and 5 females with an average age of 18.27±15.30 years. The preoperative peak pressure gradient was 61.8–110.0 (80.30±24.50) mm Hg, and 50% of patients had aortic regurgitation. Results All patients successfully underwent PBAV. Aortic annulus diameter was 18.65±3.17 mm and balloon diameter was 17.62±3.77 mm, with balloon diameter to annulus diameter ratio of 0.92±0.07. The peak transaortic gradient was 16-51 (36.72±12.33) mm Hg immediately after procedure, which was significantly different from the preoperation (P=0.000). During the follow-up period, the peak transaortic gradient was 21-58 (37.06±13.52) mm Hg, and there was no significant difference between the follow-up and immediate postoperation (P=0.310). Immediately after procedure and during follow-up, 58% of patients had aortic regurgitation, which was not statistically different from the preoperation (P=0.682). Conclusion Systematic use of Doppler echocardiographic guidance for PBAV is feasible, and that it is associated with a high success rate and a very low complication rate.

关键词: 经皮球囊主动脉瓣成形术; 先天性主动脉瓣狭窄; 超声心动图

Key words: Percutaneous balloon aortic valvuloplasty; congenital aortic stenosis; echocardiography

引用本文: 谢涌泉, 赵广智, 李慕子, 龚丁旭, 张凤文, 欧阳文斌, 潘湘斌. 单纯超声心动图引导下经皮球囊主动脉瓣成形术治疗先天性主动脉瓣狭窄的中期结果. 中国胸心血管外科临床杂志, 2018, 25(10): 829-833. doi: 10.7507/1007-4848.201805060 复制

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