摘要
目的分析单纯超声引导经皮球囊主动脉瓣成形术(PBAV)治疗先天性主动脉瓣狭窄(CAS)的远期结果。方法回顾性分析2016年1月至2018年12月收治的采用单纯超声引导PBAV治疗的CAS患者13例。收集PBAV手术资料、超声心动图检查结果。采集患者手术前后主动脉瓣环直径、球囊直径与球囊瓣环直径比(BAR)、主动脉瓣反流、左心室短轴缩短率(LVFS)、左心室舒张末期内径(LVEDD)、主动脉瓣血流速度(AV)、平均跨瓣压差(MTPG)、峰值跨瓣压差(PTPG)、主动脉瓣口面积(AVA)、左心室射血分数(LVEF),并进行比较。同时观察患者术后并发症发生情况。结果BAR为0.92±0.06。术后患者的LVEDD为(51.6±6.5)mm,小于术前的(65.2±5.9)mm;术后AV为(3.7±0.8)m/s,低于术前的(4.8±0.6)m/s;术后即刻MTPG为(33.8±13.9)mm Hg(1 mmHg=0.133 kPa),低于术前的(54.5±13.8)mmHg;术后即刻PTPG为(37.2±9.4)mm Hg,低于术前的(82.7±19.9)mmHg;术后AVA为(2.0±0.2)cm^(2),高于术前的(1.0±1.0)cm^(2);术后LVEF为(64.5±11.5)%,高于术前的(56.3±11.0)%,且差异均有统计学意义(P<0.05)。1例患者术后较术前新增主动脉瓣反流。无术后并发症发生。在随访过程中,13例患者仅1例在术后18个月由2级以下主动脉瓣反流逐渐发展为明显的主动脉瓣反流,术后26个月接受生物瓣置换术。结论应用单纯超声引导PBAV治疗CAS效果显著,安全有效,远期结果良好。
Objective To study the long-term outcome of ultrasound-guided percutaneous balloon aortic valvuloplasty(PBAV in patients with congenital aortic stenosis(CAS).Methods A retrospective analysis of 13 CAS patients who were treated in our hospital from January 2016 to December 2018.The patient’s demographic data(gender,weight and age),surgical data of PBAV,and echocardiography examination results were collected.For patient’s aortic annulus diameter,balloon diameter to balloon annulus diameter ratio(BAR),aortic regurgitation,left ventricular fractional shortening(LVFS),left ventricular end-diastolic diameter(LVEDD),aortic valve velocity(AV),mean transvalvular pressure gradient(MTPG),peak transvalvular pressure gradient(PTPG),aortic valve orifice area(AVA),and left ventricular ejection fraction(LVEF)were collected.The occurrence of postoperative complications was observed.Results The BAR is 0.92±0.06.The LVEDD of patients after surgery was(51.6±6.5)mm,less than(65.2±5.9)mm before surgery,and theatrical mobilization rate was(3.7±0.8)m/s,which was lower than(4.8±0.6)m/s before surgery.The immediate mean transvalvular pressure gradient(MTPG)after operation was(33.8±13.9)mmHg,lower than(54.5±13.8)mmHg before operation.The immediately PTPG was(37.2±9.4)mmHg,lower than(82.7±19.9)mmHg before surgery.The postoperative aortic valve orifice area was(2.0±0.2)cm^(2),It was higher than(1.0±1.0)cm^(2)before operation,and LVEF after operation was(64.5±11.5)%,higher than(56.3±11.0)%before operation(P<0.05),The differences were statistically significant(P<0.05).One patient had increased aortic regurgitation after operation.There were no hospital complications.During the follow-up of 13 patients,only one patient developed from grade 2 or below to obvious aortic regurgitation 18 months after operation,and underwent biological valve replacement 26 months after operation.Conclusions The application of PBAV surgery in the treatment of patients with aortic valve stenosis is effective,safety and with good long-term outcome.
作者
李叶丹
曲冉
杨善日
李慕子
王浩
孟红
LI Yedan;QU Ran;YANG Shanri;LI Muzi;WANG Hao;MENG Hong(Department of Echocardiography,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100037,China)
出处
《中国分子心脏病学杂志》
CAS
2022年第4期4760-4763,共4页
Molecular Cardiology of China
基金
云南省阜外心血管病临床医学中心项目(FZX2019-06-012022YFKY085)。
