CAJ | 학술논문

目的探讨低体质量、重度先天性主动脉瓣狭窄婴儿经外科途径行球囊成形术的方法和疗效.方法入选5例重度先天性主动脉瓣狭窄婴儿,年龄(40.2±7.0)d,体质量(4.48 ±0.75)kg.所有患儿均经胸骨正中切口行主动脉瓣球囊成形术.术后观察主动脉瓣启闭及反流情况.出院后在门诊进行超声心动图随访.结果所有患儿均成功实施开胸直视下主动脉瓣球囊成形术.主动脉瓣跨瓣压差从术前的(98.8 ±9.0)mm Hg(1 mm Hg=0.133 kPa)下降至术后的(13.8±3.3)mm Hg,两者差异有统计学意义(P＜0.05).术后无轻度以上主动脉瓣反流,患儿均顺利出院.术后随访9～13(11.0±1.4)个月.随访期间,患儿均存活；主动脉瓣跨瓣压差为(18.8±2.5)mm Hg,与术前比较差异有统计学意义(P＜0.05)；无轻度以上的主动脉瓣反流；无再次临床干预病例.结论经外科途径球囊成形术是一种安全、有效的治疗低体质量、重度先天性主动脉瓣狭窄婴儿的新方法.
목적 탐토저체질량、중도선천성주동맥판협착영인경외과도경행구낭성형술적방법화료효.방법 입선5례중도선천성주동맥판협착영인,년령(40.2±7.0)d,체질량(4.48 ±0.75)kg.소유환인균경흉골정중절구행주동맥판구낭성형술.술후관찰주동맥판계폐급반류정황.출원후재문진진행초성심동도수방.결과 소유환인균성공실시개흉직시하주동맥판구낭성형술.주동맥판과판압차종술전적(98.8 ±9.0)mm Hg(1 mm Hg=0.133 kPa)하강지술후적(13.8±3.3)mm Hg,량자차이유통계학의의(P＜0.05).술후무경도이상주동맥판반류,환인균순리출원.술후수방9～13(11.0±1.4)개월.수방기간,환인균존활；주동맥판과판압차위(18.8±2.5)mm Hg,여술전비교차이유통계학의의(P＜0.05)；무경도이상적주동맥판반류；무재차림상간예병례.결론 경외과도경구낭성형술시일충안전、유효적치료저체질량、중도선천성주동맥판협착영인적신방법.
Objective To observe the efficacy of hybrid balloon valvuloplasty for the treatment of low-body weight infants with severe congenital valvular aortic stenosis ( AS ).Methods Five infants with severe congenital valvular aortic stenosis underwent the hybrid balloon aortic valvuloplasty through median sternotomy in the hybrid operating room.The mean age was (40.2 ± 7.0) days,weight was (4.48 ± 0.75 )kg.The patients were followed up by echocardiography for 9 - 13 months post procedure.Results Operation was successful in all 5 patients and they were discharged from hospital uneventfully.The gradient pressure decreased significantly from (98.8 ±9.0)mm Hg( 1 mm Hg =0.133 kPa) to ( 13.8 ±3.3) mm Hg (P ＜0.05)post operation. There was no moderate or severe aortic insufficiency. All patients were alive,the gradient pressures was ( 18.8 ± 2.5) mm Hg and there was no moderate or severe aortic insufficiency during follow-up [ 9 - 13 (11.0 ± 1.4) months ].Conclusion The hybrid balloon aortic valvnloplasty is an effective option for the low-body weight infants with severe congenital valvular aortic stenosis.