中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2014年
9期
703-705
,共3页
宋勇战%李俊杰%曾国洪%张智伟%李渝芬%钱明阳%潘薇%王树水
宋勇戰%李俊傑%曾國洪%張智偉%李渝芬%錢明暘%潘薇%王樹水
송용전%리준걸%증국홍%장지위%리투분%전명양%반미%왕수수
主动脉瓣狭窄%心脏起搏,人工%儿童
主動脈瓣狹窄%心髒起搏,人工%兒童
주동맥판협착%심장기박,인공%인동
Aortic valve stenosis%Cardiac pacing,artificial%Child
目的 探讨右心室起搏辅助下经皮球囊主动脉瓣成形(RVP-PBAV)术治疗先天性主动脉瓣狭窄(AS)的效果及相关经验.方法 对广东省心血管病研究所心儿科2008至2013年所行的16例RVP-PBAV术的患儿资料进行分析,年龄6个月～15岁,中位年龄为5.4岁,体重8.5～59.0 kg,平均(22.3±16.5)kg,所有患儿术中、术后即刻均用导管测量跨主动脉瓣压差并观察主动脉瓣反流情况.术后随访1个月～5.5年.结果 所有患儿均成功进行RVP-PBAV手术,手术过程中无严重并发症.球囊直径/瓣环直径0.86 ～1.12,导管测量跨主动脉瓣峰值压差由术前ΔP=(96±32)mmHg(1 mmHg=0.133 kPa)下降至术后即刻ΔP=(41±26)mmHg,差异有统计学意义(P＜0.05).其中1例为外科术后再狭窄;3例合并主动脉瓣2叶畸形,其中1例随访5.5年时因重度主漏行外科换瓣;其余患儿仍在随诊,主漏面积0 ～ 3.3 cm2,左心室射血分数57％ ～ 78％.结论 RVP-PBAV治疗患儿先天性主动脉瓣狭窄较安全可靠,RVP下扩张球囊易固定.
目的 探討右心室起搏輔助下經皮毬囊主動脈瓣成形(RVP-PBAV)術治療先天性主動脈瓣狹窄(AS)的效果及相關經驗.方法 對廣東省心血管病研究所心兒科2008至2013年所行的16例RVP-PBAV術的患兒資料進行分析,年齡6箇月～15歲,中位年齡為5.4歲,體重8.5～59.0 kg,平均(22.3±16.5)kg,所有患兒術中、術後即刻均用導管測量跨主動脈瓣壓差併觀察主動脈瓣反流情況.術後隨訪1箇月～5.5年.結果 所有患兒均成功進行RVP-PBAV手術,手術過程中無嚴重併髮癥.毬囊直徑/瓣環直徑0.86 ～1.12,導管測量跨主動脈瓣峰值壓差由術前ΔP=(96±32)mmHg(1 mmHg=0.133 kPa)下降至術後即刻ΔP=(41±26)mmHg,差異有統計學意義(P＜0.05).其中1例為外科術後再狹窄;3例閤併主動脈瓣2葉畸形,其中1例隨訪5.5年時因重度主漏行外科換瓣;其餘患兒仍在隨診,主漏麵積0 ～ 3.3 cm2,左心室射血分數57％ ～ 78％.結論 RVP-PBAV治療患兒先天性主動脈瓣狹窄較安全可靠,RVP下擴張毬囊易固定.
목적 탐토우심실기박보조하경피구낭주동맥판성형(RVP-PBAV)술치료선천성주동맥판협착(AS)적효과급상관경험.방법 대광동성심혈관병연구소심인과2008지2013년소행적16례RVP-PBAV술적환인자료진행분석,년령6개월～15세,중위년령위5.4세,체중8.5～59.0 kg,평균(22.3±16.5)kg,소유환인술중、술후즉각균용도관측량과주동맥판압차병관찰주동맥판반류정황.술후수방1개월～5.5년.결과 소유환인균성공진행RVP-PBAV수술,수술과정중무엄중병발증.구낭직경/판배직경0.86 ～1.12,도관측량과주동맥판봉치압차유술전ΔP=(96±32)mmHg(1 mmHg=0.133 kPa)하강지술후즉각ΔP=(41±26)mmHg,차이유통계학의의(P＜0.05).기중1례위외과술후재협착;3례합병주동맥판2협기형,기중1례수방5.5년시인중도주루행외과환판;기여환인잉재수진,주루면적0 ～ 3.3 cm2,좌심실사혈분수57％ ～ 78％.결론 RVP-PBAV치료환인선천성주동맥판협착교안전가고,RVP하확장구낭역고정.
Objective To evaluate the efficacy and experience in right ventricular pacing-percutaneous balloon aortic valvuloplasty (RVP-PBAV) for congenital aortic stenosis (AS).Method A total of sixteen children with AS accepted the treatment with RRVP-PBAV.The patients were at ages 6 months to 15 years,their median age was 5.4 years.Their body weight was between 8.5 and 59.0 kg,average (22.3 ± 16.5) kg.The gradient pressure across the aortic valve was measured for all the patients and aortic regurgitation was observed.The follow-up time ranged from 1 month to 5.5 years.Result All patients underwent RVP-PBAV successfully.The ratios of balloon/valve were 0.86 to 1.12.The gradient pressure varied from preoperative Δp =(96 ± 32) mmHg (1 mmHg =0.133 kPa) to the immediate postoperative ΔP =(41 + 26) mmHg,(P ＜ 0.05).One case had postoperative restenosis,and 3 cases were complicated with bicuspid aortic valve deformity.Conclusion The treatment with RVP-PBAV for congenital aortic stenosis is safe and reliable.Rapid ventricular pacing is a safe procedure to stabilize the balloon during balloon aortic valvuloplasty and may decrease the incidence of aortic insufficiency.
