经外科途径球囊成形术治疗低体质量重度先天性主动脉瓣狭窄婴儿  

Efficacy of hybrid balloon valvuloplasty via sternotomy for treating low-body weight infants with severe congenital valvular aortic stenosis

作　　者：潘湘斌[1] 张浩[1] 胡盛寿[1] 陈泽锐[1] 马凯[1] 欧阳文斌[1] 洪亮[1] 李文雷[1] 李守军[1] 

机构地区：[1]中国医学科学院北京协和医学院阜外心血管病医院心脏外,100037

出　　处：《中华心血管病杂志》2012年第8期681-683,共3页Chinese Journal of Cardiology

基　　金：卫生行业科研专项（200907.001）;厄尔巴肯奖学金（2011-01）;首都医学发展科研基金（2009-1008）

摘　　要：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151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）mmHg（1mmHg=0．133kPa）下降至术后的（13．8±3．3）mmHg，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）mmHg，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。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 va[vuloplasty 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 valvuloplasty is an effective option for the low-body weight infants with severe congenital valvular aortic stenosis.

关 键 词：主动脉瓣狭窄 气囊扩张术 婴儿 

分 类 号：R725.4[医药卫生—儿科]