经皮导管双球囊成形术治疗主动脉瓣上狭窄  

Percutaneous Double Balloon Angioplasty in the Treatment of Supravalvular Aortic Stenosis

作　　者：郑宏[1] 彭剑[2] 马小静[2] 陶凉[2] 苏希[2] 李炬[2] 韩湘蓉[2] 简小同[3] 朱晓东[4] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院放射科,北京市100037 [2]武汉亚洲心脏病医院 [3]江西省南昌市第二医院 [4]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院心外科,北京市100037

出　　处：《中国循环杂志》2000年第6期378-379,共2页Chinese Circulation Journal

摘　　要：目的 :报告 1例主动脉瓣上狭窄经皮导管双球囊成形术治疗成功 ,获得良好近期疗效 ,并做简要讨论。　　方法 :女性患者 7.5岁 ,具部分 Williams综合征表现。超声显示于主动脉瓣上约 1.0 cm处可见一隔膜样结构 ,中央开口约 0 .7cm,主动脉瓣环内径为 1.6 cm,主动脉瓣开口约为 1.2 cm。造影诊断为主动脉瓣上狭窄。心导管检查测得狭窄的压力阶差为 70 mm Hg(1mm Hg=0 .133 k Pa)。经双侧股动脉穿刺分别送入 12 mm× 2 0 mm及 10 mm× 40 mm的球囊进行扩张。　　结果 :术后造影显示主动脉瓣上狭窄基本消失 ,其压力阶差降至 12 mm Hg。超声心动图复查示主动脉瓣上隔膜由原固定不动变得随主动脉舒缩而摆动并于舒张期明显张开。　　结论 :作为一种少创有效的介入技术经皮导管双球囊成形术治疗主动脉瓣上狭窄 1例获得良好疗效。双球囊径稍大于主动脉瓣环径 (≤ 1.3)亦安全可行 。Objective:To report a patient with supravalvular aortic stenosis was successfully treated by percutaneous double balloon angioplasty and a good short term result obtained. Methods:A seven and a half years' old girl with an incomplete appearance of william's syndrome,and the echocardiography demonstrated supravalvular aortic stenosis,i.e.a fixed membranous structure with central orifice of 0 7 cm in diameter 1 0 cm above the aortic valve,and the internal diameter of aortic annulus and valve 1 6 cm and 1 2 cm.The above stated supravalvular aortic stenosis was proven by left ventriculographic and aortographic study,the peak systolic pressure gradient was of 70 mmHg (1 mmHg=0 133 kPa) across the stenosed segment measured by cardiac catheterization.The percutaneous double balloon dilatation of supravalvular aortic stenosis was performed with two balloons(12 mm×20 mm and 10 mm×40 mm)through the approach of left and right femoral artery respectively. Results:The membranous stenosis was almost completely disappeared as shown by post aortography,and the pressure gradient dropped to 12 mmHg.The echocardiography also demonstrated that the supravalvular fixed membrane was ruptured and opened on diastolic phase. Conclusion:The percutaneous double balloon angioplasty,as a less invasive and effective interventional procedure,was used in treating a patient with supravalvular aortic stenosis and a good result was obtained.The dimension(≤1 3) of double balloon slightly larger than that of aortic annulus seems to be safe and useful.Further follow up study is needed to verify the long term result of the patient.

关 键 词：先天性心脏病 主动脉瓣上狭窄 球囊导管成形术 

分 类 号：R654.2[医药卫生—外科学]