主動脈縮窄之經皮氣球導管血管造型術

Percutaneous Transluminal Balloon Coarctation Angioplasty

吳俊仁(Jiunn-Ren Wu) ； Zuhdi Lababidi

《Acta Paediatrica Sinica》 25卷1期 (1984/03) Pp. 27-32

摘要

Percutaneous balloon dilatation angioplasty (BDA) is a new therapeutic approach to the treatment of coarctation of the aorta. Coarctation angioplasty was performed on 10 patients with coarctation of the aorta at the University of Missouri-Columbia, U.S.A. The patients were 2 weeks to 27 years of age. After routine right and left heart cardiac catheterizations, the balloon was positioned at the point of the coarctation and was inflated for 10-15 seconds to the coarctation diameter. Peak systolic pressure gradients across the coarctation were measured before and 15 minutes after BDA. The pressure gradients decreased from 67±13mmHg to 11±5mmHg after BDA (P＜0.01). The peak systolic pressure before coarctation area dropped from 162±23mmHg to 122±9 mmHg (P＜0.01). The angiographic diameter of the coarctation increased from 4.5±1.5mm to 8.6±2.8 mm (P＜0.01) after the angioplasty. This represents a 90% increase in the coarctation diameter, resulting in an 82% decrease in the coarctation gradient. No morbidity or mortality was observed during the procedure. The absent or weak femoral pulses became strong and almost equaled to the radial pulses immediately after BDA and remained so during the one to nine months follow-up period. The BDA seems to be an alternative to surgical treatment of localized coarctation of the aorta. The advantages of BDA are that it is a low risk procedure, does not involve sternotomy, can be used as a palliative procedure to buy time in infancy. It can also be performed in children who have previously undergone coarctation surgery. The effectiveness of BDA needs long term follow-up.

並列摘要

Percutaneous balloon dilatation angioplasty (BDA) is a new therapeutic approach to the treatment of coarctation of the aorta. Coarctation angioplasty was performed on 10 patients with coarctation of the aorta at the University of Missouri-Columbia, U.S.A. The patients were 2 weeks to 27 years of age. After routine right and left heart cardiac catheterizations, the balloon was positioned at the point of the coarctation and was inflated for 10-15 seconds to the coarctation diameter. Peak systolic pressure gradients across the coarctation were measured before and 15 minutes after BDA. The pressure gradients decreased from 67±13mmHg to 11±5mmHg after BDA (P＜0.01). The peak systolic pressure before coarctation area dropped from 162±23mmHg to 122±9 mmHg (P＜0.01). The angiographic diameter of the coarctation increased from 4.5±1.5mm to 8.6±2.8 mm (P＜0.01) after the angioplasty. This represents a 90% increase in the coarctation diameter, resulting in an 82% decrease in the coarctation gradient. No morbidity or mortality was observed during the procedure. The absent or weak femoral pulses became strong and almost equaled to the radial pulses immediately after BDA and remained so during the one to nine months follow-up period. The BDA seems to be an alternative to surgical treatment of localized coarctation of the aorta. The advantages of BDA are that it is a low risk procedure, does not involve sternotomy, can be used as a palliative procedure to buy time in infancy. It can also be performed in children who have previously undergone coarctation surgery. The effectiveness of BDA needs long term follow-up.

並列關鍵字

percutaneous balloon angioplasty ； coarctation of the aorta