- 期刊
Balloon Valvuloplasty for Critical Aortic Stenosis in Two Infants
使用氣球擴張術治療重型主動脈瓣狹窄：兩病例報告
摘要
重型主動脈瓣狹窄是臨床上一個相當難以處理的狀況。除了支持性內科療法，疏解瓣膜狹窄對病人之存活是最重要的。我們報告兩病例使用心導管氣球擴張術治療小嬰兒的重型主動脈瓣狹窄的經驗。病例一是一個兩個月大嬰兒，有心肺衰竭的現象，主動脈環爲8mm，第一次使用6mm直徑氣球接著用8mm直徑氣球，壓力差由83降至13mmHg。病例二是七天大嬰兒，主動脈環爲6.7mm，使用6mm直徑氣球，壓力差由87降至44mmHg。除了病例有一暫時性的股動脈脈搏微弱，並無其他嚴重之併發症。在我們有限的經驗中，心導管氣球擴張術於治療小嬰兒的重型主動脈瓣狹窄是一個有效且安全的方式，具有以下優點：不需全身麻醉及體外循環、較短的住院天數、減少暴露血液製劑以及沒有疤痕。
並列摘要
Critical aortic valve stenosis (AS) is a difficult clinical condition. Besides supportive medical care, relief of the stenosis is most important to the patients’survival. We present two cases using transcatheter balloon valvuloplasty in managing critical AS in young infants. Case 1 was a 2 month- old female infant. She presented with cardiopulmonary failure. Aortic annulus was 8mm and the aortic valve was dilated with a 6mm and then an 8mm diameter balloon. The pressure gradient was reduced from 83 to 13 mmHg. Case 2 was a 7 day-old male infant. Aortic annulus was 6.7mm and the aortic valve was dilated with a 6mm diameter balloon. The pressure gradient was reduced from 87 to 44mmHg. Both patients tolerated the procedure well. No major complications developed except that a transient weak femoral pulse was noted in case 1. In our limited experience, balloon valvuloplasty is a safe and effective therapeutic choice for managing critical AS in young infants. The advantages include no need of bypass or general anesthesia, shortened hospital course, reduced exposure to blood product, and no scar.
延伸閱讀
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