- 期刊
Percutaneous Transluminal Pulmonary Valvuloplasty for Native Valvular Pulmonary Stenosis in Children
經皮心導管肺動脈瓣膜擴張術治療兒科病人患有單純肺動脈辦狹宰
並列摘要
ackground and purpose: We reported the clinical experience of percutaneous transluminal pulmonary valvuloplasty (PTPV) in pediatric patients with isolated native valvular pulmonary stenosis. Methods: From May 1997 to October 2003, a total of 21 consecutive patients with isolated native valvular pulmonary stenosis (pressure gradient between 40 and 80 mm Hg) were enrolled in this retrospective study. We performed PTPV by using single balloon catheter in all 21 patients. Following PTPV, the pressure gradients were obtained immediately by pullback pressure tracings and rechecked within 24 hrs by Doppler echocardiography to determine the immediate success rate. Physical examinations and Doppler echocardiography, at variable intervals of follow-up, were performed to determine the ultimate success rate after PTPV. Results: The pressure gradients of valvular pulmonary stenosis ranged from 40 to 65 mm Hg (51.1±8.0, median 50.0 mm Hg) by Doppler echocardiography, and from 40 to 70 mm Hg (53.0±10.0, median 51.0 mm Hg) by the pullback pressure tracings at cardiac catheterization before PTPV. Within 24 hours of PTPV, the pressure gradients ranged from 12 to 40mm Hg (25.3 ±8.4, median 25.0 mmHg) by the immediate pullback pressure tracings (P ＜0.001), and from 11 to 35 mm Hg (23.6±6.6, median 24.0 mm Hg) by Doppler echocardiography (P ＜0.001). The ratio of systolic pressure of the right ventricle to that of the left ventricle (sRV/sLV) ranged from 0.55 to 1.09 (0.78±0.15, median 0.76) before PTPV, and from 0.30 to 0.71 (0.46±0.13, median 0.42) after PTPV (P ＜0.001). Follow-up Doppler echocardiography, varied at intervals after PTPV, showed the gradients ranging from 11 to 36 mm Hg (22.0±6.7, median 23.0 mm Hg). Conclusions: For pediatric patients with isolated native valvular pulmonary stenosis, PTPV can attain a good immediate success rate, a low complication rate, and a high ultimate success rate.
延伸閱讀
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