PERCUTANEOUS BALLOON VALVOTOMY OF CONGENITAL PULMONARY STENOSIS USING OVERSIZED BALLOONS

[摘要] Percutaneous balloon valvotomy was attempted in 27 patients (aged 6 days to 91 years, median 2 years, 11 months) with unoperated typical valvular pulmonary stenosis using a balloon 7 to 60% (mean 30%) larger than the valve anulus. One patient had undergone a previous balloon valvotomy elsewhere. To achieve an oversized dilation diameter in three larger patients, two balloons were inflated side by side. Their effective dilation diameter''; was determined by the diameter of the circle with the same area as that of the oval enveloping the two balloons. A significant reduction of the transvalvular gradient occurred in all patients (mean .+-. SD = 74.3 .+-. 14.7%; range 33 to 100%). The average gradient of 65.0 .+-. 19.0 mm Hg (mean .+-. SD) fell to 15.9 .+-. 7.6 mm Hg (0 to 30 mm Hg). Twenty-five of 27 patients had a residual transvalvular gradient of less than 25 mm Hg. The calculated valve orifice area increased by an average of 183 .+-. 80%. No significant complications occurred. It is concluded that percutaneous balloon valvotomy with a balloon 20 to 40% larger than the valve anulus is the treatment of choice for typical congenital valvular pulmonary stenosis.

[发布日期] 1986-10-01