E Uruchurtu, A Sánchez, A Pavía, I Hernández, L Valle, M Esquivel, O Medel, C Vargas
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引用次数: 0
摘要
直到1982年,手术是主动脉缩窄的治疗方法,39%的病例术后再狭窄。自1984年以来,气囊主动脉成形术已成功地应用于青少年和成人患者。我们报告了6例接受该手术的先天性主动脉缩窄患者的即时结果和超过6个月的随访。6例患者中5例为男性,平均年龄28.6岁(15-46岁),其中4例置入了支架。升主动脉收缩压由187.1 mm Hg(+/- 41.8)降至128(+/- 25.4),经主动脉梯度由66 mm Hg(+/- 21.8)降至4.8(+/- 7.6)。主动脉球囊成形术患者的缩窄管径从4.6 mm(+/- 1.41)增加到14.3 mm(+/- 3),支架置入术患者的缩窄管径增加到17.8 mm, p = NS。3例支架患者6个月血管造影未发现再狭窄,6例患者均需减少降压药。急性和慢性并发症、再狭窄的百分比和时间、长期结果以及支架可能带来的益处尚未确定。
[Arthroplasty in congenital aortic coarctation in adults with balloon and endovascular prosthesis: immediate results and 6-month follow-up].
Up to 1982, surgery was the treatment of aortic coarctation, with postsurgical recoarctation in 39% of cases. Since 1984 balloon aortoplasty has been performed successfully in adolescents and adult patients. We present the immediate results, and more than six months follow up of 6 patients with congenital aortic coarctation, who underwent this procedure. Five of the six patients were male, with an average age of 28.6 years (15-46), and in 4 of them a stent was placed. Systolic pressure of ascending aorta decreased from 187.1 mm of Hg (+/- 41.8) to 128 (+/- 25.4), and transaortic gradient from 66 mm of Hg (+/- 21.8) to 4.8 (+/- 7.6). Coarctation luminal diameter increased from 4.6 mm (+/- 1.41) to 14.3 (+/- 3) in patients with only balloon aortoplasty and to 17.8 mm with stent placement, p = NS. Angiography in three patients with stent at 6 months did not reveal restenosis, all six patients require less antihypertensive medications. Acute and chronic complications, percentage and time of restenosis, long term results, and possible benefit of stents are yet to be determined.