Percutaneous insertion of the pulmonary valve
Percutaneous insertion of the pulmonary valve
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DOI：
10.1016/s0735-1097(02)01822-3
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发表时间：
2002-05-15
影响因子：
24
通讯作者：
Sidi, D
中科院分区：
文献类型：
--
作者：
Bonhoeffer, P;Boudjemline, Y;Sidi, D
目的报告经皮肺位瓣膜置入术的临床经验。背景：在过去的40年里，人工血管被用来在外科手术中建立右心室和肺动脉之间的连续性。然而，由于瓣膜退变或瓣内生长导致的管道狭窄和功能不全的情况经常发生，限制了患者的生命。经皮导管内支架置入术是近年来出现的一种延缓外科替代手术的方法，但它在跨越瓣膜时会造成肺反流。方法7名儿童和1名成人因移植肺狭窄和/或功能不全而行经皮肺位牛颈静脉瓣膜置入术。术后早期、随访均未出现并发症。术后血管造影、血流动力学检查和超声心动图检查显示植入的瓣膜无明显返流。5例患者植入支架后有效解除梗阻。所有患者在最近一次随访(平均10.1个月)时临床状况均有改善。结论非手术置入术是可行的，且无任何重大并发症。这项新技术可能在导管阻塞和肺返流的治疗中发挥重要作用。(J Am Coll心脏ol 2002；39：1664-9)(C)2002，由美国心脏病学会基金会主办。
OBJECTIVES We report our experience of percutaneous valve insertion in pulmonary position in humans.BACKGROUND Over the past 40 years, prosthetic conduits have been developed to surgically establish continuity between the right ventricle and the pulmonary artery. However, stenosis and insufficiency of the conduit due to valvular degeneration or panus ingrowth frequently occur, limiting patients' lifespan. Percutaneous stenting of conduits has recently emerged as a technique for delaying surgical replacement, but it creates a pulmonary, regurgitation when crossing the valve.METHODS Seven children and one adult with stenosis and/or insufficiency of the pulmonary graft underwent percutaneous implantation of a bovine jugular valve in pulmonary position.RESULTS Percutaneous pulmonary valve (PV) replacement was successful in ail patients. No complications occurred in early, follow-up. Angiography, hemodynamic studies and echocardiography after the procedure showed no significant regurgitation of the implanted valve. Implantation was effective in relieving the obstruction in five patients. All patients showed improvement in their clinical status at the latest follow-up (mean 10.1 months).CONCLUSIONS Non-surgical insertion of the PV is possible without any major complications. This new technique may have an important role in the management of conduit obstructions and pulmonary regurgitation. (J Am Coll Cardiol 2002;39:1664-9) (C) 2002 by the American College of Cardiology Foundation.