大動脈弁形成術、大動脈弁形成

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/11/20 21:36:33」(JST)

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Aortic valvuloplasty is the repair of a stenotic aortic valve using a balloon catheter inside the valve. The balloon is placed into the aortic valve that has become stiff from calcium buildup. The balloon is then inflated in an effort to increase the opening size of the valve and improving blood flow.

According to the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease ^[1], balloon valvuloplasty (also referred to as balloon valvotomy) is not indicated for most patients with aortic stenosis. The preferred alternative, if available, is aortic valve replacement. However the guidelines noted specific settings in adults in which balloon valvotomy can be considered:

As a "bridge" to surgery in haemodynamically unstable patients who are at high risk for aortic valve replacement.
Use for palliation in patients with serious comorbid conditions that prevent performance of aortic valve replacement.

In addition, there are two other settings in which balloon valvotomy has been considered:

As a "bridge" to delivery to symptomatic pregnant women.
In patients who require urgent noncardiac surgery. However, the ACC/AHA guidelines concluded that most asymptomatic patients with severe AS can undergo urgent noncardiac surgery at relatively low risk with careful intraoperative and postoperative management.

Recent improvements in both balloon technology and procedural technique may lead to a resurgence in the clinical application of balloon valvuloplasty. Valvuloplasty is an important part of the procedure to delpoy a percutaneous aortic valve.

References

^ "ACC/AHA 2006 Guidelines for the Management of Patients with Valvular Heart Disease". American Heart Association. August 1, 2006. http://www.americanheart.org/presenter.jhtml?identifier=3040632.

External links

Valvuloplasty, information by Stanford Hospital

UpToDate Contents

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1. 経皮的バルーン大動脈弁膜切開術 percutaneous balloon aortic valvotomy
2. 大動脈弁狭窄症患者における非心臓手術 noncardiac surgery in patients with aortic stenosis
3. 腹部大動脈瘤ステントグラフト留置術に対する麻酔 anesthesia for endovascular aortic repair
4. 成人における大動脈二尖弁疾患のマネージメント management of adults with bicuspid aortic valve disease
5. 小児における大動脈弁狭窄 valvar aortic stenosis in children

English Journal

Ascending aortic aneurysm and aortic valve dysfunction in bicuspid aortic valve disease.

Aydin A, Desai N, Bernhardt AM, Treede H, Detter C, Sheikhzadeh S, Rybczynski M, Hillebrand M, Lorenzen V, Mortensen K, Robinson PN, Berger J, Reichenspurner H, Meinertz T, Willems S, von Kodolitsch Y.SourceCentre of Cardiology and Cardiovascular Surgery, University Hospital Eppendorf, Hamburg, Germany.
International journal of cardiology.Int J Cardiol.2013 Apr 15;164(3):301-5. doi: 10.1016/j.ijcard.2011.07.018. Epub 2011 Jul 30.
BACKGROUND: The relationship of aortic valve dysfunction and ascending aortic aneurysm is unclear in adults with bicuspid aortic valve disease.METHODS: We retrospectively studied 134 consecutive out-patients (98 men, 36 women aged 43±18years) with bicuspid aortic valve disease. To investigate the r
PMID 21802748

Clinical profile and outcome of patients with severe aortic stenosis at high surgical risk: Single-center prospective evaluation according to treatment assignment.

Dvir D, Sagie A, Porat E, Assali A, Shapira Y, Vaknin-Assa H, Shafir G, Bental T, Nevzorov R, Battler A, Kornowski R.SourceDepartment of Cardiology, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.Catheter Cardiovasc Interv.2013 Apr;81(5):871-81. doi: 10.1002/ccd.24623. Epub 2012 Sep 24.
BACKGROUND: The study sought to assess the clinical profile, outcome, and predictors for mortality of "real-world" high-risk severe aortic stenosis patients according to the mode of treatment assigned.METHODS: Patients were referred to a dedicated clinic for meticulous screening and multidisciplinar
PMID 22915555

Stroke volume determination using transcardiopulmonary thermodilution and arterial pulse contour analysis in severe aortic valve disease.

Petzoldt M, Riedel C, Braeunig J, Haas S, Goepfert MS, Treede H, Baldus S, Goetz AE, Reuter DA.SourceDepartment of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany, m.petzoldt@uke.de.
Intensive care medicine.Intensive Care Med.2013 Apr;39(4):601-11. doi: 10.1007/s00134-012-2786-7. Epub 2013 Jan 4.
PURPOSE: Transcardiopulmonary thermodilution (TPTD, SVTD) as well as calibrated (SVPC CAL) and uncalibrated (SVPC UNCAL) arterial pulse contour analysis (PC) are increasingly promoted as less-invasive technologies to measure stroke volume (SV) but their reliability in aortic valve disease was unknow
PMID 23287875

Japanese Journal

経皮的バルーン大動脈弁形成術, 経皮的バルーン僧帽弁形成術を施行した超高齢連合弁膜症患者の1例

村西寛実,溝渕正寛,江島恵美子,宇都宮誠,柴田兼作,舩津篤史,小林智子,円城寺由久,中村茂
Cardiovascular Interventional and Therapeutics = 日本心血管インターベンション治療学会誌 : CVIT Jpn Ed 2(4), 283-289, 2010-11-15
NAID 10027498405