经皮球囊二尖瓣成形术治疗70例严重二尖瓣狭窄

Percutaneous transseptal balloon mitralvalvuloplasty in 70 cases of severe rheumatic mitral stenosis.

采用改良的 Inoue 法经皮球囊二尖瓣成形术治疗严重风湿性二尖瓣狭窄70例,成功67例(96%)。术后左房压由4.08±1.22降至2.09±0.61kPa,平均肺动脉压由4.61±1.89降至2.7B±1.30kPa,二尖瓣跨瓣压差由2.96±1.14降至0.88±0.48kPa(P<0.01)心排血量由7.3±1.8提高至7.8±2.1L/min(P>0.05);二尖瓣口面积由1.09±0.34增大至1.89±0.69cm^2(P<0.01)。心尖部第一音,肺动脉第二音显著减弱,开瓣音消失,心尖部舒张期杂音显著减轻或消失。认为应严格选择病例,谨慎操作,防止并发症。

This article reported our experiences with percutaneous balloon mitral valvuloplasty (PBMV) in 70 patients with rheumatic mitral stenosis.PBMV with the Inoue balloon catheter was successfully performed in 67 patients (96%),After successful PBMV,the left atrial pressure decreased from 4.08±1.22 to 2.09±0.61kPa (P<0.01),mean pulmonary arterial pressure decreased from 4.61±1.89 to 2.78±1.30kPa(P<0.01);mitral valve gradient decreased from 2.96±1.14 to 0.8g±0.48kPa (P<0.01),cardiac output increased from 7.3±1.8 to 7.8±2. 1L/min (P>0.05);mitral valve area increased from 1.09±0.34 to 1.89+0.69cm (P<0. 01);the apical diastolic murmur diminished markedly or disappeared,the intensifies of the apical first heart sound and the pulmonic second sound all decreased significantly,the opening snap all disappeared.The procedure was discontinued in two patients because of failure of the balloon to tranverse the stenostic mitral orifice and in one patient because of cardiac tamponade produced by injury to the left atral wall before insertion of the balloon catheter. The results show that PBMV is a highly effective and safe nonsurgical method of relfeving mitral stenosis.