经皮球囊二尖瓣成形术治疗严重二尖瓣狭窄(附70例分析)

Percutaneous balloon mitral valvuloplasty in 70 cases of severe rheumatic mitral stenosis

采用改良Inouc 法经皮球囊二尖瓣成形术(PBMV)治疗70例风湿性二尖瓣狭窄,成功67例。手术后左房压、平均肺动脉压和二尖瓣跨瓣压差均明显下降(P<0.01),二尖瓣口面积明显增加(P<0.01)。就手术方法、球囊大小选择,疗效判断和影响疗效因素分析,认为PBMV 具有安全、创伤小、可重复应用和适合国情之特点。

This article reports our experience in percutaneous balloon mitral valvulo-plasty(PBMV)in 70 patients with rheumatic mitral stenosis.PBMV was performed withthe Inoue balloon catheter in 67 patients(96%)successfully.The resuts showed that theleft atrial pressure decreased from 4.08±1.22 to 2.09±0.61kPa(P<0.01),mean pulmonaryarterial pressure decreased from 4.61±1.89 to 2.78±1.30kPa(P<0.01);mitral valve grad-ient decreased from2.96±1.14 to 0.88±0.48kPa(P<0.01),cardiac output increased from7.3±1.8 to 7.8±2.1L/min(P<0.01);the apical diastolio murmur diminished markedly ordisappeared,the intensity of the apical first heart sound and the pulmonic second sound,became all decreased significantly,while the opening snap disappeared totally.The proc-edure was discontinued in two patients because of failure of the balloon to traverse thestenostic mitral orifice and in one patient because of cardiac tamponade produced byinjury to the left atrial wall before insertion of the balloon catheter.It suggested that PBMV is a highly effective and safe nonsurgical method for reliefof mitral stenosis.