经皮穿刺球囊二尖瓣成形术30例临床分析

PERCUTANEOUS TRANSLUMINAL MITRAL VALVULOPLASTY WITH INNER BALLOON WAS OPERATED ON 32 CASES OF MITRAL STENOSIS

我院自1991年以来共行PBMV32例，30例获得成功。24例单纯MS，4例合并轻度返流，2例合并轻度主动脉瓣关闭不全。行PBMV术后3例心关部舒张期杂音消失，其余听诊及心音图检查减弱，心功能除6例Ⅱ级外，其余24例均为Ⅰ级；术后即刻二尖瓣房室压力队差平均压下降1．51kpa，肺动脉平均压下降1．11kpa，左房平均压下降1．45kpa，二尖辩四面积平均增大1．36倍，上述参数与术前比较有显著差异（P＜0．001）。提示房间隔穿刺部位根据左房大小定点较准确。术中心律失常多在球囊扩张二尖瓣口时出现，常为室早、室速，球囊回缩，心律失常自行消失，提示球囊充盈一排空时间一般不应超过15秒。

From, 1991 to 1994 percutaneous transluminal mitral valvuloplasty with inner balloon (PBMV) was operated on 32 cases who suffered from miltral stenosis.Among them 30 ones (93. 8% ) were successful. After operation the diastolic murmur at apical regivn of heart disappeared in 3 cases and weakened in the rest. Also,the cardiac funetion was Ⅰ degree in 6 cases and Ⅱ degree in 24 ones. The other effectsshowed that on an average there was a 1. 51kpa decrease in the pressure of miltral valve, a 1. 11kpa one in pulmonary artery pressure, a 1. 45kpa one in left atrium and the area of the miltral opening was 1. 36 time increase. There was a significant difference between the postoperative indexes mentioned above and the preoperative ones. The puncturing point and complications were also siscussed in this paper.