经皮二尖瓣球囊扩张术治疗二尖瓣狭窄伴返流(附52例分析)

Percutaneous Balloon Mitral Valvotomy for Mitral Stenosis and Regurgitation in 52 Cases of Rheumatic Heart Disease

目的探讨经皮二尖瓣球囊扩张术(PBMV)治疗二尖瓣狭窄伴返流的疗效。方法采用Inoue球囊对52例风湿性心脏病二尖瓣狭窄伴返流的患者进行PBMV治疗,比较术前术后血流动力学参数。结果术后左心房平均压、肺动脉压力、心功能NYHA分级分别比手术前减少了50·9%、20·8%、21·3%(P<0·05);二尖瓣口面积、EF值分别比手术前增加了119·5%、9·8%(P<0·05);左心房最大直径、左心室最大直径分别比手术前减少了2·1%和1·2%(P>0·05);二尖瓣返流和手术前比较并没有增加。结论PBMV是治疗二尖瓣狭窄合并关闭不全的有效安全方法,并且不增加二尖瓣返流。

Objective To evaluate the effects of percutaneous balloon mitral valvotomy （PBMV） for mitral stenosis （MS） with mitral regurgitation （MR）. Methods PBMV was performed in 52 patients with both MS and MR. The hemodynamic parameters were measured before and after the operation. Results After the operation of PBMV, Mean left atrial pressure,Pulmonary arterial pressure and NYH class were significantly decreased by 50.9% ,20.8% and 21.3% respectively （ P 〈0.05）. Mitral valve area and Ejection fraction were significantly increased by 119.5% and 9.8% respectively（ P 〈 0.05）. But Left atrial maximal diameter and Left ventricular maximal diameter were no significantly decreased by 2.1% and 1.2% respectivey （ P 〉 0.05） .The level of MR had no significant difference along with PBMV. Conclusion PBMV is an effective and safety procedure in the treatment of MS with MR, and does not increase the level of MR.