经皮球囊扩张术用于妊娠合并二尖瓣狭窄5例报告

Percutaneous balloon mitral valvotomy on pregnant women with rheumatic mitral stenosis-a report of five cases

目的探讨风湿性二尖瓣狭窄合并妊娠患者,于妊娠中晚期行经皮二尖瓣球囊扩张术的可行性及安全性。方法总结5例风湿性二尖瓣狭窄合并妊娠者于妊娠中晚期行经皮二尖瓣球囊扩张术的临床资料。结果5例孕妇术后二尖瓣口面积由术前的平均(0.83±0.24)cm2(0.57～1.15cm2)扩大到术后的平均(1.94±0.1)cm2(1.80～2.05cm2);心功能术前III级2例,术后至围生期I级2例,II级3例。5例婴儿发育均正常。5例孕妇中除4例术后合并轻度二尖瓣反流外,未发生严重并发症。结论经皮二尖瓣球囊扩张术对于出现急性肺水肿和咯血的风湿性心脏病二尖瓣狭窄妊娠中晚期患者,是可行并且安全有效的急救方法。

Objective To investigate the effect and safty of percutaneous balloon mitral valvotomy （PMBV）on pregnant women with rheumatic mitral stenosis. Methods Five pregnant women with rheumatic mitral stenosis underwent percutaneous balloon mitral valvotomy （PMBV）during second and third thrimester. Results The procedure was successful in 5 cases with no maternal mortality and all patients subsequently had symptomatic improvement and uneventful cesarean section deliveries. The five babies horn alive and had normal growth at follow-up. Conclusions In pregnant patients with severe rheumatic mitral stenosis admitted to the hospital because of acute pulmonary edema and hemoptysis, PMBV is safe and provides good immediate results during second and third thrimester.