经皮球囊导管治疗二尖瓣狭窄的近期疗效

Short-term effects of percutaneous balloon catheteriz mitral ralvoplasty in patients with mitral stenosis

目的:总结经皮球囊导管治疗二尖瓣狭窄的疗效。方法:实施114例经皮球囊导管治疗二尖瓣狭窄,观察血液动力学和临床心功能疗效。结果:术后左心房压、肺动脉收缩压、经二尖瓣压力阶差减低,心排量和二尖瓣瓣口面积增加,临床心功能明显改善。超声心动图与心导管血液动力学测值有显著相关性。结论:经皮球囊导管治疗是一种非开胸治疗二尖瓣狭窄的有效方法,超声心动图可作为术后随访的重要手段。

Objective:To assess the short-term effects of percutaneous balloon catheterized mitral valvuloplasty in patients with severe rheumatic mitral stenosis.Methods:One hundred and fourteen patients with mitral stenosis under- went percutaneous catheter mitral commissurotomy using standard transseptal approach and Inoue balloon technique. Right heart pressures,left atrial pressure and cardiac output were measured,and transmitral pressure gradient was cal- culated.The mitral valve area was derived from the Gorlin formula.For all patients,cardiacl function and echocardio- graphic changes were assessed before and after interventional procedures.Results:After the procedure,left atrial pres- sure,pulmonary systolic pressure and transmitral pressure gradient were decreased,whereas cardiac output and mitral valve area were increased significantly.These were true for patients with sinus rhythm or atrial fibrillation.Clinical functional status was improved in 95% of patients one week after the procedure.Pulmonary systolic pressure(r=0.74) and mitral valve area (r-0. 74)determined by echocardiographic method correlated well with those assessed by hemody- namic technique.Conclusion:Percutanceous balloon mitral vulvoplasty is an effective therapeutic approach for patients with mitral stenosis,and echocardiography can be used to assess the hemodynamic and left ventricular functional changes during follow-up.