二尖瓣狭窄伴左房血栓的球囊成形术治疗

Treatment of rheumatic mitral stenosis complicated with left atrial thrombus by percutaneous balloon mitral valvuloplasty

目的 探讨经皮球囊成形术 (PBMV)治疗合并左房血栓的风湿性二尖瓣狭窄的可行性、安全性和临床效果。方法 选择风湿性二尖瓣狭窄合并左房血栓患者 5 8例进行PBMV ,早期 18例术前静滴尿激酶 2周 ,后期 4 0例术前口服华法令 4周。结果 5 7例患者手术成功 ,1例失败。成功率 98 4 % ,无 1例发生脑及其它部位栓塞。

Objective To observe safty and effect of percutaneous balloon mitral valvuloplasty(PBMV) on the patients with rheumatic mitral stenosis complicated with left atrial thrombus.Methods We selected 58 patients with 24 male and 34 female,average age 42.6±5.9(27～62) years old.The early 18 patients were given urokinase intravenously every day for 2 weeks and the latter 40 cases received warfarin orally every day for 4 weeks before given PBMV.Results PBMV with 57 cases were successful and 1 was failed.The successful rate was 98.4%.None of the patients had cerebral embolism and other organs embolism.Conclusion The study showed that PBMV on the patients with rheumatic mitral stenosis complicated left atrial thrombus is safe and effective after certain thrombolysis and anticoagulation treatment.