二尖瓣狭窄并中度反流的经皮二尖瓣球囊扩张术42例及随访观察

A follow up study of mitral valve stenosis with moderate regurgitation treated by percutaneous balloon mitral valvuloplasty in 42 cases

目的 探讨二尖瓣狭窄 (MS)并中度反流 (MR)患者经皮二尖瓣球囊扩张术 (PBMV)近远期疗效。方法 采用Inoue单球囊对 42例风心病二尖瓣狭窄并中度反流患者行PAMV治疗。结果 二尖瓣口面积由 (0 92± 0 2 2 )cm2 增至 (1 94± 0 2 5 )cm2 (P <0 0 1) ;二尖瓣跨瓣压差由 (2 7± 1 0 1)kPa降至 (1 0 2± 0 5 6 )kPa(P <0 0 1) ;心功能由 (2 6 1± 0 2 2 )级改善至 (1 42± 0 46 )级 (P <0 0 1) ;左室最大前后径无明显变化 (P >0 0 5 )。 2例患者二尖瓣反流较术前加重。随访 37例患者 (18± 4)个月 ,二尖瓣口面积、左室最大前后径及心功能与术后比较 ,均无明显变化 (P >0 0 5 )。结论 掌握好病例选择 ,严格把握球囊扩张尺度 ,风心病二尖瓣狭窄并中度反流患者PBMV近。

Objective To evaluate the short term and long term effect of mitral valve stenosis (MS) with moderate mitral valve regurgitation (MR) treated by percutaneous balloon mitral valvuloplasty (PBMV) Methods 42 cases of MS with moderate MR were treated by PBMV with Inoue single balloon Results After valvuloplasty, the area of mitral valve increased from (0 92±0 22) cm 2 to (1 94±0 25) cm 2 ( P <0 01); the average transmural pressure of mitral valve decreased from (2 71±1 01) kPa to (1 02±0 56) kPa ( P <0 01); the grade of cardiac function increased from (2 61±0 22) to (1 42±0 46) ( P <0 01); the end diastolic diameter of left ventricle has no marked change ( P >0 05) 2 cases′ regurgitation become more sever after the procedure 37 cases were followed up for (18±4) months There are no magnificent difference in mitral vulve area, diastolic diameter of left ventricle and cardiac function comparing with that of 7 days after the procedure ( P >0 05) Conclusion The satisfied result of PBMV in MS with moderate MR is depended on the selection of patients and the optimal dilatation of the valve