PBMV治疗二尖瓣狭窄伴中-重度肺动脉高压

Percutaneous Balloon Mitral Valvotomy for Mitral Stenosis with Moderate to Severe Pulmonary Hypertension

目的评价经皮二尖瓣球囊扩张术 (PBMV)治疗二尖瓣狭窄伴中或重度肺动脉高压的疗效。 方法用Inoue球囊导管行PBMV治疗二尖瓣狭窄伴肺动脉收缩压≥ 6 0mmHg(8.0 0kPa)患者 1 0 1例。用超声心动图和心导管法观察血流动力学效应。 结果术后血流动力学明显改善 ,二尖瓣瓣口面积增加 (P <0 .0 1 ) ;肺动脉收缩压及肺循环阻力明显降低 (P <0 .0 0 1 ) ,这些变化在心房颤动患者中尤为明显。

Objective To assess efficacy of percutaneous balloon mitral valvotomy (PBMV) with an Inoue balloon catheter in the treatment of mitral stenosis with high pulmonary hypertension. Methods 101 patients with severe mitral stenosis and pulmonary systolic pressure ≥ 8.00 kPa (60mmHg) underwent PBMV using a standard Inoue technique. The hemodynamic changes were observed. All patients were followed up by echocardiography. Results After the procedure, pulmonary systolic pressure decreased from 9.66±2.23kPa to 6.40±1.59kPa (1kPa=7.5mmHg, P<0.001), pulmonary vascular resistance decreased from 117.32±36.91kPa·s/L to 73.50±31.60kPa·s/L (1kPa·s/L=10dyn·s·cm -5 , P<0.001), and the mitral valve area increased from 0.83±0.16cm 2 to 1.78±0.36cm 2. These hemodynamic changes were specially significantly greater for patients with atrial fibrillation. Conclusion PBMV with an Inoue balloon catheter is safe and efficacious for patients with mitral stenosis and pulmonary hypertension. There were no major complications.