二尖瓣狭窄合并左心房血栓患者的球囊扩张术探讨

EXPLORING OF PERCUTANEOUS BALLOON MITRAL VALVUOPLASTY OF PATIENTS WITH MITRAL STENOSIS AND LEFT ATRIAL THROMBI

目的 :探讨二尖瓣狭窄合并左心房血栓患者安全接受二尖瓣球囊扩张术 (PBMV)的方法。方法 :对二尖瓣狭窄合并左心房血栓的 2 9例患者 ,给予正规的华法林抗凝治疗 3～ 12个月 ,然后再施行 PBMV。结果 :华法林抗凝治疗后有 2 4例患者的左心房血栓消失 ,2 3例患者的血栓消失的时间是 6个月以内 ;5例患者的血栓均有不同程度的缩小并呈现高强度回声。对血栓消失的 2 4例患者及血栓缩小机化的 5例患者成功地进行了 PBMV ;所有患者在抗凝治疗期间、术中及术后均未发生栓塞并发症。结论 :二尖瓣狭窄合并左心房血栓的患者经华法林抗凝治疗后 ,如血栓消失或血栓机化可安全地接受 PBMV;正规的华法林抗凝治疗时间以 6个月为宜。

Objective:To explore the way that the patients with mitral stenosis and left atrial thrombi can accept percutaneous balloon mitral valvuoplasty (PBMV) safely Methods:29 patients with mitral stenosis and left atrial thrombi were given PBMV after 3~12 months by regular dose wafarin therapy Results:Left atrial thrombi of 24 patients disappeared after wafarin therapy;thrombi of 23 patients (23/24) disappeared within 6 months Thrombi of 5 patients were lessened to difference degrees and high and intensie echo appeared in transesophageal echocardiography Successful PBMV was performed in 24 patients after resolution of left atrial thrombi and 5 patients after thrombi had been lessened and organized There weren't complications of embolism in all patients during the wafarin therapy,PBMV and after PBMV Conclusion:The results suggested that PBMV on the patients with mitral stenosis and left atrial thrombi is safe if the thrombi disappeared or organized after wafarin therapy Wafarin therapy should be at least maintained more than 6 months for majority of patients