单纯超声引导下经皮二尖瓣球囊扩张术治疗妊娠期中重度二尖瓣狭窄的临床疗效

Clinical efficacy of percutaneous balloon mitral valvuloplasty under echocardiographic guidance for moderate to severe mitral stenosis during pregnancy

目的探讨单纯超声引导下经皮二尖瓣球囊扩张术治疗妊娠期中重度二尖瓣狭窄患者的效果。方法纳入2018年8月—2022年6月于阜外医院明确诊断为中重度二尖瓣狭窄并接受单纯超声引导下经皮二尖瓣球囊扩张术治疗的妊娠期患者,对其基线资料、手术情况、超声心动图结果和随访结果进行回顾性分析。结果共纳入3例妊娠期患者,年龄30~35岁,孕周19~26周,纽约心脏协会(NYHA)心功能分级均为Ⅲ级。3例患者均成功完成手术,平均二尖瓣瓣口面积由术前0.9 cm^(2)增加至术后2.1 cm^(2),平均跨瓣压差由术前15.0 mm Hg降至术后6.7 mm Hg,无围术期不良事件。术后随访3~48个月,3例患者均顺利完成分娩并恢复正常生活,母胎安全。结论单纯超声引导下经皮二尖瓣球囊扩张术治疗妊娠期中重度二尖瓣狭窄患者安全有效,母胎结局满意。

Objective To investigate the effect of percutaneous balloon mitral valvuloplasty under echocardiographic guidance for patients with moderate to severe mitral stenosis during pregnancy.Methods A retrospective observational study was conducted to include pregnant women who were diagnosed with moderate to severe mitral stenosis and underwent percutaneous balloon mitral valvuloplasty under echocardiographic guidance in Fuwai Hospital from August 2018 to June 2022,and their baseline characteristics,surgical outcomes,echocardiographic results,and follow-up results were analyzed.Results A total of 3 pregnant women aged 30-35 years,with gestational age of 19-26 weeks,and New York Heart Association(NYHA)function classⅢwere included.All the procedures were successfully performed.The mitral valve orifice area increased from 0.9 cm^(2)preoperatively to 2.1 cm^(2)postoperatively.The mean transvalvular pressure gradient decreased from 15.0 mm Hg preoperatively to 6.7 mm Hg postoperatively.No perioperative adverse events occurred.The follow-up time ranged from 3 to 48 months.All patients delivered uneventfully and returned to normal life,with maternal-fetal safety.Conclusion Percutaneous balloon mitral valvuloplasty under echocardiographic guidance is a feasible and effective procedure for the treatment of patients with moderate to severe mitral stenosis in pregnancy,with satisfactory maternal-fetal outcomes.