摘要
目的 探讨经皮球囊二尖瓣成形术 (PBMV)在二尖瓣狭窄 (MS)合并心房颤动 (Af)患者中的疗效与安全性。方法 观察 12 5例MS合并Af患者 (Ⅰ组 )与 2 2 5例MS伴窦性心律患者 (Ⅱ组 )的PBMV成功率、PBMV后血流动力学与超声心动图指标改变、远期随访结果及并发症情况。结果 (1)两组成功率分别为 96 %(12 0 12 5 )和 99 6 %(2 2 4 2 2 5 ) (P <0 0 5 )。 (2 )PBMV后即刻两组左心房压力与肺动脉压力均明显下降 (P均 <0 0 0 1) ,Ⅰ组前者降值 <Ⅱ组 (P <0 0 5 )。 (3)PBMV后近期两组二尖瓣口面积 (MVA)明显增大 (P均 <0 0 0 1) ,组间无差异 ;两组左心房内径 (LAD)明显下降 (P均 <0 0 0 1) ,Ⅰ组下降值 <Ⅱ组。 (4)远期随访两组再狭窄率分别为 17 0 %(8 4 7)和 6 9%(4 5 8) (P <0 0 5 ) ;两组死亡率分别为 4 1%(2 4 9)和 1 7%(1 5 9) (P <0 0 5 ) ;两组MVA与LAD均仍较术前明显改善 ,但Ⅰ组较Ⅱ组差 ,且Ⅰ组MVA较术后近期结果缩小 (P <0 0 5 )。 (5 )两组并发症发生率分别为16 8%及 10 7%,组间差异无显著性 ,但 5例体循环栓塞者均发生于Ⅰ组。结论 PBMV在MS合并Af者中成功率高 ,再狭窄率低 ,疗效确切 ,但较窦性心律组差 ,需注意防止体循环栓塞 。
Objective To investigate the efficacy and safety of percutaneous balloon mitral valvuloplasty (PBMV) in patients with mitral stenosis (MS) and atrial fibrillation (Af) Methods The success rates of PBMV, changes of hemodynamic and echocardiographic indices after PBMV, restenosis rates during follow up and complications were observed in 125 patients with MS and Af (group Ⅰ) and 225 patients with MS in sinus arrhythmia (group Ⅱ) Results The success rate was 96% (120/125) and 99 6% (224/225) respectively in two groups ( P <0 05) PBMV made the hemodynamic and echocardiographic indices modified markedly in both groups just after PBMV Echocardiographic indices were still markedly modified during follow up, both much more significantly in group Ⅱ, restenosis rate was 17 0% and 6 9% respectively ( P <0 05),and mortality was 4 2% and 1 7% respectively in two groups The total incidence of complications was 16 8% and 10 7% ( P >0 05) respectively in two groups, but 5 cases of systemic embolization all occurred in group Ⅰ Conclusion PBMV was effective in patients with MS and Af, but not as good as in patients with sinus arrhythmia, so in patients with Af it should be much careful to select for PBMV and to prevent systemic embolization
出处
《中国介入心脏病学杂志》
2002年第4期183-185,共3页
Chinese Journal of Interventional Cardiology
