机械扩张器介入治疗瓣膜条件差的二尖瓣狭窄临床评价

Clinical evaluation of percutaneous mechanical mitral commissurotomy for transcatheter to therapy mitral stenosis with bad vuluar conditon

目的 初步评价经皮穿刺二尖瓣联合部机械扩张术 (PMMC)治疗瓣膜条件差的风湿性二尖瓣狭窄的疗效。方法 全组 14例病人 ,年龄 2 8～ 5 3岁 ,平均 ( 34± 11 7)岁 ,术前心脏超声心动图 (TTE)示二尖瓣口面积 (MVA)为0 72～ 0 94cm2 ,平均 ( 0 81± 0 18)cm2 ,二尖瓣评分 9～ 12。所有病例进行PMMC。术中检测二尖瓣跨瓣压差为 13～2 8mmHg ,平均 ( 19± 8 8)mmHg。结果 手术成功率为10 0 % ,术后二尖瓣跨瓣压差为 ( 1 4± 0 8)mmHg。术后 1dTTE示MVA为 1 70～ 2 5 0cm2 ,平均 ( 1 98± 0 2 3)cm2 。结论 PMMC是治疗瓣膜条件差的二尖瓣狭窄的一种安全、经济及有效的手术方式。

Objective Investigated the therapic efficiency of percutaneous mechanical mitral commissurotomy(PMMC) to therapy mitral stenosis with bad valvular condition. Methods A total of 14 patients with mitral stenosis were treated by PMMC. The mean age of patients was (34±11 7) years(ranged from 28～53 years). The mean areas of mitral valve(MVA) were (0 81±0 18)cm 2 (ranged from 0 72～0 94 cm 2),and the score of mitral valve was 9 to 12, shown by transthoracic echocardiography(TTE) before interventions. The mean gradients of mitral valve were (19±8 8)mmHg before the operation. Result PMMC could be achieved in all 14 patients. The mean post PMMC gradients of mitral valve were (1 4±0 8)mmHg. 1 day after operation, the mean mitral valve areas were (1 98±0 23)cm 2 (ranged from 1 70～2 50 cm 2). Conclusions PMMC is an efficient, safe and economic method to theraphy the mitral stenosis with bad valvular condition. The long term follow up remains to be studied.