球囊松脱法对二尖瓣球囊扩张术后瓣口面积的评估价值Deflating-balloon was pulled through the orifice (DBPO): A method to assess the valve area after PBMV
傅向阳,刘春,徐颖,吕俊豪,叶文胜,刘映峰,刘品明,杨福庆,赵霞
摘要(Abstract):
目的 为进一步了解二尖瓣球囊扩张术后的瓣口面积 ,评价球囊扩张效果。方法 二尖瓣球囊扩张术完成后再次将球囊导入左室并充盈 ,边慢慢排空边轻轻地回撤 ,记录可回撤至左房时的球囊最大充盈量。球囊撤出体外后测量该充盈量时的球囊最大直径并换算成面积。此面积即为球囊松脱法所测得的二尖瓣口面积。结果 本组 2 5例的球囊松脱法所测得的二尖瓣口面积为 (3 40±0 48)cm2 ,与二维超声二尖瓣短轴轨迹法 (2 0 3± 0 2 7)cm2 、多普勒频谱压差减半法 (1 91± 0 2 5 )cm2 及异丙基肾上腺素超声负荷MVA(2 47± 0 32 )cm2 相关良好但明显较大。结论 球囊松脱法可进一步了解及评估二尖瓣球囊扩张的效果 ,它有可能近似地代表扩张后二尖瓣的解剖面积
关键词(KeyWords): 二尖瓣狭窄;球囊扩张术;球囊松脱法
基金项目(Foundation):
作者(Author): 傅向阳,刘春,徐颖,吕俊豪,叶文胜,刘映峰,刘品明,杨福庆,赵霞
参考文献(References):
- 1PalaciosI .Whatisthegoldstandardtomeasuremitralvalveareapostmitralballoonvalvuloplasty?CathetCardiovascDiagn ,1994,3 3 :3 15 3 16.
- 2KawanishiDT ,MekayCR ,ReidCL .Spontaneousvariationandexercise inducedchangesinmeasurementofmitralvalveareausingtheGorlinformula :Implicationsforevaluationofchangesfollowingcatheterballoonvalvuloplastyformitralstenosis (abstract) .JAmCollCardiol,1988,11:2 3 4A .
- 3TamaiJ,NagataS ,AkaikeM ,etal.Improvementinmitralflowdynamicsduringexerciseafterpercutaneoustransvenousmitralcommissurotomy :noninvasiveevaluationusingcontinuonswaveDopplertechnique .Circulation ,1990 ,81:46 5 1.
- 4DahanM ,PailloleC ,MartinD ,etal.Determinantsofstorkevolumeresponsetoexerciseinpatientswithmitarlstenosis :aDoppleechocardiographicstudy .JAmCollCardiol,1993 ,2 1:3 84 3 89.
- 5OkayT ,Delig n櫣lU ,SancaktarD ,etal.Contributionofmitralvalvereservecapacitytosustainedsymptomaticimprovementafterballoonvalvulotomyinmitrlstenosis:implicationforrestenosis .JAmCardiol,1993 ,2 2 :1691 1696.
- 6傅向阳 ,吕俊豪 ,吴群 ,等 .异丙肾上腺素超声负荷试验对二尖瓣球囊扩张术后疗效的评价 .中华心血管病杂志 ,1998,2 6:465 467.
- 7傅向阳 .“主动脉根部标志 穿刺套管推送法”房间隔穿刺法 3 0 2例 .第一军医大学学报 ,1997,17:68 69.
- 8FeldmanT ,CarrollJD ,InserJM ,etal.EffectofvalvedeformityonresultsandmitralregurgitationafterInoueballooncommissurotomy .Circulation ,1992 ,85 :180 182 .