伴巨大左心房的二尖瓣狭窄经皮球囊成形术的疗效评价Immediate outcomes of percutaneous balloon mitral valvuloplasty for mitral stenosis with huge left atrium
胡承恒,杜志民,李怡,伍贵富,罗初凡
摘要(Abstract):
目的 评价伴巨大左房的二尖瓣狭窄患者行经皮二尖瓣球囊成形术 (PBMV)的疗效。方法 对 36例患者按改良的Inoue方法行PBMV ,观察手术操作成功率 ,术前后左房平均压 (LAP) ,二尖瓣跨瓣压差 (MVG) ,肺动脉收缩压 (SPAP) ,二尖瓣口面积 (MVA)和临床NYHA心功能变化。结果 手术操作成功率达 94%。术后LAP、MVG及SPAP均明显下降 (12 2± 4 4vs 2 7 6± 10 3;5 2± 2 3vs2 0 7± 5 5 ;41 1± 15 4vs 76 8± 19 3;P均 <0 0 1) ,MVA明显增加 (1 88± 0 31vs 0 6 5± 0 12 ,P <0 0 1) ,NYHA心功能明显改善。结论 伴巨大左心房的二尖瓣狭窄患者行PBMV的成功率仍很高 ,临床疗效满意
关键词(KeyWords): 二尖瓣狭窄;瓣膜成形术;左心房
基金项目(Foundation):
作者(Author): 胡承恒,杜志民,李怡,伍贵富,罗初凡
参考文献(References):
- 1InoueK ,OwakiT ,NakamuraT ,etal.Clinicalapplicationoftransvanousmitralcommissurotomybyanewballooncatheter.JthoracCardioVascularSurg,1984,87:394402.
- 2李华泰,吴京南.经皮二尖瓣球囊分离术操作难点及对策.中华医学杂志英文版,1998,111(Suppl):180182.
- 3InoueK ,HungJS ,ChenCR ,etal.Mitralstenosis:Inoueballooncathetertechnique.Tokyo:IGAKU SHOINMedicalPublishers,1992,237279.
- 4IungB ,ComierB ,DucimetiereP ,etal.Immediateresultsofpercutanousmitralcommissurotomy.Apredictivemodelonaseriesof1514patients.Circulation,1996,94:2124.
- 5欧知宏,侯子山,魏延津,等.二尖瓣狭窄并中度返流的经皮二尖瓣球囊扩张术42例及随访观察.中国介入心脏病学杂志,2000,8:3637.