经皮球囊二尖瓣成形术200例方法学探讨
马长生,张金荣
摘要(Abstract):
本文报告200例经皮球囊二尖瓣成形术方法学总结.Ross方法穿刺房间隔成功率100%,198例只采用正位透视,仅2例需左侧位透视,100%病例穿刺左房有左房压力波形出现,本文对Inoue方法进行简化使球囊导管通过狭窄的二尖瓣口及扩张二尖瓣的操作时间缩短.严重并发症包括2例脑梗塞(死亡1例)、3例心包填塞、1例室颤和2例重度二尖瓣返流.8例房颤患者有左心耳血栓,在华法令抗凝治疗3~8个月后血栓消失而安全地施行了二尖瓣球囊成形术.
关键词(KeyWords): 经皮球囊二尖瓣成形术;方法学;并发症
基金项目(Foundation):
作者(Author): 马长生,张金荣
参考文献(References):
- [1] Lnoue K,Owaki T,Nakamura T,et al.Clinical application of transvenous mitral commissurotomy by a balloon catheter.J Thoracic Cardiovasc surg,1984,87:394.
- [2] 陈传荣,陈纪言,胡世舞,等.经皮穿刺气囊二尖瓣成形术.中华心血管病杂志,1986,14:321.
- [3] 李华泰,何建楚,罗发瑞,等.经皮气囊导管二尖瓣分离术的临床应用.中华内科杂志,1988,27:460.
- [4] 戴汝平,朱杰敏,谢若兰,等.经皮穿刺瓣膜成形术治疗二尖瓣狭窄(附50报告).中华放射学杂志,1990,24:206.
- [5] Ross J.Consideration regarding the technique for transseptal left heart catheterization.Circulation.1966,34:391.
- [6] Inoue K,Feldman T.Percutaneous transvenous mitral commissurotomy using the inoue balloon catheter.Cathet Cardiovasc Diagn,1993,28:119.
- [7] Lin SL,Hsu TL,Liou JY,et al.Usefulness of transesophageal echocardiography for the detection of left atrial thrombi in patients with rheumatic heart disease.Echocardiography,1992,9:161.
- [8] 张桂珍,马长生,张晋,等.经食道超声心动图的临床应用.心肺血管学报,1991,10:286.
- [9] NHLBI Balloon Valvuloplasty Registry.Complications and Mortality of percutaneous Balloon Mitral Commissurotomy.Circulation,1992,85:2014.
- [10] Mckay RG,Grossman W.Balloon Valvuloplasty.in:Grossman W.Bain DS(eds).Cardiac catheterization,angiography,and intervention.3rd ed.PHILADELPHlA:Lea Febiger,1991. 511~533.