Unal N, Meşe T, Hüdaoglu S, Celikkol B, Yunus S, Saylam G S, Akçoral A
Department of Pediatric Cardiology, Dokuz Eylül University Faculty of Medicine, Izmir.
Turk J Pediatr. 1999 Jul-Sep;41(3):341-8.
Six patients with mitral valve stenosis underwent percutaneous balloon mitral valvuloplasty (PBMV) in our department between November 1992 and December 1997. Five patients had rheumatic mitral valve stenosis and one had congenital mitral valve stenosis and Eisenmenger's syndrome with patent ductus arteriosus (PDA). Functional status before PBMV was class IV in two patients, class III in two patients, and class II-III in two patients, as classified by the New York Heart Association (NYHA). The mean diastolic pressure gradient across the mitral valve measured during heart catheterization before and immediately after PBMV was 18.8 +/- 10.42 and 9.4 +/- 7.7 mmHg, respectively (p < 0.01). The patients were followed for a mean period of 36.6 +/- 8.5 months (range 12 to 72 months) after the procedure. During follow-up, post PBMV mean diastolic transmitral gradient measured by color Doppler echocardiography decreased from 19.3 +/- 11.16 to 7.43 +/- 7.3 mmHg (p < 0.01) and the mitral valve area increased from 1.09 +/- 0.7 to 3.1 +/- 0.9 cm2 (p < 0.002). Functional capacity showed improvement to NYHA class I in four patients, to class II-III in the patient with congenital mitral valve stenosis and Eisenmenger's syndrome with PDA and to class II in one patient with severe mitral valve calcification in whom restenosis occurred three years after PBMV. Percutaneous balloon mitral valvuloplasty PBMV can achieve very good short- and mid-term results in relieving symptomatic rheumatic mitral valve stenosis.
1992年11月至1997年12月期间，我科对6例二尖瓣狭窄患者进行了经皮二尖瓣球囊成形术（PBMV）。5例为风湿性二尖瓣狭窄，1例为先天性二尖瓣狭窄合并艾森曼格综合征及动脉导管未闭（PDA）。根据纽约心脏协会（NYHA）分级，PBMV术前功能状态为IV级的有2例，III级的有2例，II-III级的有2例。PBMV术前及术后即刻心导管检查测得的二尖瓣平均舒张期压力阶差分别为18.8±10.42和9.4±7.7 mmHg（p<0.01）。术后患者平均随访36.6±8.5个月（范围12至72个月）。随访期间，经彩色多普勒超声心动图测得的PBMV术后二尖瓣平均舒张期跨瓣压差从19.3±11.16降至7.43±7.3 mmHg（p<0.01），二尖瓣瓣口面积从1.09±0.7增加至3.1±0.9 cm²（p<0.002）。4例患者的功能能力改善至NYHA I级，合并PDA的先天性二尖瓣狭窄及艾森曼格综合征患者改善至II-III级，1例严重二尖瓣钙化患者在PBMV术后3年发生再狭窄，改善至II级。经皮二尖瓣球囊成形术（PBMV）在缓解有症状的风湿性二尖瓣狭窄方面可取得非常好的短期和中期效果。
