Joseph George, George Oommen K, Mandalay Asishkumar, Sathe Sunil
Department of Cardiology, Christian Medical College Hospital, Vellore, India.
Catheter Cardiovasc Interv. 2002 Nov;57(3):353-62. doi: 10.1002/ccd.10358.
Ten patients who had anatomic alterations that cause impediments to successful completion of conventional transfemoral balloon mitral valvuloplasty (BMV) underwent transjugular BMV. They included six patients in whom conventional BMV could not be completed due to cardiac anatomic distortion; two patients with dextrocardia (one with visceroatrial situs solitus and the other with situs inversus); two patients with venous abnormalities (one with azygous continuation of the inferior vena cava and the other with bilateral iliac/femoral vein occlusion). Transjugular BMV was successful in all 10 patients (mean mitral valve area increasing from 0.68 +/- 0.17 to 1.92 +/- 0.40 cm(2); range, 1.56-2.76 cm(2)); it was quick (mean total fluoroscopy time, 10.5 +/- 2.7 min; range, 7.3-15.2 min); and it was safe (no major or minor complications except one patient who developed severe mitral regurgitation that only required medical therapy). The jugular approach to BMV overcomes many of the technical problems caused by anatomic changes that are encountered in transfemoral BMV and complements the latter approach.
10例因解剖结构改变导致传统经股动脉球囊二尖瓣成形术（BMV）无法成功完成的患者接受了经颈静脉BMV。其中包括6例因心脏解剖结构扭曲而无法完成传统BMV的患者；2例右位心患者（1例为内脏心房位置正常，另1例为内脏反位）；2例静脉异常患者（1例为下腔静脉奇静脉延续，另1例为双侧髂/股静脉闭塞）。所有10例患者经颈静脉BMV均获成功（二尖瓣平均面积从0.68±0.17增加至1.92±0.40 cm²；范围为1.56 - 2.76 cm²）；操作迅速（平均总透视时间为10.5±2.7分钟；范围为7.3 - 15.2分钟）；且安全（除1例出现严重二尖瓣反流仅需药物治疗外，无重大或轻微并发症）。经颈静脉途径的BMV克服了经股动脉BMV中因解剖结构改变所引起的许多技术问题，并对后者起到补充作用。
