Krishnamoorthy K M, Radhakrishnan S, Shrivastava S
Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Int J Cardiol. 2003 Jan;87(1):31-6. doi: 10.1016/s0167-5273(02)00205-x.
We studied the predictors and natural history of moderate mitral regurgitation following valvuloplasty using Inoue balloon since it has not been well documented in a large series.
Balloon mitral valvuloplasty was performed in 590 consecutive patients with severe mitral stenosis with mitral regurgitation of mild or lesser grade. Echocardiography and haemodynamics of patients who developed moderate mitral regurgitation were compared with those who did not. They were followed-up. Factors that predicted the development of moderate regurgitation were studied.
21 patients (3.5%) developed moderate regurgitation (identified by auscultation, haemodynamics, angiography and colour flow mapping). They were managed conservatively. At 3 months, regurgitation decreased in severity to mild grade in 12 patients. At 1 year, it was trivial in 5, mild in 11 and remained moderate in 5. There was progressive symptomatic improvement. No clinical, echocardiographic, hemodynamic or procedural variables could predict the development of moderate mitral regurgitation.
Patients with moderate regurgitation after mitral valvuloplasty show gradual improvement in regurgitation and symptoms. There were no factors-clinical, echocardiographic, hemodynamic or procedural-that predicted the occurrence of moderate MR after BMV.
由于在大量病例中尚未有充分记录，我们研究了使用Inoue球囊进行瓣膜成形术后中度二尖瓣反流的预测因素和自然病程。
对590例患有严重二尖瓣狭窄且伴有轻度或更低级二尖瓣反流的连续患者进行球囊二尖瓣成形术。将发生中度二尖瓣反流的患者的超声心动图和血流动力学与未发生的患者进行比较。对他们进行随访。研究预测中度反流发生的因素。
21例患者（3.5%）出现中度反流（通过听诊、血流动力学、血管造影和彩色血流图确定）。他们接受了保守治疗。3个月时，12例患者的反流严重程度降至轻度。1年时，5例患者的反流轻微，11例患者的反流为轻度，5例患者的反流仍为中度。症状有逐渐改善。没有临床、超声心动图、血流动力学或手术变量能够预测中度二尖瓣反流的发生。
二尖瓣成形术后出现中度反流的患者，反流和症状逐渐改善。没有临床、超声心动图、血流动力学或手术因素能够预测球囊二尖瓣成形术后中度二尖瓣反流的发生。
