Yonga G O, Bonhoeffer P
Hurlingham Heart Clinic, PO Box 76555, Nairobi, Kenya.
East Afr Med J. 2003 Apr;80(4):172-4. doi: 10.4314/eamj.v80i4.8637.
To determine the efficacy and safety of percutaneous transvenous mitral commissurotomy (PTMC), using multi-track double balloon technique in juvenile mitral stenosis.
Open non-randomised intervention.
Cardiac catheterisation laboratories of The Mater Hospital, The Nairobi Hospital and Kenyatta National Hospital from 1996 to 2001.
Forty five consecutive patients aged less than 21 years with severe pure mitral stenosis and suitable mitral valve apparatus (leaflets, chordae and papillary muscles) for successful commissurotomy.
Percutaneous transvenous mitral commissurotomy under local anaesthesia. Standard left and right heart catheterisation for mitral valve disease. Trans-septal left atrial entry using standard septal puncture technique and left ventricular position secured by super-stiff guide-wire. Double-balloon mitral valvotomy on single guide-wire using multi-track balloon catheters.
Mitral valve area, left atrial pressures, mitral regurgitation grade, NYHA functional class.
Mitral valve area increased from 0.6 +/- 0.19 cm2 to 1.9 +/- 0.19 cm2 (p<0.001), left atrial pressures from 30.5 +/- 3.9 mmHg to 11.5 +/- 3.8 mmHg (p<0.001). Most patients NYHA functional class immediately improved from class III-IV to class I-II. There was no significant changes in grades of mitral regurgitation or significant complications related to the procedure.
PTMC in juvenile mitral stenosis using the multi-track technique is safe and effective yielding satisfactory immediate results.
确定采用多轨道双球囊技术行经皮经静脉二尖瓣交界切开术（PTMC）治疗青少年二尖瓣狭窄的疗效和安全性。
开放性非随机干预研究。
1996年至2001年期间，马特医院、内罗毕医院和肯雅塔国家医院的心导管实验室。
45例年龄小于21岁的连续患者，患有严重单纯二尖瓣狭窄且二尖瓣装置（瓣叶、腱索和乳头肌）适合成功进行交界切开术。
局部麻醉下经皮经静脉二尖瓣交界切开术。针对二尖瓣疾病进行标准的左右心导管检查。采用标准的房间隔穿刺技术进入左心房，并通过超硬导丝固定左心室位置。使用多轨道球囊导管在单根导丝上进行双球囊二尖瓣成形术。
二尖瓣面积、左心房压力、二尖瓣反流分级、纽约心脏病协会（NYHA）心功能分级。
二尖瓣面积从0.6±0.19平方厘米增加到1.9±0.19平方厘米（p<0.001），左心房压力从30.5±3.9毫米汞柱降至11.5±3.8毫米汞柱（p<0.001）。大多数患者的NYHA心功能分级立即从III-IV级改善为I-II级。二尖瓣反流分级无显著变化，也未出现与该手术相关的严重并发症。
采用多轨道技术对青少年二尖瓣狭窄进行PTMC是安全有效的，可立即取得满意的效果。
