Cardoso L F, Ratti M A, Grinberg M, Medeiros C C, Tarasoutchi F, Rossi E G, Avila W S, Pomerantzeff P M, de Moraes A V, Arie S
Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo.
Arq Bras Cardiol. 1992 Jun;58(6):445-51.
To evaluate percutaneous mitral balloon valvuloplasty (PMBV) results immediately and one year follow-up.
One hundred and four procedures in 103 patients, 89 (87%) were women and mean age was 33. Ninety five (91%) had mitral stenosis, 7 (7%) mitral restenosis and 2 (2%) stenotic bioprosthesis. Twelve (10%) patients were in functional class (FC) II (NYHA), 73 (70%) in FC III and 19 (18%) in FC IV. Ninety three (89%) were in sinusal rhythm, 10 (10%) had atrial fibrillation and 1 (1%) junctional rhythm. In 99% cases the transseptal access was used.
The comparative haemodynamic results late x immediately after-PMBV were mitral valve area (cm2) 0.75 +/- 0.27 x 1.68 +/- 0.48 (p < 0.0001), gradient AE-VE average (mmHg) 19.52 +/- 8.03 x 5.44 +/- 4.38 (p < 0.0001); average pressure AE (mmHg) 24.72 +/- 8.76 x 9.63 +/- 6.11 (p < 0.0001), cardiac index (L/min/m2) 2.55 +/- 0.69 x 2.92 x 0.77 (p < 0.0001); average pressure PA (mmHg) 40.17 +/- 16.52 x 25.65 +/- 13.77 (p < 0.0001). The echocardiography results pré-PMBV, post-PMBV, 6 and 12 months after PMBV were respectively: mitral valve area (cm2) 0.89 +/- 0.23 x 1.87 +/- 0.41 x 1.72 +/- 0.43 x 1.64 +/- 0.44 and mitral transvalvar gradient (mmHg) 13.12 +/- 4.66 x 6.44 +/- 2.93 x 7.72 +/- 3.24 x 8.30 +/- 4.17. There was one death immediately after-PMBV in a patient with pulmonary thromboembolism. Four (4%) had severe mitral regurgitation and went to surgery (1 death). There were 2 mitral reestenosis.
For selected patients PMBV is a safe method and the good results are maintained in 1 year follow-up.
评估经皮二尖瓣球囊成形术（PMBV）即刻及一年随访结果。
103例患者接受了104次手术，其中89例（87%）为女性，平均年龄33岁。95例（91%）为二尖瓣狭窄，7例（7%）为二尖瓣再狭窄，2例（2%）为生物瓣狭窄。12例（10%）患者心功能分级（FC）为II级（纽约心脏协会分级），73例（70%）为FC III级，19例（18%）为FC IV级。93例（89%）为窦性心律，10例（10%）为心房颤动，1例（1%）为交界性心律。99%的病例采用经房间隔穿刺入路。
PMBV术后即刻与晚期血流动力学比较结果如下：二尖瓣瓣口面积（cm²）0.75±0.27对比1.68±0.48（p<0.0001），平均跨瓣压差（AE-VE，mmHg）19.52±8.03对比5.44±4.38（p<0.0001）；平均左房压（AE，mmHg）24.72±8.76对比9.63±6.11（p<0.0001），心脏指数（L/min/m²）2.55±0.69对比2.92×0.77（p<0.0001）；平均肺动脉压（PA，mmHg）40.17±16.52对比25.65±13.77（p<0.0001）。超声心动图检查结果在PMBV术前、术后即刻、术后6个月及12个月分别为：二尖瓣瓣口面积（cm²）0.89±0.23对比1.87±0.41对比1.72±0.43对比1.64±0.44，二尖瓣跨瓣压差（mmHg）13.12±4.66对比6.44±2.93对比7.72±3.24对比8.30±4.17。1例患者在PMBV术后即刻因肺血栓栓塞死亡。4例（4%）出现严重二尖瓣反流并接受手术治疗（1例死亡）。有2例二尖瓣再狭窄。
对于选定患者，PMBV是一种安全的方法，且在一年随访中可维持良好效果。
