Ruzyllo W, Dabrowski M, Woroszylska M, Rydlewska-Sadowska W
Department of General Cardiology, National Institute of Cardiology, Warsaw, Poland.
J Heart Valve Dis. 1992 Nov;1(2):209-12.
Percutaneous mitral commissurotomy using the Inoue balloon was performed in seven pregnant women between May 1990 and November 1991. The mean age of the group was 31.5 years (range 28-35 years). The mean gestation time was 29 weeks (range 20-38 weeks). All patients presented with severe symptoms; two had a recent history of pulmonary oedema, the rest exhibited marked shortness of breath, and mild exercise and paroxysmal nocturnal dyspnea. All were in sinus rhythm. Two patients had previously undergone closed mitral valvulotomy five and 14 years before their recent hospitalization. Echocardiographic examination revealed severe mitral stenosis, with the mitral valve area being less than 1.2 cm2 in all but one patient. None of the patients had left atrial thrombi or mitral regurgitation as seen on two-dimensional and Doppler echocardiography. Four patients (two with restenosis) had severe lesions of the subvalvular apparatus with thickening and marked shortening of the chordae, as assessed by echocardiography. Successful percutaneous mitral valvulotomy was completed in all seven patients using 25-28 mm Inoue balloons. There was one, transient maternal complications. Fetal complication did not occur. It is concluded that percutaneous, transseptal, mitral balloon valvulotomy during pregnancy with the Inoue balloon is a safe procedure, which can be recommended for suitable clinical cases.
1990年5月至1991年11月期间，对7名孕妇实施了使用Inoue球囊的经皮二尖瓣交界切开术。该组患者的平均年龄为31.5岁（范围28 - 35岁）。平均妊娠时间为29周（范围20 - 38周）。所有患者均有严重症状；2例近期有肺水肿病史，其余患者表现为明显气短、轻度运动及阵发性夜间呼吸困难。所有患者均为窦性心律。2例患者在近期住院前5年和14年曾接受过闭式二尖瓣切开术。超声心动图检查显示严重二尖瓣狭窄，除1例患者外，所有患者的二尖瓣瓣口面积均小于1.2平方厘米。二维及多普勒超声心动图检查显示，所有患者均无左心房血栓或二尖瓣反流。经超声心动图评估，4例患者（2例再狭窄）有严重的瓣下装置病变，腱索增厚并明显缩短。所有7例患者均使用25 - 28毫米的Inoue球囊成功完成了经皮二尖瓣切开术。有1例短暂的母体并发症。未发生胎儿并发症。结论是，孕期使用Inoue球囊行经皮、经房间隔二尖瓣球囊切开术是一种安全的手术方法，可推荐用于合适的临床病例。
