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经皮二尖瓣交界切开术与鲁腾巴赫综合征

[Percutaneous mitral commissurotomy and Lutembacher syndrome].

作者信息

Belghiti H, Kettani M, Chami L, Srairi N, Fekri N, Bennani R, Fellat N, El Haitem N, Mesbahi R, Benomar M

机构信息

Service de cardiologie A, hôpital Ibn-Sina, CHU de Rabat-Salé, Rabat, Maroc.

出版信息

Ann Cardiol Angeiol (Paris). 2006 Jun;55(3):153-6. doi: 10.1016/j.ancard.2005.05.007.

Abstract

INTRODUCTION

Lutembacher syndrome refers to the rare combination of congenital atrial septal defect and acquired mitral stenosis. This condition is usually treated surgically by mitral valve operation with concomitant closure of the atrial septal defect.

MATERIALS AND METHODS

Between 1993 and 2003, 4 patients with congenital Lutembacher syndrome had percutaneous mitral commissurotomy without closure of the atrial septal defect at our institution. The 4 patients were very symptomatic with right-sided heart failure signs and NYHA functional class III-IV.

RESULTS

The procedure was carried out successfully for the four patients. Mitral valve area increased from 0.87 to 1.97 cm2 at mean; left atrial pressure decreased from 28.2 to 12.7 mmHg and the mean valve mitral gradient was reduced from 15.5 to 3.9 mmHg. Functional and clinical improvement was observed in all the cases. During a mean follow up of 55 +/- 29 months, our 4 patients remain pauci symptomatic under medical treatment.

CONCLUSION

The percutaneous treatment of the Lutembacher syndrome is currently a possible alternative to the surgery among patients having an anatomy favourable to the procedure.

摘要

引言

鲁腾巴赫综合征指先天性房间隔缺损与后天性二尖瓣狭窄的罕见组合。这种病症通常通过二尖瓣手术并同时闭合房间隔缺损进行外科治疗。

材料与方法

1993年至2003年间,我院有4例先天性鲁腾巴赫综合征患者接受了经皮二尖瓣交界切开术,未闭合房间隔缺损。这4例患者均有明显症状,伴有右心衰竭体征,纽约心脏协会(NYHA)心功能分级为III-IV级。

结果

4例患者手术均成功。二尖瓣面积平均从0.87平方厘米增加至1.97平方厘米;左心房压力从28.2毫米汞柱降至12.7毫米汞柱,二尖瓣平均压差从15.5毫米汞柱降至3.9毫米汞柱。所有病例均观察到功能和临床改善。在平均55±29个月的随访期间,我们的4例患者在接受药物治疗后症状仍较轻。

结论

对于解剖结构适合该手术的患者,经皮治疗鲁腾巴赫综合征目前是手术的一种可行替代方案。

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