Watson K R, Chisholm R J, Azpiri J R, Armstrong P W
Department of Medicine, St. Michael's Hospital, University of Toronto, Ontario, Canada.
Cathet Cardiovasc Diagn. 1991 Nov;24(3):173-5. doi: 10.1002/ccd.1810240306.
To assess the hemodynamic factors affecting left-to-right shunting following balloon mitral valvuloplasty we studied 10 patients at 3 points during the procedure: pre-septal dilation, post-septal dilation pre-valvuloplasty, and post-valvuloplasty. Hemodynamic parameters were recorded and an oximetry run was obtained at each stage. Mitral valvuloplasty was successful in 8 and unsuccessful in 2 patients. No patient had a significant oxygen step-up at any stage, including the 2 patients with unsuccessful valvuloplasty. Significant left-to-right shunting through the atrial septal puncture in mitral valvuloplasty is infrequent, even before successful balloon valvuloplasty when left atrial pressure is maximally elevated.
为评估球囊二尖瓣成形术后影响左向右分流的血流动力学因素，我们在手术过程中的3个时间点对10例患者进行了研究：房间隔扩张前、房间隔扩张后瓣膜成形术前以及瓣膜成形术后。记录血流动力学参数，并在每个阶段进行一次血氧测定。二尖瓣成形术8例成功，2例失败。包括2例瓣膜成形术失败的患者在内，所有患者在任何阶段均未出现明显的氧含量升高。即使在成功的球囊瓣膜成形术之前左心房压力最大程度升高时，二尖瓣成形术中通过房间隔穿刺的明显左向右分流也很少见。
