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[风湿性二尖瓣狭窄患者经皮气球二尖瓣成形术的长期预后]

[Long-term outcome of percutaneous balloon mitral valvuloplasty in patients with rheumatic mitral valve stenosis].

作者信息

Hou Zi-Shan, Ou Zhi-Hong, Wei Yan-Jin, Hou Ya-Min, Shao Ming-Feng, Song Kai-You, Ma Jian-Guo, Xu Tong-Long

机构信息

Department of Cardiology, Linyi People's Hospital, Linyi 276003, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2009 Nov;37(11):994-7.

Abstract

OBJECTIVE

To observe the outcome of percutaneous balloon mitral valvuloplasty (PBMV) in patients with rheumatic mitral valve stenosis.

METHODS

From April 1992 to November 2008, 1768 patients underwent PBMV in our hospital.Clinical and echocardiographic follow up data were analyzed in 426 patients from April 1992 to August 1998. Left atrial pressure and the mitral valve gradient (MVG) were measured before and immediately after PBMV in all patients.

RESULTS

PBMV was successful in 1748 out of 1768 patients (98.86%). Left atrial pressure decreased from (38 +/- 7) mm Hg (1 mm Hg = 0.133 kPa) to (12 +/- 4) mm Hg (P < 0.001), MVG decreased from (28 +/- 6) mm Hg to (8 +/- 3) mm Hg (P < 0.001) and the area of the mitral valve increased from (0.98 +/- 0.26) cm(2) to (1.97 +/- 0.39) cm(2) (P < 0.001) post PBMV. The main complications included death (n = 2), acute pericardial effusion (n = 1), severe mitral regurgitation (n = 12), cerebral embolism (n = 2) and pulmonary edema (n = 1). Ten years follow up was finished in 426 patients and 288 patients (67.6%) were still in NYHA class Ior II without mitral valve replace operation or repeated PBMV, restenosis was evidenced in 140 patients (33.3%) and 31 patients dead (7.5%).

CONCLUSION

PBMV was an effective therapy option for patients with rheumatic mitral valve stenosis.

摘要

目的

观察经皮球囊二尖瓣成形术(PBMV)治疗风湿性二尖瓣狭窄患者的疗效。

方法

1992年4月至2008年11月,我院1768例患者接受了PBMV治疗。对1992年4月至1998年8月期间426例患者的临床和超声心动图随访数据进行分析。所有患者在PBMV术前及术后即刻测量左心房压力和二尖瓣压差(MVG)。

结果

1768例患者中1748例PBMV成功(98.86%)。PBMV术后左心房压力从(38±7)mmHg(1mmHg = 0.133kPa)降至(12±4)mmHg(P < 0.001),MVG从(28±6)mmHg降至(8±3)mmHg(P < 0.001),二尖瓣面积从(0.98±0.26)cm²增加至(1.97±0.39)cm²(P < 0.001)。主要并发症包括死亡(2例)、急性心包积液(1例)、严重二尖瓣反流(12例)、脑栓塞(2例)和肺水肿(1例)。426例患者完成了10年随访,288例患者(67.6%)仍处于纽约心脏协会(NYHA)I级或II级,未进行二尖瓣置换手术或重复PBMV,140例患者(33.3%)出现再狭窄,31例患者死亡(7.5%)。

结论

PBMV是治疗风湿性二尖瓣狭窄患者的有效治疗选择。

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