Block P C, Tuzcu E M, Palacios I F
St. Vincent Heart Institute, Portland, Oregon.
Cardiol Clin. 1991 May;9(2):271-87.
Percutaneous balloon mitral valvotomy is a technique that allows relief of mitral stenosis without thoracotomy. Commissurotomy of the mitral valve with proper sized balloons that are placed antegrade by means of a transseptal catheterization results in good immediate and midterm results in most patients. Younger patients with echocardiographic scores of 8 or lower and who are without atrial fibrillation, mitral regurgitation or valvular calcification, and histories of surgical commissurotomy are the best candidates for PMV. Nevertheless, many patients who are not ideal candidates for PMV also derive substantial relief from this procedure. Mortality and morbidity related to the procedure are low in most experienced centers. Complications include pericardial tamponade, thromboembolism, rhythm abnormalities, left to right shunting, and mitral regurgitation. The survival with freedom from mitral valve replacement at 2 years after PMV is 84%. In addition to history and physical examination, echocardiography has a central role in the selection of patients for PMV.
经皮气球二尖瓣成形术是一种无需开胸即可缓解二尖瓣狭窄的技术。通过经房间隔导管插入术顺行放置尺寸合适的球囊对二尖瓣进行交界切开术，在大多数患者中可取得良好的近期和中期效果。超声心动图评分8分或更低、无房颤、二尖瓣反流或瓣膜钙化且无外科交界切开术史的年轻患者是经皮气球二尖瓣成形术的最佳候选人。然而，许多并非经皮气球二尖瓣成形术理想候选人的患者也能从该手术中获得显著缓解。在大多数经验丰富的中心，与该手术相关的死亡率和发病率较低。并发症包括心包填塞、血栓栓塞、心律失常、左向右分流和二尖瓣反流。经皮气球二尖瓣成形术后2年无需进行二尖瓣置换的生存率为84%。除病史和体格检查外，超声心动图在经皮气球二尖瓣成形术患者的选择中起着核心作用。
