Rifaie Osama, Ismail Mohamed, Helmy Mohamed, El-Bialy Mohamed, Nammas Wail
Cardiology Department, Faculty of Medicine, Ain Shams University; Cairo, Egypt.
Indian Heart J. 2010 Jul-Aug;62(4):303-7.
In a retrospective study design, we explored the immediate results of redo-percutaneous mitral valvuloplasty in comparison with initial percutaneous mitral valvuloplasty.
We included 30 consecutive patients with de-novo mitral stenosis (group A) and 40 consecutive patients with mitral restenosis after successful initial percutaneous mitral valvuloplasty (group B). Echocardiographic assessment of the mitral valve was performed in all patients by trans-thoracic echocardiography and transesophageal echocardiography excluded left atrial thrombosis. Percutaneous mitral valvuloplasty was performed by the antegrade trans-septal approach using either the standard Inoue technique or the multi-track technique. Patient assessment by trans-thoracic echocardiography was repeated 48 hours following the procedure. Procedural success was defined as a 50% or more increase of mitral valve area with a final mitral valve area > or = 1.5 cm2, without major complications. Procedural success was achieved in 28 (93.3%) patients in group A and in 37 (92.5%) patients in group B (p > 0.05). The two groups were similar concerning the final mitral valve area, gain of mitral valve area, mean pressure gradient across the mitral valve and complication rate (p > 0.05 for all). The final mitral valve area correlated negatively with the initial mitral valve score in both group A and B.
Redo-percutaneous mitral valvuloplasty for mitral restenosis achieves comparable immediate results to initial percutaneous mitral valvuloplasty.
在一项回顾性研究设计中，我们探讨了再次经皮二尖瓣球囊成形术与初次经皮二尖瓣球囊成形术相比的即刻结果。
我们纳入了30例连续性初发二尖瓣狭窄患者（A组）和40例初次经皮二尖瓣球囊成形术成功后出现二尖瓣再狭窄的连续性患者（B组）。所有患者均通过经胸超声心动图和经食管超声心动图进行二尖瓣超声心动图评估，排除左心房血栓形成。采用标准的Inoue技术或多轨道技术经房间隔顺行途径进行经皮二尖瓣球囊成形术。术后48小时通过经胸超声心动图对患者进行再次评估。手术成功定义为二尖瓣瓣口面积增加50%或更多，最终二尖瓣瓣口面积≥1.5 cm²，且无重大并发症。A组28例（93.3%）患者和B组37例（92.5%）患者手术成功（p>0.05）。两组在最终二尖瓣瓣口面积、二尖瓣瓣口面积增加量、二尖瓣平均跨瓣压差和并发症发生率方面相似（所有p>0.05）。A组和B组的最终二尖瓣瓣口面积均与初始二尖瓣评分呈负相关。
二尖瓣再狭窄的再次经皮二尖瓣球囊成形术取得了与初次经皮二尖瓣球囊成形术相当的即刻结果。
