Department of Cardiology, Topiwala National Medical College & B Y L Nair Charitable Hospital, Mumbai, India.
Catheter Cardiovasc Interv. 2013 Dec 1;82(7):E932-8. doi: 10.1002/ccd.24698. Epub 2013 Mar 2.
Percutaneous balloon tricuspid valvotomy was successfully performed in a 45-year-old female with congenitally corrected transposition of great arteries with severe rheumatic left atrioventricular (tricuspid) valve stenosis. Technical modifications in the standard procedure were made keeping in mind the left-handed ventricular loop, left and anterior aorta, wedged pulmonary valve between the interatrial septum and the mitral valve with deviation of the atrial septum away from the ventricular septum, side-by-side positioned ventricles with an added superoinferior obliquity produced by excessive tilting, and an abnormal orientation of ventricular mass in relation to the thorax, with the apex pointing slightly rightwards. A final valve area of 1.4 cm(2) and a fall in the peak/mean left atrial pressures from 37/32 mm Hg to 13/10 mm Hg were achieved without complications. This case of percutaneous transvenous commissurotomy is unique in view of the rarity of the combination of this congenital heart disease and rheumatic heart disease and successful commissurotomy in such an unusual cardiac anatomy using the Inoue technique.
经皮球囊三尖瓣切开术成功地应用于一位 45 岁的女性患者，该患者患有先天性矫正性大动脉转位伴严重风湿性左房室（三尖瓣）瓣狭窄。在牢记左心室环、左前主动脉、楔入房间隔和二尖瓣之间的肺动脉瓣以及房间隔偏离室间隔、并排心室和因过度倾斜而产生的上下倾斜、以及心室质量相对于胸腔的异常方向，心尖略微指向右侧的情况下，对标准手术进行了技术修改。最终获得 1.4cm² 的瓣口面积，左心房压力峰值/平均从 37/32mmHg 降至 13/10mmHg，无并发症。鉴于这种先天性心脏病和风湿性心脏病的罕见组合，以及使用 Inoue 技术在如此异常的心脏解剖结构中成功进行的经皮经腔二尖瓣交界分离术，该病例具有独特性。
