Kasper W, Wollschläger H, Spillner G, Meinertz T, Geibel A, Just H
Innere Medizin III der Albert-Ludwigs-Universität Freiburg.
Z Kardiol. 1990 Jul;79(7):499-505.
A percutaneous transfemoral, transatrial double-balloon valvuloplasty was performed on 21 patients (53 +/- 14 years) with rheumatic mitral stenosis. An open commissurotomy was performed in six patients, 20 +/- 9 years previously; in three patients an arterial embolism had occurred previously. Balloon valvuloplasty resulted in a reduction of the mean diastolic gradient from 16 +/- 7 to 8 +/- 3 mm Hg (p less than 0.001), and the mitral valve orifice area increased from 1.1 +/- 0.3 to 2.2 +/- 0.8 cm2 (p less than 0.001). Mitral insufficiency increased in three patients and was first observed after valvuloplasty in four patients. Complications were seen in three patients: a left ventricular perforation resulting in pericardial tamponade occurred in two patients, which required cardiothoracic intervention. In one patient a pulmonary embolism occurred five days after the invasive procedure. The study shows that percutaneous transfemoral balloon valvuloplasty can successfully be performed in patients with severe or even calcified mitral valve stenosis. The risk of severe complications is, however, not negligible.
对21例（年龄53±14岁）风湿性二尖瓣狭窄患者实施了经皮股动脉、经心房双球囊瓣膜成形术。6例患者曾在20±9年前接受过直视二尖瓣交界切开术，其中3例曾发生过动脉栓塞。球囊瓣膜成形术后，平均舒张期压力阶差从16±7 mmHg降至8±3 mmHg（p<0.001），二尖瓣口面积从1.1±0.3 cm²增加至2.2±0.8 cm²（p<0.001）。3例患者二尖瓣反流加重，4例患者在瓣膜成形术后首次出现二尖瓣反流。3例患者出现并发症：2例患者发生左心室穿孔导致心包填塞，需进行心胸外科干预；1例患者在侵入性操作后5天发生肺栓塞。该研究表明，经皮股动脉球囊瓣膜成形术可成功应用于重度甚至钙化性二尖瓣狭窄患者。然而，严重并发症的风险不可忽视。
