鲁登巴赫综合征的成功经皮治疗
Successful percutaneous management of Lutembacher syndrome.
作者信息
Goel Sandeep, Nath Ranjit, Sharma Ajay, Pandit Neeraj, Wardhan Harsh
机构信息
Senior Resident, Department of Cardiology, Dr RML Hospital and PGIMER, New Delhi, India.
Associate Professor, Department of Cardiology, Dr RML Hospital and PGIMER, New Delhi, India.
出版信息
Indian Heart J. 2014 May-Jun;66(3):355-7. doi: 10.1016/j.ihj.2014.03.016. Epub 2014 May 15.
BACKGROUND
The surgical management of Lutembacher syndrome is straight forward but percutaneous management, though technically demanding, is always desirable.
METHODS
A 17 year old unmarried female presented with severe Mitral stenosis and a 19 mm almost circular Ostium secundum ASD with moderate pulmonary artery hypertension and dilated right sided chambers. She was managed in a staged manner. Percutaneous trans mitral commissurotomy (PTMC) was done first, using a 26 mm Inoue balloon catheter set, and after 48 h, ASD was closed with a 20 mm Cocoon Septal Occluder.
RESULTS
The mitral valve area increased after PTMC from 0.8 cm2 to 2.1 cm2 and QP/QS decreased from 4.9 to 2. ASD was successfully closed under echocardiographic and fluoroscopic guidance.
CONCLUSION
Percutaneous management of the Lutembacher syndrome (PTMC and ASD device closure) is an effective and low risk procedure and avoids considerable morbidity and mental trauma for the patients.
背景
鲁登巴赫综合征的外科治疗 straightforward 但经皮治疗虽然技术要求高，但总是更可取的。
方法
一名 17 岁未婚女性，患有严重二尖瓣狭窄和一个 19 毫米几乎圆形的继发孔房间隔缺损，伴有中度肺动脉高压和右侧心腔扩大。对她进行了分期治疗。首先使用 26 毫米井上球囊导管套装进行经皮经二尖瓣交界切开术（PTMC），48 小时后，用 20 毫米茧形房间隔封堵器关闭房间隔缺损。
结果
PTMC 后二尖瓣瓣口面积从 0.8 平方厘米增加到 2.1 平方厘米，QP/QS 从 4.9 降至 2。在超声心动图和荧光透视引导下，房间隔缺损成功关闭。
结论
鲁登巴赫综合征的经皮治疗（PTMC 和房间隔缺损装置封堵）是一种有效且低风险的手术，可避免患者出现相当大的发病率和精神创伤。
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