经皮球囊二尖瓣成形术治疗重度二尖瓣狭窄孕妇的有效性和安全性研究

Study of Effectiveness and Safety of Percutaneous Balloon Mitral Valvulotomy for Treatment of Pregnant Patients with Severe Mitral Stenosis.

作者信息

Joshi Hasit Sureshbhai, Deshmukh Jagjeet Kishanrao, Prajapati Jayesh Somabhai, Sahoo Sibasis Shahsikant, Vyas Pooja Maheshbhai, Patel Iva Vipul

机构信息

Associate Professor, Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC) , Ahmedabad, India .

Head of Department, Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC) , Ahmedabad, India .

出版信息

J Clin Diagn Res. 2015 Dec;9(12):OC14-7. doi: 10.7860/JCDR/2015/14765.6923. Epub 2015 Dec 1.

DOI:10.7860/JCDR/2015/14765.6923

PMID:26816932

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4717775/

Abstract

INTRODUCTION

In pregnant women mitral stenosis is the commonest cardiac valvular lesion. When it is present in majorly severe condition it leads to maternal and fetal morbidity and mortality. In mitral stenosis pregnancy can lead to development of heart failure.

AIM

To evaluate the safety and efficacy of balloon mitral valvulotomy (BMV) in pregnant females with severe mitral stenosis.

MATERIALS AND METHODS

A total of 30 pregnant patients who underwent BMV were included in the study from July 2011 to November 2013. Clinical follow-up during pregnancy was done every 3 months until delivery and after delivery. The mean follow up time after BMV was 6.72±0.56 months.

RESULTS

From the 30 pregnant females 14 (46.67%) and 16 (53.3%) patients underwent BMV during the third and second trimester of pregnancy respectively. The mean mitral valve area was 0.85+0.16 cm(2) before BMV that increased to 1.60+0.27 cm(2) (p<0.0001) immediately after BMV. Peak and mean diastolic gradients had decreased significantly within 48 hours after the procedure (p<0.001) but remained very much unchanged at 6.72 month period of follow-up. Two patients had an increase in mitral regurgitation by 2 grades.

CONCLUSION

During pregnancy BMV technique is safe and effective in patients with severe mitral stenosis. This results in marked symptomatic relief along with long term maternal and fetal outcomes.

摘要

引言

在孕妇中，二尖瓣狭窄是最常见的心脏瓣膜病变。当病情严重时，会导致母婴发病和死亡。在二尖瓣狭窄患者中，怀孕可能会导致心力衰竭。

目的

评估球囊二尖瓣成形术（BMV）对重度二尖瓣狭窄孕妇的安全性和有效性。

材料与方法

2011年7月至2013年11月，共有30例接受BMV的孕妇纳入本研究。孕期每3个月进行一次临床随访，直至分娩及产后。BMV术后平均随访时间为6.72±0.56个月。

结果

30例孕妇中，分别有14例（46.67%）和16例（53.3%）在妊娠晚期和中期接受了BMV。BMV术前二尖瓣平均瓣口面积为0.85+0.16 cm²，术后即刻增加至1.60+0.27 cm²（p<0.0001）。术后48小时内，舒张期峰值和平均压力阶差显著降低（p<0.001），但在6.72个月的随访期内基本保持不变。2例患者二尖瓣反流程度增加2级。