Medina A, Bethencourt A, Coello I, Hernandez E, Goicolea J, Laraudogoitia E, Melián F, Jimenez F, Drumond A, Olalla E
Unidad de Cardiologia Hemodinámica, Hospital Nuestra Señora del Pino, Las Palmas, Canary Islands, Spain.
Am J Cardiol. 1989 Sep 15;64(10):620-4. doi: 10.1016/0002-9149(89)90490-6.
Between August 1987 and November 1988, combined mitral and aortic balloon valvuloplasty was performed in 10 patients (mean age 42 +/- 9 years), all of whom had symptomatic mitral and aortic stenosis. The procedure was performed using a transarterial approach with a multiballoon catheter and an exteriorized intracardiac long guidewire circuit. The procedure could be considered successful in 9 patients where significant increases in the mean mitral (0.97 +/- 0.19 to 1.80 +/- 0.26 cm2) and aortic (0.63 +/- 0.18 to 1.15 +/- 0.32 cm2) areas were achieved. Severe mitral regurgitation that required surgery developed in 1 patient in the following 24 hours. Femoral vascular surgery was necessary in 1 patient. Mid-term follow-up was available in 8 patients for a period averaging 8 +/- 3 months. The 9 patients in whom the procedure was successful showed persistent clinical improvement in functional class, Doppler echocardiography showed 2 cases of aortic restenosis and none of mitral restenosis. Combined mitral and aortic balloon valvuloplasty could be a valid alternative treatment in selected patients with both mitral and aortic rheumatic stenosis. Further experience and long-term hemodynamic follow-up are necessary to define the role of this mode of treatment.
1987年8月至1988年11月期间，对10例患者（平均年龄42±9岁）实施了二尖瓣和主动脉瓣联合球囊瓣膜成形术，所有患者均有症状性二尖瓣和主动脉瓣狭窄。该手术采用经动脉入路，使用多球囊导管和心内长导丝外置回路进行。9例患者手术可视为成功，二尖瓣平均面积（从0.97±0.19增至1.80±0.26平方厘米）和主动脉瓣平均面积（从0.63±0.18增至1.15±0.32平方厘米）显著增加。1例患者在术后24小时内出现需要手术治疗的严重二尖瓣反流。1例患者需要进行股血管手术。8例患者进行了中期随访，平均随访时间为8±3个月。手术成功的9例患者功能分级持续改善，多普勒超声心动图显示2例主动脉瓣再狭窄，无二尖瓣再狭窄病例。二尖瓣和主动脉瓣联合球囊瓣膜成形术对于选定的二尖瓣和主动脉瓣风湿性狭窄患者可能是一种有效的替代治疗方法。需要进一步的经验和长期血流动力学随访来确定这种治疗方式的作用。
