Vahanian A, Michel P L, Slama M, Cormier B, Trabelsi S, Dermine P, Acar J
Service de cardiologie, Hopital Tenon, Paris, France.
Z Kardiol. 1987;76 Suppl 6:105-9.
To assess the feasibility of percutaneous mitral commissurotomy, we undertook dilatation of mitral stenosis in 26 adults. The procedure was unsuccessful in six patients (hemopericardium in one, and five failures). In 20 patients (mean age: 41 +/- 13 years) the procedure was successful. We used a single balloon (Trefoil 3 X 12 mm) in eight patients and two balloons in 12 (Trefoil 3 X 10 mm + 19 mm). After valvuloplasty, valve function was improved: the mean transvalvular gradient decreased from 14 +/- 4 mm Hg to 7 +/- 2 mm Hg (P less than 0.001) and valve area increased from 1.1 +/- 0.2 cm2 to 2.2 +/- 0.4 cm2 (P less than 0.01). In a patient with severe valvular and subvalvular disease, mitral regurgitation increased from grade I to grade III. From this preliminary series, we conclude firstly that percutaneous valvuloplasty is feasible in adults with mitral stenosis, and secondly, that it results in a significant improvement in valve function with a low incidence of complications.
为评估经皮二尖瓣交界切开术的可行性，我们对26例成人二尖瓣狭窄患者进行了扩张术。该手术在6例患者中未成功（1例发生心包积血，5例失败）。20例患者（平均年龄：41±13岁）手术成功。我们对8例患者使用了单个球囊（三叶形3×12mm），对12例患者使用了两个球囊（三叶形3×10mm + 19mm）。瓣膜成形术后，瓣膜功能得到改善：平均跨瓣压差从14±4mmHg降至7±2mmHg（P＜0.001），瓣膜面积从1.1±0.2cm²增加至2.2±0.4cm²（P＜0.01）。在1例患有严重瓣膜和瓣膜下疾病的患者中，二尖瓣反流从I级增加至III级。从这个初步系列研究中，我们首先得出结论，经皮瓣膜成形术在成人二尖瓣狭窄患者中是可行的，其次，该手术能显著改善瓣膜功能，且并发症发生率较低。
