Khanal Suraj, Yamasandi Siddegowda Shrimanth, Kumar Basant
Cardiology, Postgraduate Institute of Medical Education & Research, Chandigarh, IND.
Cureus. 2022 Apr 29;14(4):e24610. doi: 10.7759/cureus.24610. eCollection 2022 Apr.
Objective Despite the decline in the incidence of rheumatic heart disease in developed countries, the disease still remains endemic among individuals of low socioeconomic status. The aim of the study is to assess immediate and one-year outcomes of balloon mitral valvotomy using the double-lumen Accura balloon (Vascular Innovations Co., Nonthaburi, Thailand) in patients with mitral valve stenosis. Methods This was a single-centre, observational, investigator-initiated retrospective study. All consecutive patients undergoing balloon mitral valvotomy with the Accura balloon between January 2015 and June 2020 were included. The primary endpoint was procedural success defined as an increase in mitral valve area (MVA) ≥50% from basal valve area or final valve area of ≥1.5 cm, in the absence of mitral regurgitation grade >2. Clinical, echocardiographic, and haemodynamic parameters were assessed at the one-year follow-up. Results A total of 62 patients underwent balloon mitral valvotomy. The mean age was 34.9 ± 8.0 years, and 54 (87.1%) patients were female. Mean Wilkins' echo score was 7.5 ± 0.5. Procedural success was achieved in 59 (96.7%) patients. Mean MVA increased from 0.75 ± 0.14 cm to 1.64 ± 0.21 cm, and mean mitral valve gradient decreased from 24.9 ± 5.5 mmHg to 7.30 ± 1.40 mmHg. Atrial fibrillation, mitral valve replacement, and moderate to severe mitral regurgitation occurred in 36 (59.0%), two (3.3%), and two (3.3%) patients, respectively. No death, cerebrovascular accidents, restenosis, or redo procedures occurred. Conclusion Balloon mitral valvotomy using the double-lumen Accura balloon is safe in patients with mitral valve stenosis.
目的 尽管发达国家风湿性心脏病的发病率有所下降，但该疾病在社会经济地位较低的人群中仍然流行。本研究的目的是评估使用双腔Accura球囊（泰国暖武里府Vascular Innovations公司）对二尖瓣狭窄患者进行球囊二尖瓣成形术的即刻和一年期结果。方法 这是一项单中心、观察性、研究者发起的回顾性研究。纳入2015年1月至2020年6月期间所有使用Accura球囊进行球囊二尖瓣成形术的连续患者。主要终点是手术成功，定义为二尖瓣面积（MVA）较基础瓣膜面积增加≥50%或最终瓣膜面积≥1.5 cm²，且无>2级二尖瓣反流。在一年随访时评估临床、超声心动图和血流动力学参数。结果 共有62例患者接受了球囊二尖瓣成形术。平均年龄为34.9±8.0岁，54例（87.1%）患者为女性。平均威尔金斯超声评分7.5±0.5。59例（96.7%）患者手术成功。平均MVA从0.75±0.14 cm²增加到1.64±0.21 cm²，平均二尖瓣跨瓣压差从24.9±5.5 mmHg降至7.30±1.40 mmHg。分别有36例（59.0%）、2例（3.3%）和2例（3.3%）患者发生房颤、二尖瓣置换和中重度二尖瓣反流。未发生死亡、脑血管意外、再狭窄或再次手术。结论 使用双腔Accura球囊对二尖瓣狭窄患者进行球囊二尖瓣成形术是安全的。
