Commeau P, Grollier G, Huret B, Foucault J P, Potier J C
Br Heart J. 1987 Aug;58(2):142-7. doi: 10.1136/hrt.58.2.142.
Three patients with rheumatic mitral stenosis were treated with percutaneous mitral valvotomy. A Brockenbrough catheter was advanced transseptally into the left atrium and then into the left ventricle over a long guide wire. An angle wire loop retriever was advanced through a 10 Fr straight catheter via the femoral artery into the left ventricle. The retriever was used to catch the flexible end of the long guide wire. This end of the long guide wire was then drawn out of the right femoral artery by the retriever through the straight catheter. The straight catheter was left in the descending aorta; the Brockenbrough catheter was removed and a 7 Fr balloon catheter was introduced percutaneously over the long guide wire through the femoral vein. This balloon catheter was used for interatrial septal dilatation and right femoral venous dilatation. In two patients this catheter was replaced over the long guide wire with a 9 Fr Schneider-Medintag Grüntzig catheter (3 X 12 mm diameter when inflated) and in the other by a Mansfield (18 mm diameter when inflated). The procedure was well tolerated in these three patients and there were no complications. Haemodynamic function improved, there was appreciable decrease in dyspnoea, and exercise tolerance was increased. This procedure has several advantages: the balloon is more easily positioned through the mitral valve; the stability of the balloon during inflation is improved by traction at both ends of the long guide wire; and there is the option of rapidly exchanging one balloon for a larger one over the long guide wire. This technique seems to be less arrhythmogenic and results in less blood loss because manual compression of the femoral vessels after the procedure is easier.
三名风湿性二尖瓣狭窄患者接受了经皮二尖瓣球囊成形术治疗。一根布罗肯布罗导管经房间隔穿刺进入左心房，然后通过一根长导丝进入左心室。一根角度钢丝圈套器通过一根10F直导管经股动脉推进到左心室。该圈套器用于抓住长导丝的柔性末端。然后，长导丝的这一端被圈套器通过直导管从右股动脉抽出。直导管留在降主动脉；取出布罗肯布罗导管，通过股静脉在长导丝上经皮插入一根7F球囊导管。该球囊导管用于房间隔扩张和右股静脉扩张。两名患者在长导丝上更换为一根9F施耐德-美迪泰格·格鲁恩齐格导管（充盈时直径3×12mm），另一名患者更换为曼斯菲尔德导管（充盈时直径18mm）。这三名患者对该手术耐受性良好，未出现并发症。血流动力学功能改善，呼吸困难明显减轻，运动耐量增加。该手术有几个优点：球囊更容易通过二尖瓣定位；通过牵拉长导丝两端，球囊充盈时的稳定性得到改善；并且可以选择在长导丝上快速将一个球囊更换为更大的球囊。该技术似乎致心律失常性较低，且术后对股血管的手动压迫更容易，导致失血更少。
