McKay C R, Kawanishi D T, Rahimtoola S H
JAMA. 1987 Apr 3;257(13):1753-61.
Catheter balloon valvuloplasty (CBV) using the double-balloon technique was performed on 12 symptomatic patients (mean age, 43 years) with rheumatic mitral valve stenosis. Two dilatation balloons were used in which the diameters approximately equaled the mitral valve anulus diameter as determined. After CBV, the mean mitral valve gradient decreased in all patients (mean +/- SD, 16 +/- 6 to 5 +/- 2 mm Hg), the mean left atrial pressure decreased (29 +/- 7 to 16 +/- 4 mm Hg), and the cardiac output increased (4.4 +/- 1.2 to 5.5 +/- 1.4 L/min). The mitral valve area increased from 1.0 +/- 0.3 to 2.4 +/- 0.8 cm2. Oximetry demonstrated small left to right shunts of pulmonary to systemic flow ratios of 1.4:1 and 1.3:1 in two patients. Mitral regurgitation did not increase. Gradual decreases in mean pulmonary artery pressures and pulmonary vascular resistance were recorded over the subsequent 24 hours. Our patients left the hospital two days after CBV. The New York Heart Association Functional Class improved in 11 of 12 patients. We conclude that CBV using the double-balloon technique effectively relieves mitral valve obstruction, reduces elevated pulmonary pressures, and reduces symptoms in selected adult patients with symptomatic mitral stenosis.
采用双球囊技术对12例有症状的风湿性二尖瓣狭窄患者（平均年龄43岁）实施了导管球囊瓣膜成形术（CBV）。使用了两个扩张球囊，其直径大致等于所测定的二尖瓣瓣环直径。CBV术后，所有患者的平均二尖瓣压差均降低（平均±标准差，从16±6降至5±2 mmHg），平均左心房压力降低（从29±7降至16±4 mmHg），心输出量增加（从4.4±1.2升至5.5±1.4 L/min）。二尖瓣面积从1.0±0.3增加至2.4±0.8 cm²。血氧测定显示，两名患者存在肺循环至体循环的小的左向右分流，肺循环与体循环血流量之比分别为1.4:1和1.3:1。二尖瓣反流未增加。在随后的24小时内记录到平均肺动脉压和肺血管阻力逐渐下降。我们的患者在CBV术后两天出院。12例患者中有11例纽约心脏协会心功能分级得到改善。我们得出结论，采用双球囊技术的CBV能有效缓解二尖瓣梗阻，降低升高的肺压力，并减轻有症状的二尖瓣狭窄成年患者的症状。
