Fang W Y, Yu W X, Lu Z X, Li X M, Bu D X, Xu W L
Department of Cardiology, 1st Teaching Hospital, Dalian Medical University.
Chin Med J (Engl). 1994 Sep;107(9):678-82.
Percutaneous balloon mitral valvuloplasty (PBMV) was successfully performed in 50 selected patients with mitral stenosis by using Inoue pillow-shaped balloon and Inoue technique. The average diameter of balloon used was 26.9 +/- 0.9 mm. 90% (45/50) of cases had either double or single mitral commissura split. Of the rest 5 cases, 1 had a mitral score 13 and 4 had a history of mitral valve commissurotomy. Totally they had a mean mitral valve area increase from 1.13 +/- 0.32 to 2.21 +/- 0.43 cm2, left atrial pressure decrease from 31.8 +/- 9.3 to 14.7 +/- 5.6 mmHg, left atrial diameter reduction from 44.9 +/- 7.7 to 37.4 +/- 4.9 mm, and transmitral gradient decrease from 21.7 +/- 9.8 to 4.0 +/- 5.2 mmHg. Most patients had a obvious cardiac function improvement, especially in patients with mitral score of 8 or less. 30% patients (15/50) had a mild mitral regurgitation, but relieved 3-6 months after procedure. During one year of follow up, the majority of patients (16/20) were found in a good cardiac function, mitral area and the left atrial diameter, except in 4 patients with a high mitral score of more than 10. It is suggested that for patient with lower mitral morphological score and good general health, a larger diameter balloon might be suitable for effectively improving patient's symptom, but for patients with a previous surgical mitral commissurotomy, PBMV should not be selected.
采用Inoue球囊和Inoue技术，对50例选定的二尖瓣狭窄患者成功实施了经皮球囊二尖瓣成形术（PBMV）。所用球囊的平均直径为26.9±0.9mm。90%（45/50）的病例二尖瓣瓣叶联合处出现双裂或单裂。其余5例中，1例二尖瓣评分13分，4例有二尖瓣交界切开术病史。总体而言，二尖瓣平均瓣口面积从1.13±0.32cm²增加至2.21±0.43cm²，左心房压力从31.8±9.3mmHg降至14.7±5.6mmHg，左心房直径从44.9±7.7mm减小至37.4±4.9mm，跨二尖瓣压差从21.7±9.8mmHg降至4.0±5.2mmHg。大多数患者的心功能有明显改善，尤其是二尖瓣评分8分及以下的患者。30%的患者（15/50）出现轻度二尖瓣反流，但术后3 - 6个月缓解。在一年的随访中，除4例二尖瓣评分高于10分的患者外，大多数患者（16/20）的心功能、二尖瓣瓣口面积和左心房直径良好。提示对于二尖瓣形态学评分较低且全身状况良好的患者，较大直径的球囊可能适合有效改善患者症状，但对于既往有二尖瓣交界切开术的患者，不应选择PBMV。
