Lau K W, Hung J S
Section of Cardiology, Chang Gung Medical College, Taiwan, Republic of China.
Cathet Cardiovasc Diagn. 1994 Oct;33(2):120-9; discussion 130-1. doi: 10.1002/ccd.1810330207.
This study was carried out to examine whether the previously determined balloon sizing method based on patient height was valid for percutaneous transvenous mitral commissurotomy using the current second-generation Inoue balloon catheter. The study consisted of 70 patients with pliable noncalcified mitral valves (group 1) and 85 patients with calcified mitral valves and/or severe subvalvular lesions (group 2). The mitral valve area was increased more in group 1 than in group 2 (1.0 +/- 0.3 to 1.9 +/- 0.5 cm2 versus 1.0 +/- 0.3 to 1.6 +/- 0.5 cm2, P = 0.002). Using the stepwise dilatation technique, none of the group 1 patients developed severe mitral regurgitation. Severe mitral regurgitation occurred in 4 patients (4.7%) in group 2. In conclusion, a simple balloon sizing method based on body height for selection of an appropriate-sized balloon catheter, as well as an initial inflated balloon diameter for the stepwise dilatation technique is useful for optimal acute outcomes in mitral commissurotomy.
本研究旨在探讨先前基于患者身高确定的球囊尺寸测量方法，对于使用当前第二代Inoue球囊导管进行经皮经静脉二尖瓣交界切开术是否有效。该研究包括70例二尖瓣柔软无钙化的患者（第1组）和85例二尖瓣钙化和/或严重瓣下病变的患者（第2组）。第1组二尖瓣瓣口面积增加幅度大于第2组（从1.0±0.3增加至1.9±0.5cm²，而第2组从1.0±0.3增加至1.6±0.5cm²，P = 0.002）。采用逐步扩张技术，第1组患者均未发生严重二尖瓣反流。第2组有4例患者（4.7%）发生严重二尖瓣反流。总之，基于身高选择合适尺寸球囊导管的简单球囊尺寸测量方法，以及逐步扩张技术的初始充气球囊直径，对于二尖瓣交界切开术的最佳急性手术效果是有用的。
