Stefanadis C, Stratos C, Kallikazaros I, Tsiamis E, Vlachopoulos C, Sideris A, Toutouzas C P, Toutouzas P
Department of Cardiology, Hippokration Hospital, University of Athens, Greece.
Cathet Cardiovasc Diagn. 1994 Nov;33(3):224-33. doi: 10.1002/ccd.1810330307.
Retrograde nontransseptal balloon mitral valvuloplasty, a method developed in our institution for the treatment of symptomatic mitral stenosis, avoids transseptal catheterization. Until recently, the self-positioning Inoue balloon catheter, unlike all other commercially available balloon catheters, had not been employed in this nontransseptal technique due to the short length of its catheter shaft. To employ a self-positioning balloon in retrograde nontransseptal balloon mitral valvuloplasty, we modified the Inoue device by extension of the catheter shaft. After retrograde nontransseptal left atrial catheterization using a steerable cardiac catheter, the modified Inoue balloon catheter was inserted through the femoral artery and advanced to the mitral valve retrogradely. Valvuloplasty was performed in 20 patients, with a successful result achieved in all. The modified Inoue balloon catheter was easy to use in retrograde nontransseptal balloon mitral valvuloplasty and showed excellent stability during inflation. Mean mitral valve area increased from 1.0 +/- 0.29 to 2.23 +/- 0.64 cm2 (P < 0.001) and mean transmitral gradient decreased from 11.4 +/- 6 to 4.3 +/- 2.1 mm Hg (P < 0.001). No major or minor complications were observed. Retrograde nontransseptal balloon mitral valvuloplasty using a modified Inoue balloon catheter is a feasible and effective technique for the treatment of symptomatic mitral stenosis. It appears to combine the advantages of avoiding transseptal catheterization with the advantages of this balloon's special configuration.
逆行非经房间隔球囊二尖瓣成形术是我院研发的一种治疗有症状二尖瓣狭窄的方法，可避免经房间隔导管插入术。直到最近，由于其导管轴长度较短，与所有其他市售球囊导管不同，自定位的Inoue球囊导管尚未用于这种非经房间隔技术。为了在逆行非经房间隔球囊二尖瓣成形术中使用自定位球囊，我们通过延长导管轴对Inoue装置进行了改良。使用可操纵的心导管进行逆行非经房间隔左心房导管插入术后，将改良的Inoue球囊导管经股动脉插入并逆行推进至二尖瓣。对20例患者进行了瓣膜成形术，全部获得成功。改良的Inoue球囊导管在逆行非经房间隔球囊二尖瓣成形术中易于使用，充气时显示出极好的稳定性。二尖瓣平均瓣口面积从1.0±0.29cm²增加至2.23±0.64cm²（P<0.001），平均跨二尖瓣压差从11.4±6mmHg降至4.3±2.1mmHg（P<0.001）。未观察到严重或轻微并发症。使用改良的Inoue球囊导管进行逆行非经房间隔球囊二尖瓣成形术是一种治疗有症状二尖瓣狭窄的可行且有效的技术。它似乎结合了避免经房间隔导管插入术的优点以及这种球囊特殊构造的优点。
