Feldman T
Hans Hecht Hemodynamics Laboratory, Pritzker School of Medicine, University of Chicago Hospitals, Illinois 60637.
Cathet Cardiovasc Diagn. 1994;Suppl 2:2-7.
Percutaneous transvenous mitral commissurotomy (PTMC) was performed in 290 patients enrolled from 16 clinical centers in the United States and Canada. The mean age was 54 +/- 15 years and the mean total echocardiographic score was 7.3 +/- 2.8. Mitral valve dilatation resulted in an increase in mitral valve area from 1.0 +/- 0.3 to 1.7 +/- 0.6 cm2 (P < 0.001). Technical success, defined as final mitral area > or = 1.5 cm2 or a > or = 50% increase in area, was achieved in 83% of patients. Significant complications included mitral valve replacement in the hospital 1.0% and hospital death in 1.4%. Failure to cross the mitral valve occurred in 1.7%. Other complications that did not interfere with discharge from the hospital with a completed PTMC procedure occurred in 12.1% of patients. Among patients with successful PTMC, the valve area remained constant over a 24-month follow-up period. Although a minority of patients were NYHA Class I or II prior to PTMC, > 80% remained in Class I or II throughout the 2-yr follow-up period. The overall results in this registry demonstrate that the acute hemodynamic results of the procedure are excellent, the incidence of procedure related complications is acceptable, and a majority of patients remain symptomatically improved during a 2-yr follow-up period.
对来自美国和加拿大16个临床中心的290例患者实施了经皮经静脉二尖瓣交界切开术（PTMC）。平均年龄为54±15岁，平均超声心动图总评分7.3±2.8。二尖瓣扩张使二尖瓣面积从1.0±0.3增加至1.7±0.6 cm²（P<0.001）。技术成功率（定义为最终二尖瓣面积≥1.5 cm²或面积增加≥50%）在83%的患者中实现。严重并发症包括1.0%的患者在住院期间进行二尖瓣置换以及1.4%的患者住院死亡。无法穿过二尖瓣的发生率为1.7%。在完成PTMC手术的患者中，12.1%发生了不影响出院的其他并发症。在PTMC成功的患者中，在24个月的随访期内瓣膜面积保持稳定。尽管少数患者在PTMC术前为纽约心脏协会（NYHA）I级或II级，但在整个2年随访期内，超过80%的患者仍保持在I级或II级。该登记研究的总体结果表明，该手术的急性血流动力学结果良好，与手术相关并发症的发生率可接受，并且大多数患者在2年随访期内症状持续改善。
