Bahl V K, Chandra S, Talwar K K, Kaul U, Manchanda S C, Sharma S, Wasir H S
Department of Cardiology and Cardiovascular Radiology, All India Institute of Medical Sciences, New Delhi.
Am Heart J. 1994 Jun;127(6):1554-8. doi: 10.1016/0002-8703(94)90385-9.
In 136 consecutive patients who underwent percutaneous transvenous mitral commissurotomy (PTMC) with use of the single rubber-nylon (Inoue) balloon Inoue balloon angiographically analyzed subvalvular fibrosis was assessed retrospectively with regard to results and complications. There were 53 males and 83 females, with a mean age of 22 +/- 11 years (range 10 to 48 years). For the entire group, mitral valve area increased from 0.7 +/- 0.3 to 2.1 +/- 0.6 cm2 (p < 0.001). Valve area increased from 0.7 +/- 0.12 to 1.8 +/- 0.14 cm2 in patients with severe subvalvular fibrosis (n = 55) and from 0.8 +/- 0.11 to 1.9 +/- 0.12 cm2 in cases with mild to moderate subvalvular fibrosis (n = 80; p = NS). The number of patients with 2+ or greater increase in mitral regurgitation was not different between the two groups (6% vs 5.5%, p = NS). None of the patients required mitral valve replacement immediately after PTMC. We conclude that, with use of the Inoue balloon, PTMC can be successfully performed in patients with severe subvalvular fibrosis.
在136例连续接受经皮经静脉二尖瓣交界切开术（PTMC）并使用单球囊（Inoue）的患者中，通过血管造影分析回顾性评估了瓣下纤维化情况及其与手术结果和并发症的关系。其中男性53例，女性83例，平均年龄22±11岁（范围10至48岁）。对于整个研究组，二尖瓣瓣口面积从0.7±0.3cm²增加至2.1±0.6cm²（p<0.001）。重度瓣下纤维化患者（n=55）的瓣口面积从0.7±0.12cm²增加至1.8±0.14cm²，轻度至中度瓣下纤维化患者（n=80）的瓣口面积从0.8±0.11cm²增加至1.9±0.12cm²（p=无显著差异）。两组二尖瓣反流增加2级或以上的患者数量无差异（6%对5.5%，p=无显著差异）。PTMC术后无患者需要立即进行二尖瓣置换。我们得出结论，使用Inoue球囊，重度瓣下纤维化患者也能成功进行PTMC。
