Goswami K C, Shrivastava S, Das G, Dev V
All India Institute of Medical Sciences, Ansari Nagar.
Am Heart J. 1993 Nov;126(5):1147-51. doi: 10.1016/0002-8703(93)90667-x.
To determine whether mitral valve (MV) morphology influences the result of balloon mitral valvuloplasty (BMV) for mitral stenosis, two-dimensional echocardiography was performed before BMV in 53 patients and in 25 normal controls. The two-dimensional echocardiographic features of MV leaflets: thickness, length and motion, diastolic MV excursion, chordal length, MV annular diameter (MVAnD), subvalvular distance ratio (SDR), and effective balloon dilating area (EBDA) and diameter (EBDD) were then correlated to the immediate post-BMV mitral valve area (MVA). For the total patient population, post-BMV MVA increased from 0.76 +/- 0.24 to 1.91 +/- 0.59 cm2 (p < 0.0001) and mean diastolic transmitral gradient decreased from 20.1 +/- 6.15 to 5.8 +/- 3.29 mm (p < 0.0001). The patients were divided into two groups on the basis of post-BMV MVA. Group I had post-BMV MVA < 2.0 cm2 and group II had post-BMV MVA > or = 2.0 cm2. A statistically significant difference was noted in SDR (0.33 +/- 0.057 vs 0.45 +/- 0.042, p < 0.0001); mid-MV anulus to tip of papillary muscle (PM) distance (20.0 +/- 3.8 vs 27.9 +/- 4.54 mm, p < 0.0001); chordal length (4.3 +/- 3.6 vs 9.8 +/- 3.9 mm, p < 0.0001); diastolic MV excursion (15.5 +/- 2.6 vs 18.2 +/- 4.2 mm, p < 0.01); leaflet mobility (p < 0.05); and EBDA (4.4 +/- 0.6 vs 4.9 +/- 0.5 cm2, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
为了确定二尖瓣(MV)形态是否会影响二尖瓣狭窄球囊二尖瓣成形术(BMV)的结果,对53例患者及25名正常对照者在BMV术前进行了二维超声心动图检查。然后将MV瓣叶的二维超声心动图特征:厚度、长度及活动度、舒张期MV偏移、腱索长度、MV环直径(MVAnD)、瓣下距离比(SDR)、有效球囊扩张面积(EBDA)及直径(EBDD)与BMV术后即刻二尖瓣面积(MVA)进行相关性分析。对于所有患者,BMV术后MVA从0.76±0.24cm²增加至1.91±0.59cm²(p<0.0001),平均舒张期二尖瓣跨瓣压差从20.1±6.15mmHg降至5.8±3.29mmHg(p<0.0001)。根据BMV术后MVA将患者分为两组。I组BMV术后MVA<2.0cm²,II组BMV术后MVA≥2.0cm²。结果发现SDR(0.33±0.057对0.45±0.042,p<0.0001)、MV环中部至乳头肌(PM)尖端距离(20.0±3.8对27.9±4.54mm,p<0.0001)、腱索长度(4.3±3.6对9.8±3.9mm,p<0.0001)、舒张期MV偏移(15.5±2.6对18.2±4.2mm,p<0.01)、瓣叶活动度(p<0.05)及EBDA(4.4±0.6对4.9±0.5cm²,p<0.01)存在统计学显著差异。(摘要截断于250字)