Rosales O R, Hess M J, Heibig J, Smalling R W
Division of Cardiovascular Medicine, University of Texas Health Science Center, Houston 77225.
Tex Med. 1993 Aug;89(8):60-8.
Percutaneous aortic and mitral valvuloplasty are recognized as alternative interventions in cases of severe symptomatic aortic and mitral stenosis. We described the acute hemodynamic results, immediate clinical outcomes, and complications in 27 patients treated consecutively at Hermann Hospital with either percutaneous balloon aortic or mitral valvuloplasty. We review the possible mechanisms of action of balloon valvulotomy and the current indications for either procedure. Balloon aortic valvuloplasty is indicated in elderly patients with severe aortic stenosis in whom open-heart surgery is contraindicated or carries excessive mortality. All patients with symptomatic mitral stenosis are potential candidates for balloon mitral valvulotomy. In centers with an experienced interventional team in transseptal catheterization and an active surgical program, balloon valvulotomy is the initial procedure of choice for significant mitral stenosis with mobile leaflets and minimal chordal thickening.
经皮主动脉瓣和二尖瓣成形术被认为是重度有症状主动脉瓣和二尖瓣狭窄病例的替代干预措施。我们描述了在赫尔曼医院连续接受经皮球囊主动脉瓣或二尖瓣成形术治疗的27例患者的急性血流动力学结果、即时临床结局及并发症。我们回顾了球囊瓣膜切开术可能的作用机制以及这两种手术当前的适应证。球囊主动脉瓣成形术适用于有严重主动脉瓣狭窄、开胸手术禁忌或手术死亡率过高的老年患者。所有有症状的二尖瓣狭窄患者都是球囊二尖瓣切开术的潜在候选者。在具备经验丰富的经房间隔导管插入术介入团队和积极手术方案的中心,对于有活动瓣叶且腱索增厚最小的重度二尖瓣狭窄,球囊瓣膜切开术是首选的初始手术。