Inoue K, Feldman T
Department of Cardiovascular Surgery, Takeda Hospital, Kyoto City, Japan.
Cathet Cardiovasc Diagn. 1993 Feb;28(2):119-25. doi: 10.1002/ccd.1810280206.
Since its inception in 1982, percutaneous transvenous mitral commissurotomy (PTMC) with the Inoue balloon catheter has gained increasingly wide use internationally. The procedure is technically successful in over 90% of patients, and the long-term durability of commissurotomy is excellent in those with pliable mitral valve leaflets and minimally deformed submitral apparatus. PTMC offers an alternative to patients previously not considered candidates for surgery, where no alternative had existed in the past. After transseptal puncture, PTMC using the Inoue balloon can be accomplished easily in the majority of patients. In comparison to double balloon mitral valvotomy, the postdilatation valve area is similar, the incidence of mitral regurgitation is not different, and the fluoroscopic and procedure time are markedly shorter. While patients with little valve deformity are excellent candidates for this procedure, and those not considered candidates for surgical therapy are also easily defined, selection of patients for balloon dilatation among those with significant valve deformity who are otherwise candidates for valve replacement therapy remains a challenging problem.
自1982年问世以来，使用Inoue球囊导管进行的经皮经静脉二尖瓣交界切开术（PTMC）在国际上得到了越来越广泛的应用。该手术在超过90%的患者中技术上是成功的，对于二尖瓣叶柔软且二尖瓣下装置变形最小的患者，交界切开术的长期效果极佳。PTMC为以前不被认为适合手术的患者提供了一种替代方案，而在过去这些患者没有其他选择。经房间隔穿刺后，大多数患者使用Inoue球囊进行PTMC操作很容易完成。与双球囊二尖瓣切开术相比，扩张后瓣膜面积相似，二尖瓣反流发生率无差异，透视和手术时间明显更短。虽然瓣膜畸形轻微的患者是该手术的理想候选者，而且那些不被认为适合手术治疗的患者也很容易确定，但在那些有严重瓣膜畸形、原本适合瓣膜置换治疗的患者中选择进行球囊扩张的患者仍然是一个具有挑战性的问题。
