Arora R, Nair M, Kalra G S, Nigam M, Khalilullah M
Department of Cardiology, G. B. Pant Hospital, New Delhi, India.
Am Heart J. 1993 Apr;125(4):1091-4. doi: 10.1016/0002-8703(93)90118-s.
Balloon mitral valvotomy (BMV) constitutes an important alternative to surgical closed mitral valvotomy (CMV) for the treatment of rheumatic mitral stenosis. To compare the immediate and long-term results of these procedures, 200 patients with rheumatic mitral stenosis were randomly assigned to undergo either BMV (n = 100) or CMV (n = 100). The age range was 10 to 30 (mean 19.4 +/- 6.5) years. Both procedures resulted in significant and similar increases in mitral valve area (BMV: 0.85 +/- 0.26 to 2.39 +/- 0.94 cm2; CMV: 0.79 +/- 0.21 to 2.2 +/- 0.85 cm2; p = NS). Mitral regurgitation developed in 14 patients after BMV and in 12 patients after CMV. Eighty patients in each group have now been followed for a mean period of 22 +/- 6.3 (range 6 to 38) months by repeat echocardiographic study. Restenosis (defined as a loss of more than 50% of the achieved increase in mitral valve area) was seen in four (5%) patients after BMV and in three (4%) after CMV. Symptomatic restenosis was seen in only one patient who at follow-up examination 20 months after CMV had a mitral valve area of 0.8 cm2 and underwent successful balloon valvotomy. We conclude that the immediate and long-term results obtained with percutaneous BMV and surgical closed mitral commissurotomy are comparable.
球囊二尖瓣成形术（BMV）是治疗风湿性二尖瓣狭窄的一种重要替代手术，可替代外科闭式二尖瓣成形术（CMV）。为比较这两种手术的近期和远期效果，将200例风湿性二尖瓣狭窄患者随机分为两组，分别接受BMV（n = 100）或CMV（n = 100）治疗。年龄范围为10至30岁（平均19.4 +/- 6.5岁）。两种手术均使二尖瓣瓣口面积显著且相似地增加（BMV：从0.85 +/- 0.26 cm²增加至2.39 +/- 0.94 cm²；CMV：从0.79 +/- 0.21 cm²增加至2.2 +/- 0.85 cm²；p =无显著差异）。BMV术后14例患者出现二尖瓣反流，CMV术后12例患者出现二尖瓣反流。现在通过重复超声心动图检查，对每组80例患者平均随访了22 +/- 6.3个月（范围6至38个月）。BMV术后4例（5%）患者出现再狭窄（定义为二尖瓣瓣口面积增加量丧失超过50%），CMV术后3例（4%）患者出现再狭窄。仅1例患者出现有症状的再狭窄，该患者在CMV术后20个月的随访检查中二尖瓣瓣口面积为0.8 cm²，随后成功接受了球囊瓣膜成形术。我们得出结论，经皮BMV和外科闭式二尖瓣交界切开术的近期和远期效果相当。
