Röthlisberger C, Essop M R, Skudicky D, Skoularigis J, Wisenbaugh T, Sareli P
Division of Cardiology, Baragwanath Hospital, Johannesburg, South Africa.
Am J Cardiol. 1993 Jul 1;72(1):73-7. doi: 10.1016/0002-9149(93)90222-x.
The results of percutaneous balloon mitral valvotomy (PBMV) were evaluated in 235 young patients (mean age 29 +/- 11 years) with symptomatic rheumatic mitral stenosis, and the single-balloon Inoue technique was compared with the double-balloon Mansfield technique. PBMV was associated with a significant increase in Gorlin mitral valve area (0.78 +/- 0.23 to 1.61 +/- 0.64 cm2; p < 0.001), and improvement in New York Heart Association functional class (2.78 +/- 0.59 to 1.28 +/- 0.58; p < 0.001). Mitral regurgitation increased significantly (0.4 +/- 0.6 to 1.3 +/- 1.0; p < 0.001), but was significant (> or = 3+) only in 19 patients (8%). Comparison of the Inoue and Mansfield techniques showed a significantly lower Gorlin mitral valve area after PBMV (1.55 +/- 0.56 vs 1.74 +/- 0.74 cm2; p < 0.05), but a lower incidence of mitral regurgitation by color Doppler echocardiography (1.1 +/- 0.7 vs 1.5 +/- 0.8; p < 0.05) in the Inoue group. Patients were divided into those with nonpliable (valve score > 8; group I) and pliable (score < or = 8; group II) valves. Although significant increases in mitral valve area were obtained in both groups, mitral valve area by planimetry was significantly lower in group I (1.49 +/- 0.46 vs 1.86 +/- 0.44 cm2; p < 0.05), whereas there was no difference in the amount of color Doppler mitral regurgitation (1.5 +/- 1.0 vs 1.2 +/- 0.7; p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
对235例有症状的风湿性二尖瓣狭窄年轻患者(平均年龄29±11岁)进行经皮球囊二尖瓣成形术(PBMV)的结果评估,并将单球囊Inoue技术与双球囊Mansfield技术进行比较。PBMV使Gorlin二尖瓣面积显著增加(从0.78±0.23增加至1.61±0.64cm²;p<0.001),纽约心脏协会心功能分级改善(从2.78±0.59降至1.28±0.58;p<0.001)。二尖瓣反流显著增加(从0.4±0.6增至1.3±1.0;p<0.001),但仅19例患者(8%)的反流严重(≥3+)。Inoue技术与Mansfield技术比较显示,PBMV后Inoue技术组的Gorlin二尖瓣面积显著更低(1.55±0.56 vs 1.74±0.74cm²;p<0.05),但Inoue技术组经彩色多普勒超声心动图检测的二尖瓣反流发生率更低(1.1±0.7 vs 1.5±0.8;p<0.05)。患者被分为瓣膜僵硬(瓣膜评分>8;I组)和瓣膜柔韧(评分≤8;II组)两组。虽然两组二尖瓣面积均显著增加,但I组经平面测量的二尖瓣面积显著更低(1.49±0.46 vs 1.86±0.44cm²;p<0.05),而彩色多普勒检测的二尖瓣反流程度无差异(1.5±1.0 vs 1.2±0.7;p=无显著性差异)。(摘要截断于250字)