Lau K W, Ding Z P, Hung J S
Department of Cardiology, Singapore Heart Centre, Singapore.
Cathet Cardiovasc Diagn. 1996 May;38(1):1-7; discussion 8. doi: 10.1002/(SICI)1097-0304(199605)38:1<1::AID-CCD1>3.0.CO;2-E.
The present study compares the outcome of percutaneous Inoue-balloon mitral valvuloplasty performed in 21 patients with (group A) and 83 patients without (group B) preexisting moderate mitral regurgitation, using our height-derived balloon-sizing method. All procedures were successfully completed without untoward complications. The immediate increments in mitral valve area measured by echocardiographic methods and optimal valvuloplasty results were significantly higher in group B compared with group A (0.9 cm2 vs. 0.7 cm2, P = 0.01, and 99% vs. 90%, P = 0.007, respectively). No patients in either group sustained a final grade > or = 3/4 angiographic mitral regurgitation. A mild increase in mitral regurgitation was encountered more commonly in group B than in group A patients (22% vs. 0%, P = 0.03). At a mean follow-up of 19-20 months, the substantial majority of patients (> or = 90%) in both groups continued to experience maintained symptomatic benefits. In conclusion, our preliminary data seem to indicate that percutaneous Inoue-balloon mitral valvuloplasty using our height-derived balloon-sizing method in the stepwise dilatation approach in selected patients with significant mitral stenosis and concomitant moderate mitral regurgitation is associated with a low risk of developing severe mitral regurgitation, with effective mitral valve enlargement, and with sustained midterm symptomatic benefits.
本研究采用我们基于身高得出的球囊尺寸测量方法，比较了21例存在中度二尖瓣反流的患者（A组）和83例不存在中度二尖瓣反流的患者（B组）接受经皮Inoue球囊二尖瓣成形术的结果。所有手术均成功完成，未出现不良并发症。通过超声心动图方法测量的二尖瓣瓣口面积即时增加值以及最佳成形术结果，B组均显著高于A组（分别为0.9平方厘米对0.7平方厘米，P = 0.01；99%对90%，P = 0.007）。两组均无患者最终出现≥3/4级的血管造影二尖瓣反流。B组患者二尖瓣反流轻度增加的情况比A组更为常见（22%对0%，P = 0.03）。平均随访19 - 20个月时，两组中绝大多数患者（≥90%）仍持续有症状改善。总之，我们的初步数据似乎表明，在选定的有严重二尖瓣狭窄并伴有中度二尖瓣反流的患者中，采用我们基于身高得出的球囊尺寸测量方法并采用逐步扩张法进行经皮Inoue球囊二尖瓣成形术，发生严重二尖瓣反流的风险较低，二尖瓣有效扩大，且中期症状持续改善。
