Ma C, Liu X, Hu D, Yang X, Shang L, Dong J, Sun Y
Beijing Red Cross Chao Yang Hospital, Capital University of Medical Sciences, PR China.
Chin Med J (Engl). 1995 Dec;108(12):883-6.
Percutaneous balloon mitral valvoplasty (PBMV) and radiofrequency catheter ablation (RFCA) have been used in the treatment of mitral stenosis (MS) and supraventricular tachycardia. The techniques of PBMV and RFCA yield better results with the development of interventional cardiology, but there is no report about PBMV performed simultaneously with RFCA in the same patient. Seven patients with mitral stenosis and Wollf-Parkinson-White (W-P-W) Syndrome were successfully treated with PBMV and RFCA by transseptal methods. LA, LAP, mPG and mPA were decreased from 43.4 +/- 4.6mm, 21.8 +/- 6.8mmHg, 21 +/- 7.7mmHg and 45.7 +/- 16.5mmHg to 39.2 +/- 3.7mm (P < 0.05), 12.7 +/- 4.5mmHg, 12 +/- 3.7mmHg and 32.3 +/- 9mmHg (P < 0.01). MVA was increased from 0.96 +/- 0.33cm2 to 1.7 +/- 0.80cm2 (P < 0.01). delta wave disappeared in 12-lead surface EKG and SVT could not be induced in electrophysiological study after the treatment. The overall time of the procedure for this series was 93 +/- 34 minutes and fluoroscopy time was 23 +/- 7 minutes on the average. Radiofrequency energy applications were 3 +/- 2 times each procedure. PBMV and RFCA are safe and highly effective in the treatment of MS and W-P-W syndrome. The results in the present study proved the feasibility of the combined use of PBMV and RFCA. We prefer a first choice of PBMV and then RFCA in order to avoid aggravation of the hemodynamics due to mitral stenosis. The results also showed that of overall procedure and fluoroscopy only took a short time for this series. We suggest that it could be used as a routine method for the treatment of mitral stenosis complicated by W-P-W syndrome.
经皮球囊二尖瓣成形术（PBMV）和射频导管消融术（RFCA）已用于二尖瓣狭窄（MS）和室上性心动过速的治疗。随着介入心脏病学的发展，PBMV和RFCA技术取得了更好的效果，但尚无关于在同一患者中同时进行PBMV和RFCA的报道。7例二尖瓣狭窄合并预激综合征（W-P-W）的患者通过经房间隔方法成功接受了PBMV和RFCA治疗。左心房（LA）、左心房压力（LAP）、平均跨瓣压差（mPG）和平均肺动脉压（mPA）分别从43.4±4.6mm、21.8±6.8mmHg、21±7.7mmHg和45.7±16.5mmHg降至39.2±3.7mm（P<0.05）、12.7±4.5mmHg、12±3.7mmHg和32.3±9mmHg（P<0.01）。二尖瓣口面积（MVA）从0.96±0.33cm²增加至1.7±0.80cm²（P<0.01）。治疗后12导联体表心电图上预激波消失，电生理检查不能诱发室上性心动过速。本系列手术的总时间平均为93±34分钟，透视时间平均为23±7分钟。每次手术射频能量应用次数为3±2次。PBMV和RFCA治疗MS和W-P-W综合征安全且高效。本研究结果证明了联合使用PBMV和RFCA的可行性。为避免二尖瓣狭窄导致血流动力学恶化，我们首选PBMV，然后进行RFCA。结果还表明，本系列手术的总时间和透视时间较短。我们建议，它可作为治疗合并W-P-W综合征的二尖瓣狭窄的常规方法。
