[经皮二尖瓣球囊成形术中Inoue单球囊与双球囊的比较研究。即刻结果及1年随访后结果]

[Comparative study between inoue single balloon and double balloon in percutaneous mitral valvuloplasty. Immediate results and after 1 year follow-up].

作者信息

Cardoso L F, Grinberg M, Patrício M, Neves Rati M A, Medeiros C C, Tarasoutchi F, Avila W S, Rossi E G, Bellotti G

机构信息

Instituto do Coração do Hospital da Clínicas-FMUSP, São Paulo, SP.

出版信息

Arq Bras Cardiol. 1996 Apr;66(4):213-6.

PMID:8935686

Abstract

PURPOSE

To compare early and 12 months results of mitral stenosis (MS) correction by percutaneous balloon valvuloplasty (PMBV) using Inoue's single-balloon or double balloon techniques.

METHODS

We submitted 139 consecutive patients to PMBV using Inoue single-balloon (n = 56, GI) or the double balloon technique (n = 83, GII). The two groups were similar, in: age, sex, functional class (FC), echocardiographic (ECHO) score, mitral valve area (MVA), and gradient (G) or presence of regurgitation. Clinical and ECHO data were compared before (PRE), immediately after (POI) and one year following the procedure (PO12M).

RESULTS

PMBV was successfully performed in 53 (95%) patients of GI and in 79 (96%) of GII. Statistical analyses showed that the groups were similar at POI but different at PO12M (p < 0.002). ECHO immediately after PMBV showed that: MVA increased from 0.99 +/- 0.23 to 2.01 +/- 0.44cm2 (p < 0.001) in GI and from 0.94 +/- 0.23 to 2.09 +/- 0.35cm2 (p < 0.001) in GII and G decreased from 11.58 +/- 5.02 to 5.16 +/- 2.23mmHg (p < 0.001) in GI and from 12.48 +/- 4.89 to 5.96 +/- 3.21mmHg (p < 0.001) in GII. After one year 36 (64%) patients in GI and 62 (74%) in GII underwent an ECHO study. A comparison between immediate and one year follow-up results showed that MVA decreased from 2.01 +/- 0.4 to 2.00 +/- 0.3cm2 (NS) in GI and from 2.09 +/- 0.3 to 1.74 +/- 0.4cm2 (p < 0.001) in GII and G decreased from 5.16 +/- 2.2 to 5.50 +/- 2.9mmHg (NS) in GI and from 5.96 +/- 3.2 to 8.61 +/- 4.8mmHg (p < 0.001) in GII. There was therefore a sustained improvement of MVA and G after one year in GI and a significant decrease in MVA and G in GII. The FC after one year was similar and satisfactory in both groups.

CONCLUSION

Both techniques are equally effective in relieving MS immediately after PMBV, but after one year, despite similar FC, Inoue-balloon technique seems to be superior to maintain MVA and G.

摘要

目的

比较采用井上单球囊或双球囊技术经皮二尖瓣球囊成形术（PMBV）矫治二尖瓣狭窄（MS）的早期及12个月结果。

方法

我们对139例连续患者进行了PMBV，其中采用井上单球囊技术（n = 56，第1组）或双球囊技术（n = 83，第2组）。两组在年龄、性别、功能分级（FC）、超声心动图（ECHO）评分、二尖瓣瓣口面积（MVA）、压差（G）或反流情况方面相似。比较术前（PRE）、术后即刻（POI）及术后1年（PO12M）的临床和ECHO数据。

结果

第1组53例（95%）患者和第2组79例（96%）患者PMBV成功实施。统计分析显示，两组在术后即刻相似，但在术后1年时不同（p < 0.002）。PMBV术后即刻的ECHO显示：第1组MVA从0.99±0.23增加至2.01±0.44cm²（p < 0.001），第2组从0.94±0.23增加至2.09±0.35cm²（p < 0.001），第1组G从11.58±5.02降至5.16±2.23mmHg（p < 0.001），第2组从12.48±4.89降至5.96±3.21mmHg（p < 0.001）。1年后，第1组36例（64%）患者和第2组62例（74%）患者接受了ECHO检查。即刻与1年随访结果比较显示，第1组MVA从2.01±0.4降至2.00±0.3cm²（无显著性差异），第2组从2.09±0.3降至1.74±0.4cm²（p < 0.001），第1组G从5.16±2.2升至5.50±2.9mmHg（无显著性差异），第2组从5.96±3.2升至8.61±4.8mmHg（p < 0.001）。因此术后第1组MVA和G持续改善，第两组MVA和G显著下降。两组术后1年的FC相似且均令人满意。