Catheter balloon valvuloplasty of the mitral valve in adults using a double-balloon technique. Early hemodynamic results.
Catheter balloon valvuloplasty of the mitral valve in adults using a double-balloon technique. Early hemodynamic results.
复制标题
使用双球囊技术对成人二尖瓣进行导管球囊瓣膜成形术。
DOI：
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发表时间：
1987
期刊：
影响因子：
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通讯作者：
S. Rahimtoola
中科院分区：
文献类型：
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作者：
C. McKay;D. Kawanishi;S. Rahimtoola
使用双球囊技术对 12 名有症状的风湿性二尖瓣狭窄患者（平均年龄 43 岁）进行了导管球囊瓣膜成形术 (CBV)。使用两个扩张球囊，其中直径大约等于所确定的二尖瓣环直径。 CBV后，所有患者的平均二尖瓣梯度下降（平均+/- SD，16 +/- 6至5 +/- 2 mm Hg），平均左心房压力下降（29 +/- 7至16 +/- 4 mm Hg），心输出量增加（4.4 +/- 1.2至5.5 +/- 1.4 L/min）。二尖瓣面积从 1.0 +/- 0.3 cm2 增加到 2.4 +/- 0.8 cm2。血氧测定显示，两名患者存在较小的左向右分流，肺与体循环血流比率分别为 1.4:1 和 1.3:1。二尖瓣反流没有增加。在随后的 24 小时内记录了平均肺动脉压和肺血管阻力的逐渐下降。我们的患者在 CBV 两天后出院。 12 名患者中有 11 名的纽约心脏协会功能分级有所改善。我们的结论是，使用双球囊技术进行 CBV 可以有效缓解二尖瓣阻塞，降低肺动脉压升高，并减轻选定的有症状二尖瓣狭窄成年患者的症状。
Catheter balloon valvuloplasty (CBV) using the double-balloon technique was performed on 12 symptomatic patients (mean age, 43 years) with rheumatic mitral valve stenosis. Two dilatation balloons were used in which the diameters approximately equaled the mitral valve anulus diameter as determined. After CBV, the mean mitral valve gradient decreased in all patients (mean +/- SD, 16 +/- 6 to 5 +/- 2 mm Hg), the mean left atrial pressure decreased (29 +/- 7 to 16 +/- 4 mm Hg), and the cardiac output increased (4.4 +/- 1.2 to 5.5 +/- 1.4 L/min). The mitral valve area increased from 1.0 +/- 0.3 to 2.4 +/- 0.8 cm2. Oximetry demonstrated small left to right shunts of pulmonary to systemic flow ratios of 1.4:1 and 1.3:1 in two patients. Mitral regurgitation did not increase. Gradual decreases in mean pulmonary artery pressures and pulmonary vascular resistance were recorded over the subsequent 24 hours. Our patients left the hospital two days after CBV. The New York Heart Association Functional Class improved in 11 of 12 patients. We conclude that CBV using the double-balloon technique effectively relieves mitral valve obstruction, reduces elevated pulmonary pressures, and reduces symptoms in selected adult patients with symptomatic mitral stenosis.