摘要
目的 评估风湿性心脏病二尖瓣狭窄 (风心二狭 )伴严重肺动脉高压的经皮球囊导管二尖瓣扩张术疗效 ;以超声多普勒检查观察术后近期的肺动脉压变化。方法 4 2例风心二狭伴严重肺动脉高压 (肺动脉收缩压≥ 75mmHg)患者以标准Inoue技术行经皮二尖瓣扩张术 ,并测定随访期临床心功能和多普勒超声肺动脉收缩压的变化。结果 39例扩张术成功 (93% )。术后二尖瓣瓣口面积自 (0 .83±0 .12 )cm2 增至 (1.75± 0 .11)cm2 ,肺动脉收缩压自 (85± 7)mmHg降至 (6 1± 13)mmHg(P值均 <0 .0 0 1)。3例并发严重二尖瓣返流 ,其中 1例行二尖瓣置换术。在平均 6个月的随访中 ,39例成功扩张者 ,尽管二尖瓣瓣口面积无显著改变 ,但临床心功能明显改善 ,肺动脉收缩压进一步降低。结论 风心二狭伴严重肺动脉高压患者行经皮球囊导管扩张术安全、有效。术后短期内肺动脉收缩压继续减低 ,临床心功能进一步改善。
Objective To determine the safety and efficacy of percutaneous balloon mitral valvuloplasty (PBMV) for patients with mitral stenosis and severe pulmonary hypertension, and to assess the changes in pulmonary systolic pressure during follow up. Methods Forty two patients with rheumatic mitral stenosis and severe pulmonary hypertension (pulmonary systolic pressure >75mmHg) underwent PBMV using standard Inoue technique, and the changes in clinical functional status and echo Doppler pulmonary systolic pressure during follow up were assessed. Results PBMV was successful in 39 patients. Immediately after the procedure, mitral valve area increased from (0.83±0.12)cm 2 to (1.75±0.11)cm 2 ,pulmonary systolic pressure decreased from (85±7)mmHg to (61±13)mmHg (all P <0.001). Severe mitral regurgitation occurred in 3 patients, one of whom underwent mitral valve replacement. During follow up(average 6 months), in 39 patients with successful PBMV, the clinical functional status was improved and pulmonary systolic pressure was further decreased despite unchanged mitral valve area.Conclusions PBMV was safe and effective for patients with mitral stenosis and severe pulmonary hypertension. Clinical functional status was improved and pulmonary systolic pressure was continuously decreased during the short term follow up.
出处
《介入放射学杂志》
CSCD
2002年第3期173-175,共3页
Journal of Interventional Radiology
关键词
二尖瓣狭窄
经皮二尖瓣成形术
肺动脉高压
Mitral stenosis
Pulmonary hypertension
Percutaneous mitral valvuloplasty
