摘要
目的 评价经皮二尖瓣球囊扩张术 (PBMV)在老年及瓣膜钙化程度重的患者中的 6个月效果。 方法 选择我院行PBMV患者 6 82例 ,以血液动力学评价术前及术后即刻左房压、肺动脉平均压、二尖瓣跨瓣压差及二尖瓣瓣口面积 ;超声心动图评价术前和术后 6个月二尖瓣口面积及跨瓣压差。 结果 PBMV有效缓解二尖瓣口的机械性狭窄 ,引起左房压、二尖瓣跨瓣压 ,肺动脉压力下降及二尖瓣口面积 (MVA)增加 ,两组患者均获益 ,老年组分别平均下降 (9 1± 1 1)mmHg、(10 9± 2 2 )mmHg、(9 1± 1 5 )mmHg、MVA增加 (0 5 2± 0 16 )cm2 ;非老年组分别为 (8 9± 2 4 )mmHg、(7 3± 0 8)mmHg、(7 3± 2 3)mmHg、MVA增加 (0 6 6± 0 11)cm2 。超声随访结果显示 ,PBMV疗效稳定。 结论 PBMV较为明显的改善二尖瓣狭窄症状 ,具有微创、低风险的特点。适用于瓣膜钙化重、条件差和高危围术期而不适合二尖瓣置换术的老年患者。
Objective To evaluate the middle term ( six months) effect of percutaneous balloon valvotomy(PBMV) in the old and heavy calcified case. Methods This was a prospective single center clinical trial. A total of 682 cases were performed in 702 consecutive procedures with Inoue PBMV. The hemodynamic evaluation criterias included left atrial (LA) pressure,mean pulmonary pressure (MPA),mean gradient across the mitral valve and calculation of mitral valve area(MVA) with Gorlin formula before and immediately after the balloon. The echocardiography assessment items before and six months after the balloon included the mitral valve area and mean gradient across the mitral valve. Results PBMV release the limit of mitral valve stenosis with result in the decrease of LA pressure,MPA and mean gradient across the mitral valve and increase of MVA respectively after the procedures(in older group (9.1±1.1)mm Hg,(10.9±2.2)mm Hg,(9.1±1.5)mm Hg,(0.52±0.16)cm 2 and non-older group (8.9±2.4)mm Hg,(7.3±0.8)mm Hg,(7.3±2.3)mm Hg,(0.66±0.11)cm 2 . Both benefited from procedure. The echocardiography six months follow-up result showed that the effect of PBMV was constant. Conclusions Inoue PBMV may be performed with less invasion,low risk and good hemodynamic results regardless the extent of calcification which is especially valuable for older patients in whom mitral valve replacement still carries a significant perioperative risk.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2004年第9期634-637,共4页
Chinese Journal of Geriatrics
