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自1984年Inoue等首次应用经皮二尖瓣球囊成形术(PBMV)治疗二尖瓣狭窄以来,已收到显著的临床效果,然而,PBMV术后二尖瓣返流(MR)仍难以完全避免。它的转归,临床意义如何?现分析我科5年来完成45例经皮二尖瓣球囊成形术后,部分病人产生不同程度的二尖瓣返流的情况报道如下。 1 资料与方法 1.1 临床资料:我科近5年为风湿性心瓣膜病二尖瓣狭窄患者行改良Inoue球囊成形术45例。其中男13,女32例,年龄在19～49岁之间,平均34.1±8.07岁。风心病史4～20年。合并轻度二尖瓣关闭不全12例,合并轻度主动脉瓣关闭不全2例,并发房颤2例。近期均无风湿活动史。术前、术后由心血管专业主治医师以上二人听取心尖部收缩期杂音估计二尖瓣返流程度,按NYHA四级分类法评估患者的心功能。
Since Inoue and his colleagues first applied percutaneous balloon mitral valvuloplasty (PBMV) to treat mitral stenosis in 1984, a significant clinical benefit has been achieved, however, postoperative PBMV mitral regurgitation (MR) remains difficult to complete avoid. Its outcome, clinical significance? Now analysis of our department in 5 years to complete 45 cases of percutaneous balloon mitral valvuloplasty, some patients have different degrees of mitral regurgitation are reported below. 1 Materials and Methods 1.1 Clinical data: In recent 5 years, our department for rheumatic mitral stenosis patients with mitral stenosis improved Inoue balloon angioplasty in 45 cases. Among them, 13 were males and 32 were females, ranging in age from 19 to 49 years with an average of 34.1 ± 8.07 years. Heart disease history of 4 to 20 years. 12 cases with mild mitral regurgitation, 2 cases with mild aortic regurgitation, and 2 cases complicated with atrial fibrillation. No recent history of rheumatic activity. Preoperative and postoperative cardiologist by the above two physicians to listen to apical systolic murmur to estimate the degree of mitral regurgitation, according to NYHA four-class classification of patients with cardiac function.