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排序方式: 共有723条查询结果,搜索用时 234 毫秒
1.
Mohamed Eid Fawzy Mohamed Shoukri Walid Hassan Vijayaraghavan Nambiar Miltiadis Stefadouros Charles C Canver 《Catheterization and cardiovascular interventions》2007,69(1):40-46
BACKGROUND: The effect of mitral valve morphology (MVM) on the long-term results of mitral balloon valvuloplasty (MBV) is not well established. The aim of the study was to evaluate the impact of MVM on long-term outcome of MBV. METHODS: Five hundred and eighteen consecutive patients (mean age, 31+/-11 years) who underwent successful MBV were followed up for 0.5-16.5 (mean, 6+/-4.5) years. Patients were divided into two groups according to their mitral echo score (MES) before MBV: group A (n=340; MES8). RESULTS: We report the immediate and long-term clinical and echocardiographic results of the above-mentioned 518 consecutive patients. The mitral valve area was significantly larger in group A than in group B, both immediately after MBV (2.0+/-0.3 vs. 1.82+/-0.3 cm2, respectively; P<0.0001) and also at the last follow-up (1.8+/-0.33 vs. 1.5+/-0.33 cm2, respectively; P<0.0001). Restenosis occurred in 38/340 (11%) in group A vs. 73/178 (41%) in group B (P<0.0001). Actuarial freedom from restenosis at 5, 10, 15 years were 92+/-2%, 85+/-3%, 65+/-6% for group A vs. 72+/-4%, 44+/-5%, 9+/-6% for group B (P<0.001). Event-free survival rates at 5, 10, 15 years for group A were 93+/-1%, 88+/-2%, 66+/-6% vs. 82+/-3%, 59+/-6%, 8+/-7% for group B (P<0.0001). Stepwise Cox multivariate regression analysis identified MES, preprocedure functional class, and postprocedure mitral valve area相似文献
2.
V Legrand J Beckers M Fastrez P Marcelle C Marchal H E Kulbertus 《European heart journal》1991,12(3):451-457
Early and late prognosis after percutaneous balloon aortic valvuloplasty (PBAV) was assessed in 38 consecutive elderly patients (mean age, 78.5 +/- 6.1 years). Significant valve opening was achieved in 35 patients. The hospital mortality was 8% (three patients); two other patients died within the first month and three underwent aortic valve replacement. At 2 years follow-up, there were 10 additional deaths (seven cardiac deaths) and five patients had symptom recurrence managed by aortic valve replacement (3) or repeat PBAV (2). Overall, six patients underwent surgery without untoward events and six had repeat PBAV. Only two out of six patients with repeat PBAV had sustained improvement; one was referred to surgery and the remaining three died soon after the second PBAV. One- and 2-year survival were respectively 72 and 62% and percentage of survivors with persistent improvement 68 and 41%. Although aortic valve area after PBAV was associated with outcome, predictors of poor long-term prognosis were primarily related to the pre-operative haemodynamic status. Patients with pulmonary resistances greater than 400 dynes cm-1 s-5 had the poorest outcome (chi 2 = 18.4-P less than 0.0001). Overall, signs of heart failure were predictors of poor long term follow-up. These data indicate that long-term success of PBAV is mainly related to the left ventricular dysfunction noted prior to intervention. 相似文献
3.
Twenty-two percutaneous transluminal balloon valvuloplasty procedures were performed on 21 patients with congenital pulmonary valve stenosis. The peak systolic pressure gradient was immediately reduced from 79.1 +/- 7.4 to 22.2 +/- 1.8 mmHg, (P less than 0.0001) and follow-up cardiac catheterization at 5.3 +/- 0.4 months in 19 patients revealed no further significant change in gradient (23.5 +/- 3.2 mmHg). The best results were obtained when balloons larger than the pulmonary annulus were used, i.e. an immediate residual transvalvular gradient of 22.0 +/- 2.2 mmHg with a balloon/annulus ratio greater than 1, as opposed to 44.2 +/- 5.4 with a balloon/annulus ratio = 1 (P less than 0.001). The angiographically determined cusp thickness of the stenotic pulmonary valves was significantly greater than that of the control group of 24 patients without pulmonary valve stenosis (1.21 +/- 0.09 vs 0.59 +/- 0.02 mmHg, P less than 0.00001). The relationship between this parameter and the residual transvalvular gradient at follow-up was found to be significant (r = 0.77, P less than 0.001). It is concluded that balloon size is a determinant factor in achieving good results with percutaneous balloon valvuloplasty although cusp thickness, a factor to which scant regard has hitherto been paid, also plays a significant role in the residual transvalvular gradient measured at follow-up. 相似文献
4.
J Thompson Sullebarger Humberto Coto Enrique Lopez Dany Sayad Hector L Fontanet 《Catheterization and cardiovascular interventions》2003,59(2):261-265
Percutaneous transvenous mitral commissurotomy was performed successfully via the transjugular approach in a patient with severe rheumatic mitral stenosis and obstruction of the inferior vena cava due to prior liver transplantation. This case demonstrates the advantage of the jugular approach in patients with difficult anatomy. 相似文献
5.
本文报告经皮球囊二尖瓣成形术治疗二尖瓣狭窄12例。10例术前平均左房压为18mmHg~40mmHg(26.7±7.15mmHg),术后即刻为4mmHg~18mmHg(10.6±3.86mmHg)P<0.01。跨瓣压差术前10mmHg~40mmHg(19.6±9.05mmHg),术后为0~5mmHg(2.65±2.21mmHg)P<0.01。1例失败,1例术后发生二尖瓣关闭不全急性左心衰竭死亡。 相似文献
6.
目的:应用彩色多普勒超声心动图指导经皮二尖瓣球囊成形术(PBMV)治疗风湿性二尖瓣狭窄的价值、方法:运用彩超对行PBMV的患进行术前术后检查,观察二尖瓣钙化程度及部位、开口形状、瓣口面积、二尖瓣返流(MR)程度、瓣下病变、左房左室大小、左房有无血栓.结果:91例PBMV术后患中,术后MR72例,其中MR新出现19例,MR加重8例、与术前对比,术后二尖瓣开放幅度、二尖瓣口面积、二尖瓣跨瓣压、二尖瓣压差半降时间较术前有明显改善趋势,左房内径、肺动脉内径较术前有缩小趋势.同时,术后左房压、右室压及肺动脉压也有下降趋势。结论:彩超能明确PBMV治疗二尖瓣狭窄的效果。影响:PBMV效果的因素较多,但二尖瓣钙化的程度、部位和瓣膜形态较为重要。 相似文献
7.
Objective To assess the effect of the balloon valvuloplasty for congenital valvular aortic stenosis (AS) in children.Methods A total of 27 (mean age 6.09 years) children with AS accepted the treatment of percutaneous balloon aortic valvuloplasty (PBAV).The ratios of balloon/valve were 0.95±0.08 for 19 cases of typical AS and 1.00±0.11 for 8 cases of hyp oplastic AS.The patients were evaluated by the gradients across aotic valves i n pre- and post-PBAV and by echocardiogram during the follow-up period.Results Fifteen of 19 (78.9%)cases of typical AS had a better outcome and the gradien t of the remaining 4 cases (26.7%) had increased after follow-up (ΔP>50 mm Hg).Four of 8 (50.0%) cases of hypoplastic AS had satisfactory responses and the gradient of the remaining 3 cases (75.0%) rose.There was no moderate to s evere aortic insufficiency (AI). Conclusion The balloon aortic valvuloplasty provides safe and significant hemodynamic and c linical improvement in pediatric patients.The outcome of PBAV for typical AS is better than for hypoplastic AS. 相似文献
8.
目的为在二尖瓣成形术中准确迅速判断瓣环和瓣叶病损的部位及程度,提高二尖瓣成形术的成功率。方法解剖测量30例国人正常新鲜心脏的二尖瓣,术中观察二尖瓣病理变化特点后研制了一种新型二尖瓣成形测瓣器。结果用测瓣器行二尖瓣成形术35例,成形手术时间由原来的(57±11)min减少到(35±15)min,手术死亡率由11%下降到3.3%。结论使用此种测瓣器可使二尖瓣成形术省时、准确,成功率明显提高。 相似文献
9.
10.
经皮球囊二尖瓣成形术10年临床经验 总被引:3,自引:1,他引:2
目的:旨在研究本院400 例经皮球囊二尖瓣成形术10 年的临床经验。 方法:采用改良的Inoue 方法。 结果:经皮球囊二尖瓣成形术即刻成功率98.3% (344/350),术后二尖瓣面积明显增加,达(1.11±0.29)~(2.19±0.40)cm 2。105 例随访9个月~8 年6 个月,二尖瓣再狭窄率为11.4% (12/105),死亡率为2.9% (3/105),二尖瓣置换术为3.8% (4/105)。 结论:经皮球囊二尖瓣成形术近、远期疗效均很好 相似文献