二尖瓣狭窄球囊成形术对瓣口面积和左心房、左心室压力及内径的影响

目的 :观察经皮球囊二尖瓣成形术 (PBMV)前后二尖瓣口面积 (MVA)和左心房左心室压力及内径的关系。方法 :2 8例手术成功二尖瓣狭窄患者分成中度狭窄组 (15例 ,A)和重度狭窄组 (13例 ,B) ,对其术前术后指标进行检验和直线回归统计分析。结果 :1周内A组左心房内径和B组左心室内径变化不明显 (P >0 0 5 ) ,A组的左心房内径缩小值 ,左心房压力下降值 ,MVA扩大值、扩大率均 B组 (P <0 0 1) ,其余指标无差异 (P >0 0 5 ) ;术前MVA与术后MVA扩大率 ,左心房内径变化有显著相关性 (P <0 0 1)影响术后左心房大小的因素主要是术前MVA ,术前左心房内径和术后MVA扩大率。据术前MVA的大小可估计术后MVA、左心房、左心室压力和内径的变化。结论 :PBMV可显著的改善患者的血流动力学指标 ,在重度二尖瓣狭窄患者更明显 ,有适应征者应积极进行此项手术治疗。

EFFECTION OF PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY ON MITRAL VALVE AREA PREESURE ANDDIAMETRE OF LEFT ATRIUM AND VENTRICLE

Objective:To evaluate the correlation of mitral valve area with pressure and diameter of left atrium and ventricle before and after percutaneous balloon mitral valvuloplasty (PBMV).Methods:The patients(n=28) were divided into 15 patients with moderate stenosis mitral as group A and 13 patients with severe stenosis mitral as group B.Linear regression analysis and test were performed to evaluate the variances before and after the procedure.Results:The variance of left atrium diameter in group A and left ventricular diameter in group B were not significant(P>0.05).The reduction of left atrium pressure and increment of mitral valve area in group A were smaller(P<0.01).The increment of left ventricular was greater(P<0.01);the other values were not significantly different(P>0.05). The variance of left atrium diameter was significantly correlated with the increment of MVA,left atrium diameter and MVOD,Post-operative MVA, LAP, LAD, LVD may be evaluated by pre-operative MVA.Conclusion:PBMV produce excellent homodynamic improvement especially in patients with severe mitral stenosis.