高龄二尖瓣狭窄患者经皮二尖瓣球囊扩张术治疗的疗效分析

目的：分析60岁以上二尖瓣狭窄的患者行经皮二尖瓣球囊扩张术（percutaneousballoonmitralvalvuloplasty，PBMV）治疗的安全性和临床效果。方法：29例60岁以上二尖瓣狭窄的患者，食道超声示未见左房血栓后，采用Ross法穿刺房间隔，用Inoue球囊进行扩张，所有患者术前、术后应用体表超声心动图监测其二尖瓣瓣口面积、跨瓣压差、左心房直径、左心房平均压。肺动脉压力以及二尖瓣反流与否。手术后24h、1个月、6个月应用体表超声心动图随访。结果：29例患者均成功实施球囊扩张术，术后及随访6个月时左心房平均压、左心房直径、肺动脉压力较术前均降低，差异有统计学意义（P〈0．05）。1例术前二尖瓣轻微反流，术后为轻度到中度反流。29例患者术后心功能均得到明显改善，舒张期杂音完全消失或减弱。结论：对于瓣膜无明显钙化、瓣下结构超声心动评分≤6分、心功能Ⅲ级以上、合并其他瓣膜病变较轻的老年患者，PBMV同样可以取得较好的疗效。

Percutaneous Mitral Valvuloplasty with Inoue Balloon Catheter in Senile Patients

Objective：To evaluate the clinical effects and safety of percutaneous mitral saccular dilation on mitral stenosis in senile patients. Methods： A total of 29 cases of mitral stenosis who were older than 60 years have been identified no thrombus in left atrium. After interatrial septum puncturation and dilation with Inoue saccule,each patient was examined with echocardiography about mitral valve orifice area, diameter of left atrium,pressure of left atrium, regurgitation of mitral valve and pulmonary artery pressure at 24 h,1 month, 6 months after operation. Results： The average pressure of left atrium and diameter of left atrium ,pulmonary artery pressure decreased after operation （P〈0.05）. Conclusions： Percutaneous mitral saccular dilation has good effect on senile cases of rheumatic heart disease.