分级次二尖瓣球囊扩张术治疗重度二尖瓣狭窄伴心房颤动的临床研究

为评价分级扩张法行经皮穿刺二尖球囊扩张术（PBMV）的临床疗效。采用分级次扩张法对52例风湿性二尖瓣狭窄（MS）患者进行,分重度MS伴心房颤动（AF）组和中，重度MS无AF组。根据身高2确定首次扩张直径，每次递量0.5-1mm，直至疗效满意。术前，术后进行二维超声和多普勒，血流动力学检查。结果显示，52例PBMV均获成功，术后血流动力学明显改善，心功能明显提高，无重要并发症发生，两组间比较无明显差异。提示分级次扩张法可有效预防二尖瓣反流，低心排，急性左心衰，栓塞等并发症，并获得良好效果，尤其对重度MS伴AE者，不失为一种理想的治疗方法。

Gradual percutaneous balloon mitral valvuoplasty on severe mitral stenosis with atrial fibrillation through

To appraise the clinical effect of gradual percutaneous balloon mitral valvuloplasty(PBMV).52 patients with mitral stenosis (MS) of atrial fibrillation were divided into two groups,one group was severe mitral stenosis with atrial fibrillation,another group was middling and severe mitral stenosis without atrial fibrillation.The first expanding diameter was confirmed according to patients' hight,then increased 0.5~1mm every time until better effect.Before and after operation,the patients were examined by the dynamics of blood stream and two dimensional doppler echocardiography.Result showed that 52 patients were succeeded in operation.The left ventricular function,the power of blood were all improved obviously,and was no serious complication.There was no difference between two groups.This suggests that the PBMV prevented effectively complication,such as low cardiac output,mitral incompetence,acute heart failure,thrombosis etc,and got a good effect.It is a value treatment for severe mitral stenosis with atrial fibrillation.