经皮球囊导管二尖瓣成形术治疗风湿性二尖瓣狭窄的长期随 …

目的 评价经皮球囊导管二尖瓣成形术（ＰＢＭＶ）治疗风湿性二尖瓣狭窄（ＭＳ）的远期疗效。方法 自１９８９年５月至１９９７年１２月对风湿性ＭＳ３３６例患者采用Ｉｎｏｕｅ法行ＰＢＭＶ，对成功的３３０例进行８年的随访，每年随访１次，根据临床症状，心尖部期杂音及第一心音的强度改变、心功能、二维及多普勒超声心动图检测的二尖瓣口面积判断远期疗效。随访时二尖瓣口面积经ＰＢＭＶ后增加的面积缩小５０％以上为再狭窄。结

Long-term follow up of percutaneous balloon mitral valvuloplasty in patients with rheumatic mitral stenosis

Objective To evaluate the long term effect of percutaneous balloon mitral valvuloplasty (PBMV) in patients with rheumatic mitral stenosis (MS). Methods From May 1989 to December 1997 PBMV was performed with Inoue technique in 336 patients, and follow up with a duration of 8 years was done in 330 successful cases once a year. Long term effect after PBMV was evaluated according to clinical symptoms, cardiac function, change of diastolic murmur in apex and loudness of first sound, and two dimmensional and Doppler echocardiography. Results Restenosis occurred in 52 cases totally with a restenosis rate of 16%, among them 44 cases (85%) developed restenosis in 5 years. Small mitral orifice area (MVA) before and less dilatation of MVA after PBMV may be the factors related to restenosis. Ten cases of restenosis underwent PBMV once again successfully. Mitral valvular replacement (MVR) was performed in 4 patients due to decrease of cardiac function. Mitral regurgitation occurred in 6 patients after PBMV, 3 of them also underwent MVR. The cardiac murmur of iatrogenic atrial septal defect in 7 cases decreased during the follow up. Conclusion The PBMV for treatment of rheumatic MS has a good long term clinical effect. Patients with restenosis still have hope to receive PBMV once again as long as they have indications of PBMV.