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目的 探讨经皮经房间隔穿刺二尖瓣扩张治疗老年和老年前期患者二尖瓣狭窄的临床意义。方法 86例患者采用一步法经皮经房间隔穿刺球囊扩张治疗二尖瓣狭窄。手术前后分别记录右心房压、左心房压、肺动脉压 ,二尖瓣口面积 ,并进行手术后随防。结果 86例患者中 83例治疗成功 ,3例失败 ,其中 1例为术中急性心包填塞 ,2例术后出现中度二尖瓣反流。术后即刻 ,左心房压、肺动脉压下降 ,二尖瓣口面积增加 ,心功能改善。 4 2例患者随访(4 .4± 2 .1)年 ,1例出现再狭窄 ,1例原因不明猝死 ,1例因二尖瓣反流行瓣膜置换术 ,其余患者心功能和生活质量明显改善。结论 对年龄≥ 5 0岁伴轻度二尖瓣和 (或 )主动脉瓣反流 ,瓣膜钙化或瓣下结构病变的二尖瓣狭窄患者 ,可安全有效地施行球囊二尖瓣成形术。
Objective To investigate the clinical significance of percutaneous transthoracic echocardiography in the treatment of mitral stenosis in elderly and elderly patients. Methods Eighty - six patients underwent transcutaneous atrial septal puncture and balloon dilation to treat mitral stenosis. Before and after surgery were recorded right atrial pressure, left atrial pressure, pulmonary artery pressure, mitral orifice area, and with the anti-surgery. Results Of the 86 patients, 83 were successfully treated and 3 failed. One patient had an acute pericardial tamponade and two had mild postoperative mitral regurgitation. Immediately after surgery, left atrial pressure, pulmonary pressure drop, mitral valve area increased, cardiac function improved. In 42 cases of patients followed up (4.4 ± 2.1) years, 1 case had restenosis, 1 case died of sudden unexplained death and 1 case had valvular replacement due to mitral valve regurgitation. The cardiac function and quality of life of other patients were significantly improved. Conclusions Balloon mitral valvuloplasty can be performed safely and effectively in patients with mitral stenosis of ≥50 years of age with mild mitral and / or aortic regurgitation, valvular calcification or subvalvular lesions.