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Title: [Mid- and long-term outcomes of percutaneous balloon mitral valvuloplasty guided solely by echocardiography].
Author: Zhao YA, Li WC, Wei PJ, Yan YM, Li H, Chang JK, Cui JN, Zhang FW, Fang F, Li SG, Dong J, Zhao GZ, Ouyang WB, Pan XB.
Journal: Zhonghua Yi Xue Za Zhi; 2024 Oct 15; 104(38):3575-3579. PubMed ID: 39414585.
Abstract:
Objective: To evaluate the mid-and long-term clinical outcomes of percutaneous balloon mitral valvuloplasty (PBMV) guided solely by echocardiography. Methods: A total of 71 patients with moderate to severe mitral stenosis who underwent PBMV guided solely by echocardiography at Fuwai Hospital, Chinese Academy of Medical Sciences, from January 2016 to December 2022 were retrospectively included. The clinical data and follow-up information were collected and analyzed. Results: Finally, 71 patients (11 males and 60 females) aged (48.6±12.4) years, including 3 pregnant women were included. One patient required surgical intervention due to moderate to severe mitral regurgitation, resulting in a procedure success rate of 98.6% (70/71). The procedural duration was (84.1±40.2) minutes, with the balloon diameter of (26.5±1.1) mm and number of dilatations of 2.9±0.7. The mean mitral transvalvular pressure gradient decreased from (12.6±6.1) mmHg (1 mmHg=0.133 kPa) preoperatively to (5.4±2.4) mmHg postoperatively, while the mitral valve orifice area increased from (0.9±0.2) cm² to (1.7±0.3) cm² (both P<0.001). Before discharge, 16 patients developed new mild mitral regurgitation, five developed new moderate mitral regurgitation, and one patient had a small amount of pericardial effusion absorbed by herself. No severe complications such as death, pericardial tamponade, or thromboembolism occurred during the perioperative period. The average follow-up duration was 12-84 (49.7±21.4) months. At two years postoperatively, the mean mitral transvalvular pressure gradient was (6.2±2.5) mmHg, and the mitral valve orifice area was (1.6±0.3) cm². Eight patients underwent surgical mitral valve replacement at an median of [M(Q₁, Q₃)] 18 (5, 53) months postoperatively, and one patient died during the follow-up period due to non-cardiac reasons. Conclusion: The mid-and long-term outcomes of PBMV guided solely by echocardiography are favorable. 目的： 评价单纯超声心动图引导下经皮二尖瓣球囊扩张术（PBMV）的中远期临床效果。 方法： 回顾性纳入2016年1月至2022年12月中国医学科学院阜外医院因中重度二尖瓣狭窄接受单纯超声心动图引导下PBMV的患者。收集患者的基线资料、手术资料和术后随访数据，分析手术效果和安全性。 结果： 共纳入71例患者，其中男11例，女60例，年龄（48.6±12.4）岁。所有患者（含3例孕妇）均在单纯超声心动图引导下完成PBMV，其中1例患者因二尖瓣中重度关闭不全接受外科手术治疗，手术成功率98.6%（70/71）。手术时间（84.1±40.2）min，球囊直径（26.5±1.1）mm，扩张次数（2.9±0.7）次。二尖瓣平均跨瓣压差由术前（12.6±6.1）mmHg（1 mmHg=0.133 kPa）降低至术后的（5.4±2.4）mmHg，二尖瓣瓣口面积由术前（0.9±0.2）cm²增加至术后的（1.7±0.3）cm²，差异均有统计学意义（均P<0.001）。16例患者出院前超声复查出现新发二尖瓣轻度反流，5例出现新发二尖瓣中度反流，1例出现少量心包积液自行吸收，未出现死亡、心包填塞、血栓栓塞等严重手术并发症。患者术后随访时间12~84（49.7±21.4）个月，术后2年二尖瓣平均跨瓣压差为（6.2±2.5）mmHg，二尖瓣瓣口面积为（1.6±0.3）cm²。8例患者于术后［M（Q₁，Q₃）］18（5，53）个月接受外科二尖瓣置换术，1例患者随访期间因非心脏原因死亡。 结论： 单纯超声心动图引导下PBMV中远期效果良好。.

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