窦性心律下成功经皮球囊二尖瓣成形术后中重度功能性三尖瓣反流的远期随访  

Long term outcome of moderate or severe functional tricuspid regurgitation after successful percutaneous balloon mitral valvuloplasty in sinus rhythm

作　　者：侯亚敏[1] 张现朝[1] 欧知宏[1] 侯子山[1] 

机构地区：[1]山东省临沂市人民医院心内科,山东临沂276003

出　　处：《临床心血管病杂志》2015年第9期989-992,共4页Journal of Clinical Cardiology

摘　　要：目的：旨在评价窦性心律下二尖瓣狭窄（MS）伴中重度功能性三尖瓣反流（FTR）经皮球囊二尖瓣成形术（PBMV）的远期疗效及FTR变化情况。方法：我院自2000-01-2012-01期间76例窦性心律的MS伴中重度FTR患者,采用Inoue球囊法行PBMV,进行远期随访。术后FTR降至轻度及轻度以下患者称为逆转,仍为中重度FTR称为残留。结果：手术成功率为96.1%。64例患者PBMV后平均随访65.32±32.02（12~132）个月,再狭窄率28.1%,无事件生存率为82.8%,三尖瓣反流逆转率为65.6%。与术前相比,术后即刻及随访右心室舒张末内径（P〈0.01）、三尖瓣反流束面积明显减小（P〈0.001）;二尖瓣瓣口面积显著增大（MVA）（P〈0.01）;三尖瓣反流程度明显减轻（P〈0.001）。结论：大多数窦性心律下二尖瓣狭窄伴中重度FTR行PBMV后,FTR可以逆转并获得良好的远期效果。Objective：To investigate the change of functional tricuspid regurgitation（FTR）and clinical outcomes after percutaneous balloon mitral valvuloplasty（PMBV）in patients with moderate or severe FTR who were in sinus rhythm.Method：From January 2001 to January 2012,76 patients of rhematic mitral value stenosis with moderate or severe FTR who were in sinus rhythm were treated by PBMV in our hospital.The long term efficacy was followed-up.At follow up,FTR regressed to trace or mild FTR were called regression,and FTR was still moderate or severe were called residue.Result：The success rate of PBMV was 96.1%,Follow-up study was carried out in 64 patients for 12-132（65.32±32.02）months.The rate of restenosis was 28.1%.The event-free survival was 82.8% and the rate of FTR regression was 65.6%.The right ventricular end diastolic diameter（all P〈0.01）and the jet area（all P〈0.001）were significantly smaller,and the area of mitral valve orifice（MVA）（all P〈0.01）was obviously larger after operation and at follow up than it was before the operation.Tricuspid regurgitation（all P〈0.001）was significantly diminished after operation.Conclusion：PBMV can achieve well long-term results in most of patients with moderate or severe functional tricuspid regurgitation who were in sinus rhythm.But tricuspid regurgitation still residue in some patients after successful PBMV.

关 键 词：二尖瓣狭窄 三尖瓣反流 窦性心律 经皮球囊二尖瓣成形术 

分 类 号：R541.1[医药卫生—心血管疾病]