风湿性二尖瓣狭窄合并心房颤动的一站式介入治疗  

Clinical analysis of one-stop interventional therapy for rheumatic mitral stenosis combined with atrial fibrillation

作　　者：刘晓霞 王皓 汤日波[1] 刘念[1] 桑才华[1] 马长生[1] LIU Xiaoxia;WANG Hao;TANG Ribo;LIUNian;SANG Caihua;MA Changsheng(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,100029 [2]郑州大学附属洛阳中心医院心内科

出　　处：《心肺血管病杂志》2023年第7期645-650,共6页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:初步探讨经皮球囊二尖瓣成形术(percutaneous balloon mitral valvuloplasty,PBMV)联合导管射频消融(radiofrequency catheter ablation,RFCA)治疗风湿性二尖瓣狭窄(mitral stenosis,MS)合并心房颤动的有效性和安全性。方法:2018年1月至2022年9月,接受PBMV联合RFCA一站式治疗的风湿性MS合并抗心律失常药物抵抗的心房颤动患者8例,回顾性分析其临床资料,观察围术期及随访期内疗效及不良事件。结果:持续性心房颤动6例,阵发性心房颤动2例。平均年龄为(59.1±11.2)岁。术后,平均左心房压(left atrial pressure,LAP)从(16.1±3.6)mmHg(1mmHg=0.133kPa)下降至(7.9±4.1)mmHg,二尖瓣口面积(mitral valve area,MVA)从(1.2±0.4)cm2增加到(1.8±0.4)cm^(2)(压差降半时间,pressure half time,PHT法)(P<0.05)。平均随访(20.3±12.4)个月,7例患者无心房颤动复发,所有患者心功能均为NYHA分级Ⅰ级,所有患者随访期间均未发生围手术期并发症及手术相关不良事件。结论:PBMV联合RFCA治疗风湿性MS合并心房颤动安全有效。Objective:This study aims to investigate the efficacy and safety of a combined interventional procedure of percutaneous balloon mitral valvuloplasty(PBMV)and radiofrequency catheter ablation(RFCA)in rheumatic mitral stenosis(MS)patients with atrial fibrillation(AF).Methods:From January 2018 to September 2022,eight patients with rheumatic MS and AF resistant to antiarrhythmic drugs underwent onestop PBMV combined with RFCA.The efficacy and adverse events during the perioperative and follow-up period were observed.Results:There were 6 cases of persistent AF and 2 cases of paroxysmal AF.The mean age was(59.1±11.2)years.After the procedure,mean left atrial pressure(LAP)decreased from(16.1±3.6)mmHg to(7.9±4.1)mmHg,and mitral valve area(MVA)increased from(1.2±0.4)cm2 to(1.8±0.4)cm^(2)(PHT)(P<0.05).During a mean follow-up of 12 months,there was no recurrence of atrial fibrillation in 7 patients,and all patients were in NYHA classⅠ.No perioperative complications and procedure-related adverse events occurred during the follow-up period.Conclusions:PBMV combined with RFCA is safe and effective in the treatment of rheumatic MS with AF.

关 键 词：风湿性二尖瓣狭窄 心房颤动 经皮球囊二尖瓣成形术 导管消融 

分 类 号：R54[医药卫生—心血管疾病]