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目的 评价经皮二尖瓣球囊扩张术 (PBMV)治疗重度二尖瓣狭窄合并左心耳血栓的可行性、安全性和有效性。方法 选择经华法令抗凝治疗 12周以上的重度二尖瓣狭窄合并左心耳部位血栓患者 11例 ,男性 2例 ,女性 9例 ,年龄 2 5～ 6 2岁 ,平均 (40 6± 5 7)岁。采用Inoue单球囊技术行PBMV。术后随访 1年以上 ,观察术中及随访期间有无体循环血栓栓塞并发症。结果 手术成功率10 0 % ,术中及随访期间无 1例发生血栓栓塞并发症。术后即刻及随访期间血流动力学及心功能明显改善。结论 对于经适当的华法令抗凝治疗后的重度二尖瓣狭窄合并左心耳血栓的患者 ,PBMV不仅安全可行而且可取得满意的疗效。
Objective To evaluate the feasibility, safety and efficacy of percutaneous balloon mitral valvuloplasty (PBMV) in the treatment of severe mitral stenosis complicated with atrial appendage thrombus. Methods Eleven patients with severe mitral stenosis and thrombus in the left atrial appendage were treated with anticoagulation with warfarin for 12 weeks. There were 2 males and 9 females aged 25-52 years, with an average of (40 6 ± 5 7) year old. PBMV was performed using the Inoue single balloon technique. The patients were followed up for more than 1 year to observe the complications of systemic thromboembolism during the operation and follow-up. Results The success rate of operation was 100%. No thromboembolic complications occurred during operation and during follow-up. Immediate hemodynamic and follow-up of hemodynamics and cardiac function improved significantly. Conclusions PBMV is not only safe and feasible but also achieves satisfactory results in patients with severe left atrial appendage thrombus after moderate warfarin treatment of anticoagulation.