Treatment of Rheumatic Mitral Stenosis Complicated with Left Atrial Thrombus by Percutaneous Balloon Mitral Valvuloplasty

摘要

Objective To demonstrate the safety and clinical effects of PBMV for patients with left atrial thrombus after thrombolytic of anticoagulating therapy. Methods 98 patients with left atrial thrombus were checked with echocardiograms before and after PBMV. Urokinase (0.2 million units) was given intravenously every day to earlier 18 patients for 2 weeks and Warfarin ( 1.5 ～ 6.0mg/d) was given to the later 80 patients. Thrombi status, PBMV outcomes, thrombolytic complications were observed. Results After using of Urokinase or Warfarin,thrombi in left atria disappeared or became smaller and organized.Only 4.3 % of patients had slight bleeding complications. 96 cases of PBMV in 98 patients were successfully treated(97.9% ) . Only one case of PBMV whose thrombus were close to mitral orifice failed. One patient died from pericardial temponade. Conclusion Our study suggests that administering PBMV in patients of left atrial thrombus is safe after appropriate thrombolytic or anticoagulating therapy. Warfarin,compared with Urokinase, has more reasons to be a candidate.