扩大Morrow术治疗肥厚性梗阻型心肌病

目的 总结肥厚性梗阻型心肌病外科治疗结果与经验.方法 2005年1月至2007年1月对13例肥厚性梗阻型心肌病病人行扩大Morrow术,其中男7例,女6例;年龄(46.5±15.6)岁.同时有5例行二尖瓣成形术,2例行二尖瓣置换术.结果 术后生存12例,死亡1例.无房室传导阻滞、室间隔穿孔等并发症.术毕测跨左室流出道压差(13.2±2.9)mm Hg,食管超声示二尖瓣前移消失.平均随访(7.14±4.91)个月,经胸超声心动图示跨左室流出道压差仅为(14.08±5.19)mm Hg,病人症状明显改善,心功能均在Ⅱ级以上.结论 扩大Morrow术治疗肥厚性梗阻型心肌病疗效满意.

Extended Morrow's myomyectomy for hypertrophic obstructive cardiomypathy

Objective To review the results of extended Morrow septal myomectomy for hypertrophic obstructive cardiomypa-thy. Methods From January 2005 to January 2007, 13 patients with hypertrophic obstructive cardiomypathy underwent Morrow ex-tended myomectomy, There were 6 females and 7 males with the age of (46.5±15.6) years. Preoperative resting left vontricular out-flow tract (LVOT) gradient was (76.0±22.8)mmHg. Five patinas underwent MVP and 2 patients underwent MVR for systolic ante-rior moron of mitral valve at the same time. Results Early postoperative mortality was 7.7% (1/13). Postoperative LVOT gradientwas ( 13.2±2.9)mm Hg with direct pressure measurement. Normal diameter of LVOT and no systolic anterior motion of mitral valvewore found by TEE. The raean follew-up time was (7.14±4.91) months. The LVOT gradient was (14.08±5.19)mm Hg by tran-sthoracic echocardiography. All cases were in NYHA function class Ⅰ-Ⅱ . Conclsion Extended Morrew's myectomy may provideexcellent relief for LVOT obstruction excellent clinical results in patients with hypertrophic cardiomyopathy.