扩大Morrow术治疗肥厚性梗阻型心肌病  

Extended Morrow＇s myomyectomy for hypertrophic obstructive cardiomypathy

作　　者：王哲[1] 夏利民[1] 陈安清[1] 徐德民[1] 杨成[1] 赵强[1] 

机构地区：[1]复旦大学附属中山医院心外科,上海200032

出　　处：《中华胸心血管外科杂志》2008年第3期169-170,共2页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：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、室间隔穿孑L等并发症。术毕测跨左室流出道压差（13．2±2．9）mmHg，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）mmHg，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。Objective To review the results of extended Morrow septal myomectomy for hypertophic obstructive cardiomypathy. Methods From January. 2005 to January 2007, 13 patients with hypertrophic obstructive cardiomypathy underwent Morrow extended myomectomy. There were6 females and 7 males with the age of （46.5 ± 15.6） years. Preoperative resting left ventricular outflow tract （LVOT） gradient was （76.0 ± 22.8）mmHg. Five patients underwent MVP and 2 patients underwent MVR for systolic anterior motion of mitral valve at the same time. Results Early postoperative reortality was 7.7% （1/13）. Postoperative LVOT gradient was （ 13.2 ± 2.9）mm Hg with direct pressure measurement. Normal diameter of LVOT and no systolic anterior motion of mitral valve were found by TEE. The mean follow-up time was （7.14 ± 4.91 ） months. The LVOT gradient was （ 14.08 ± 5.19） mm Hg by transthoracic echocardiography. All cases were in NYHA function class Ⅰ-Ⅱ. Conclusion Extended Morrow＇s myectomy may provide excellent relief for LVOT obstruction excellent clinical results in patients with hypertrephic cardiomyopathy.

关 键 词：心肌病 肥厚性 心脏外科手术 

分 类 号：R686[医药卫生—骨科学]