摘要
目的研究肥厚型梗阻性心肌病合并主动脉瓣狭窄患者的手术疗效和预后。方法回顾性分析2008年2月至2015年10月我院收治的7例肥厚型梗阻性心肌病合并主动脉瓣狭窄患者的临床资料。其中男4例、女3例,平均年龄(55.6±7.5)岁。全部患者接受同期改良扩大Morrow术和主动脉瓣置换或成形术。通过门诊及电话随访,记录患者超声心动图数据和主要术后并发症情况。结果术后室间隔厚度、左室流出道压差及主动脉瓣跨瓣压差均较术前明显降低,差异具有统计学意义(P<0.05)。平均随访(25.6±28.2)个月,1例患者因脑出血死亡,1例置入永久起搏器,1例出现新发心房颤动。所有患者人工瓣膜启闭良好,左室流出道通畅。患者症状及心功能均明显改善。结论对于肥厚型梗阻性心肌病合并主动脉瓣狭窄的患者,同期行改良扩大Morrow术和主动脉瓣手术是恰当有效的治疗方法,可以显著改善患者临床症状,提高生活质量且预后良好。
Objective To evaluate the clinical and follow-up results of the surgical treatment for hypertrophic obstructive cardiomyopathy associated with aortic stenosis.Methods We retrospectively analyzed the clinical data of the patients with hypertrophic obstructive cardiomyopathy plus aortic stenosis in our hospital from February 2008 to October2015.There were 4 males and 3 females aged 55.6±7.5 years.All the patients were received concomitant aortic valvulopasty at the time of modified extended Morrow procedure.Echocardiographic data and major complications were recorded through the outpatient clinic and telephone.Results The postoperative ventricular septal thickness,left ventricular outflow tract gradient and aortic gradient were significantly lower than those in preoperation with statistical differences(P<0.05).During the mean follow-up 25.6±28.2 months period,1 patient died of cerebral hemorrhage,1 patient was implanted a permanent pacemaker,and 1 patient had a postoperative new-onset atrial fibrillation.All patients had a satisfied prosthetic valve function and the left ventricular outflow tract gradient.The patient’s symptoms and heart function significantly improved postoperatively.Conclusion For patients with hypertrophic obstructive cardiomyopathy associated with moderate to severe aortic stenosis,concomitant aortic valvulopasty at the time of modified extended Morrow procedure is an appropriate and effective treatment,which can significantly alleviate the clinical symptoms,and improve quality of life with a satisfied prognosis.
作者
龚嘉淼
然鋆
宋云虎
刘赟
唐亚捷
邓隆
刘小希
GONG Jiamiao;RAN Jun;SONG Yunhu;LIU Yun;TANG Yajie;DENG Long;LIU Xiaoxi(Department of Cardiac Surgery,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100037,P.R.China)
出处
《中国胸心血管外科临床杂志》
CAS
CSCD
2019年第12期1233-1238,共6页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
肥厚型梗阻性心肌病
主动脉瓣狭窄
外科治疗
Hypertrophic obstructive cardiomyopathy
aortic stenosis
surgical treatment
