Ninomiya M, Takamoto S, Kotsuka Y, Ohtsuka T, Ueno K
Department of Cardiothoracic Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
Jpn J Thorac Cardiovasc Surg. 2000 Dec;48(12):820-3. doi: 10.1007/BF03218260.
A 25-year-old woman treated for hypertrophic obstructive cardiomyopathy and suffering from mitral regurgitation due to infective endocarditis was referred to our department for surgery. Preoperative examinations revealed asymmetric septal hypertrophy, a large left ventricular outflow gradient (100 mmHg), and perforation of the anterior mitral leaflet resulting in severe mitral regurgitation. The entire mitral complex was resected and septal myectomy conducted to dilate the left ventricle. A bioprosthetic valve was then implanted. Although postoperative heart failure was severe, cardiac function has gradually recovered. The left ventricular outflow gradient has decreased to 8 mmHg, the diastolic left ventricular diameter has increased from 26 to 30 mm, and her New York Heart Association classification has improved from IV to I.
一名25岁女性因肥厚性梗阻性心肌病接受治疗，且因感染性心内膜炎患有二尖瓣反流，被转诊至我科接受手术。术前检查发现室间隔不对称肥厚、左心室流出道压差大（100 mmHg）以及二尖瓣前叶穿孔导致严重二尖瓣反流。切除整个二尖瓣复合体并进行室间隔心肌切除术以扩张左心室。然后植入生物瓣膜。尽管术后心力衰竭严重，但心功能已逐渐恢复。左心室流出道压差已降至8 mmHg，左心室舒张末期直径从26 mm增加到30 mm，其纽约心脏病协会心功能分级已从IV级改善至I级。
