Shimasaki T, Minami K, Koerfer R, Gleichmann U
Department of Thoracic and Cardiovascular Surgery, Herzzentrum Nordrhein-Westfalen, West Germany.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Oct;38(10):2091-6.
The many aspects of postoperative course of hypertrophic obstructive cardiomyopathy (HOCM) have been apparent, while many studies concerning long-term follow up have been published in recent years. Many surgical approaches have been performed but recently transaortic subvalvular myectomy is most common. This study reviews 22 patients with HOCM operated on between 1984 and 1989. Transaortic approach was used for all adult patients. One patient had a complication with an iatrogenic VSD, which was closed by Dacron patch during the procedure. There was one hospital death; She is a 67 year-old woman who died due to an acute abdomen. All 14 patients followed up over 3 months had significant functional improvement. Our retrospective study suggests that myectomy in patient with HOCM seems to be not only palliative but curative operative method. Left atrial- and left ventricular dimension tended to normalize in the postoperative course. The intraoperative estimation of Brockenbrough phenomenon is effective to assess the release of left ventricular outflow obstruction.
肥厚性梗阻性心肌病（HOCM）术后病程的诸多方面已较为明显，近年来也发表了许多关于长期随访的研究。已经实施了多种手术方法，但最近经主动脉瓣下肌切除术最为常用。本研究回顾了1984年至1989年间接受手术治疗的22例HOCM患者。所有成年患者均采用经主动脉入路。1例患者出现医源性室间隔缺损并发症，术中用涤纶补片修补。有1例医院死亡；她是一名67岁女性，死于急腹症。所有随访超过3个月的14例患者功能均有显著改善。我们的回顾性研究表明，HOCM患者的肌切除术似乎不仅是一种姑息性手术，而且是一种治愈性手术方法。术后左心房和左心室大小趋于正常。术中对布罗肯布罗现象的评估有助于评估左心室流出道梗阻的解除情况。
