Varma Praveen Kerala, Raman Suneel Puthuvassery, Neema Praveen Kumar
Department of Cardiac Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Ann Card Anaesth. 2014 Jul-Sep;17(3):211-21. doi: 10.4103/0971-9784.135852.
Hypertrophic cardiomyopathy (HCM) poses many unique challenges regarding the conduct of anesthesia and surgery. Adequate preload, control of sympathetic stimulation, heart rate, and increased afterload are required to decrease the left ventricular outflow tract obstruction. Comprehensive intraoperative transesophageal echocardiography (TEE) examination confirms the diagnosis, elucidates the pathophysiology, and identifies the various anomalies of mitral valve apparatus and allows assessment of the adequacy of surgery. In this review, we focus on the preoperative assessment, conduct of anesthesia and comprehensive TEE examination of patients presenting for surgery with HCM. The various surgical options are extended myectomy and resection, plication and release.
肥厚型心肌病（HCM）在麻醉和手术实施方面带来了许多独特的挑战。需要足够的前负荷、控制交感神经刺激、心率以及增加后负荷，以减少左心室流出道梗阻。全面的术中经食管超声心动图（TEE）检查可确诊、阐明病理生理学、识别二尖瓣装置的各种异常，并评估手术的充分性。在本综述中，我们重点关注HCM患者手术前的评估、麻醉实施以及全面的TEE检查。各种手术选择包括扩大肌切除术和切除术、折叠术和松解术。
