Song Bangrong, Dong Ran
From the Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2016 Jan;95(2):e2326. doi: 10.1097/MD.0000000000002326.
This study aimed to compare the efficacy and safety of the classic Morrow septal myectomy with the modified procedure in treating hypertrophic obstructive cardiomyopathy (HOCM).A retrospective study was conducted to compare the outcomes of classic with modified Morrow septal myectomy in 42 patients treated from January 2005 to July 2011. Preoperative and postoperative ventricular septal thickness, left ventricular (LV) outflow tract velocity and gradient were measured echocardiographically.In both groups, the ventricular septal thickness, LV outflow tract velocity, and LV outflow tract gradient were significantly decreased after the operation. The modified Morrow procedure group, however, showed significantly greater reduction in these echocardiographic parameters than the classic procedure group. All patients in the modified procedure group were asymptomatic postoperatively with a postoperative transvalvular pressure gradient <30 mm Hg. In the classic procedure group, only 14 (87.5%) patients, however, were asymptomatic postoperatively with a postoperative transvalvular pressure gradient <30 mm Hg, and 2 patients still had severe LV outflow obstruction postoperatively.The modified Morrow septal myectomy is safe and effective in treating HOCM patients, and is superior to the classic procedure in reducing the LV outflow tract gradient and velocity, restoring normal anatomic atrioventricular size, and alleviating symptoms associated with HOCM.
本研究旨在比较经典的Morrow室间隔心肌切除术与改良手术治疗肥厚性梗阻性心肌病(HOCM)的疗效和安全性。进行了一项回顾性研究,比较2005年1月至2011年7月期间接受治疗的42例患者中经典Morrow室间隔心肌切除术与改良手术的结果。术前和术后通过超声心动图测量室间隔厚度、左心室(LV)流出道速度和梯度。两组患者术后室间隔厚度、LV流出道速度和LV流出道梯度均显著降低。然而,改良Morrow手术组这些超声心动图参数的降低幅度明显大于经典手术组。改良手术组所有患者术后均无症状,术后跨瓣压差<30 mmHg。在经典手术组中,然而,只有14例(87.5%)患者术后无症状,术后跨瓣压差<30 mmHg,2例患者术后仍有严重的LV流出道梗阻。改良Morrow室间隔心肌切除术治疗HOCM患者安全有效,在降低LV流出道梯度和速度、恢复正常解剖房室大小以及缓解与HOCM相关的症状方面优于经典手术。