Matsushiro Takuya, Fujimatsu Toshihiro, Miyaji Kagami
Department of Cardiovascular Surgery, Hokuto Hospital, Obihiro, Japan.
Kyobu Geka. 2019 Feb;72(2):149-152.
This report presents a case of a 68-year-old woman with hypertrophic obstructive cardiomyopathy (HOCM) and concomitant mitral regurgitation (MR). Preoperative echocardiography showed stenosis of the left ventricular outflow tract (LVOT) and systolic anterior leaflet motion (SAM) of the mitral valve. She underwent mitral valve replacement( MVR) alone, and obstruction of LVOT was successfully released. Although a septal myectomy is the "gold standard" surgical therapy for HOCM, complications such as heart-block and ventricular septal perforation still remain. It was suggested that in some cases of HOCM complicated with MR, isolated MVR could be considered as the 1st-line surgical therapy.
本报告介绍了一例68岁患有肥厚性梗阻性心肌病（HOCM）并伴有二尖瓣反流（MR）的女性病例。术前超声心动图显示左心室流出道（LVOT）狭窄以及二尖瓣收缩期前叶运动（SAM）。她仅接受了二尖瓣置换术（MVR），LVOT梗阻得以成功解除。尽管室间隔心肌切除术是HOCM的“金标准”外科治疗方法，但诸如心脏传导阻滞和室间隔穿孔等并发症仍然存在。有人提出，在某些HOCM合并MR的病例中，单纯MVR可被视为一线外科治疗方法。
