Division of Pediatric Cardiovascular Surgery Masonic Children's Hospital University of Minnesota 2450 Riverside Ave S Minneapolis, Minnesota, USA.
Multimed Man Cardiothorac Surg. 2020 Dec 23;2020. doi: 10.1510/mmcts.2020.074.
In symptomatic patients with an obstructive variant of hypertrophic cardiomyopathy and no response to maximal medical therapy, we recommend a septal myectomy. It is considered the gold standard for treatment of the basal variant of hypertrophic cardiomyopathy. It has several advantages over alcohol septal ablation, such as the immediate relief of the obstruction and the ability to reduce the septal thickness significantly, to eliminate the potential for midventricular obstruction, and to rule out any other etiologies of left ventricular outflow tract obstruction, which include the presence of abnormalities in the mitral valve subvalvular apparatus such as the presence of anomalous chords, which occured in the current case, and anomalous papillary muscles. In experienced hands, the technique is safe and is associated with excellent outcomes with improved quality of life and potential for survival benefit.
对于有梗阻性肥厚型心肌病症状且对最大药物治疗无反应的患者，我们建议进行室间隔心肌切除术。它被认为是肥厚型心肌病基底变异型的治疗金标准。与酒精室间隔消融术相比，它具有多个优势，如梗阻的即刻缓解，以及显著降低室间隔厚度、消除中室间隔梗阻的能力，并排除左心室流出道梗阻的任何其他病因，包括二尖瓣瓣下装置的异常，如异常腱索的存在，这种情况就发生在当前病例中，以及异常乳头肌。在有经验的手中，该技术是安全的，并且与改善生活质量和潜在生存获益相关的出色结果相关。
