Bellas José J Arcas, Sánchez Cristina, González Ana, Forteza Alberto, López Verónica, Fernández Javier García
Department of Anesthesia and Critical Care, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain.
Department of Cardiac Surgery, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain.
Saudi J Anaesth. 2021 Apr-Jun;15(2):189-192. doi: 10.4103/sja.sja_952_20. Epub 2021 Apr 1.
Hypertrophic cardiomyopathy (HOCM) is the most common genetic heart disorder and the most common cause of sudden cardiac death among young population and a major cause of disability for patients of any age. An extended transaortic septal myectomy is the definitive treatment. It is very important to have a good knowledge of the characteristic pathophysiology of the disease in order to optimize intraoperative treatment of these patients. We present a case of a 68-year old woman who underwent hypertrophic elective cardiomyopathy surgery. Anesthetic management is crucial to guarantee maximum safety, since HOCM has the capacity to produce hemodynamic events of such severity that put patient's life at risk. The use and combination of intraoperative transesophageal echocardiography (TEE) and direct measurement of the left ventricular outflow tract gradient provides vital information to ensure successful surgical outcome in patients with HOCM.
肥厚型心肌病（HOCM）是最常见的遗传性心脏疾病，也是年轻人群心源性猝死的最常见原因，并且是任何年龄段患者致残的主要原因。扩大经主动脉间隔肌切除术是确定性治疗方法。为了优化这些患者的术中治疗，深入了解该疾病的特征性病理生理学非常重要。我们报告一例68岁女性接受肥厚型心肌病择期手术的病例。麻醉管理对于确保最大安全性至关重要，因为HOCM能够产生严重到危及患者生命的血流动力学事件。术中经食管超声心动图（TEE）的使用和联合直接测量左心室流出道梯度，为确保HOCM患者手术成功提供了至关重要的信息。
