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梗阻性肥厚型心肌病中的二尖瓣:异常、管理与争议

Mitral Valve in Obstructive Hypertrophic Cardiomyopathy: Abnormalities, Management and Controversies.

作者信息

Wu Zhuheng, Xie Lin, Li Yajiao, Lin Ke, Zhang Songbo, Qian Hong

机构信息

Department of Cardiovascular Surgery, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China.

Department of Cardiology, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China.

出版信息

Rev Cardiovasc Med. 2023 Aug 30;24(9):246. doi: 10.31083/j.rcm2409246. eCollection 2023 Sep.

Abstract

Obstructive hypertrophic cardiomyopathy (obstructive HCM) is a hereditary disease characterized by septal hypertrophy and dynamic left ventricular outflow tract (LVOT) obstruction. Other than septal hypertrophy, mitral valve abnormalities are also quite common in patients with obstructive HCM, which may contribute to systolic anterior motion (SAM) of the mitral valve and LVOT obstruction. Surgical myectomy is the standard treatment to achieve anatomic correction of obstructive HCM, but controversies remain on whether and how the mitral valve procedures should be performed at the same time. In this review, we first described the mitral valve abnormalities in patients with obstructive HCM and their surgical corrections, we then explained the controversies based on current clinical studies, and we finally made a brief introduction on our surgical strategy and results.

摘要

梗阻性肥厚型心肌病(梗阻性HCM)是一种遗传性疾病,其特征为室间隔肥厚和动态性左心室流出道(LVOT)梗阻。除室间隔肥厚外,二尖瓣异常在梗阻性HCM患者中也相当常见,这可能导致二尖瓣收缩期前向运动(SAM)和LVOT梗阻。外科室间隔心肌切除术是实现梗阻性HCM解剖学矫正的标准治疗方法,但对于是否以及如何同时进行二尖瓣手术仍存在争议。在本综述中,我们首先描述了梗阻性HCM患者的二尖瓣异常及其外科矫正方法,然后根据当前临床研究解释了相关争议,最后简要介绍了我们的手术策略和结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdcd/11270072/df7ffafed7c8/2153-8174-24-9-246-g1.jpg

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