Wang Xuewen, Liang Ziwei, Liu Mingxin, Huang Shihao, Pan Gang
Department of Cardiology, Yueyang Central Hospital, Yueyang, 414000, Hunan, China.
Department of Clinical Laboratory, Yueyang Hospital Affiliated to Hunan Normal University, Yueyang, 414000, Hunan, China.
J Cardiothorac Surg. 2025 Mar 26;20(1):167. doi: 10.1186/s13019-025-03395-w.
Hypertrophic cardiomyopathy (HCM) is the hereditary cardiomyopathy with the highest incidence rate. Its main pathological changes are ventricular septal myocardial hypertrophy and myocardial disorder, which are prone to fatal arrhythmia and heart failure. If left ventricular outflow tract (LVOT) obstruction is combined, it is called obstructive hypertrophic cardiomyopathy (oHCM). There is currently no report on the use of MitraClip combined with percutaneous transluminal septal branch microsphere embolization (PTSBME) for treating patients with oHCM complicated with severe mitral regurgitation (MR).
This report describes a 51-year-old male patient who was admitted to the hospital due to "repeated chest tightness and shortness of breath for 2 years, worsening for 6 months". Ultrasound, left ventricular angiography (LVA), and left cardiac catheterization confirmed oHCM with moderate MR. We used MitraClip combined with PTSBME to relieve the patient's LVOT obstruction and MR simultaneously.
Traditionally, both interventricular septal and mitral valve lesions are treated simultaneously through surgical intervention. However, the surgical conditions are relatively strict, and many patients are unable to undergo surgical treatment, resulting in delays in their condition. For such patients, minimally invasive intervention may be used to simultaneously treat interventricular septal and mitral valve lesions, further reducing surgical risks and enhancing surgical efficacy. In this case, MitraClip combined with PTSBME was first performed. After the surgery, the patient's LVOT obstruction and MR were simultaneously relieved, and clinical symptoms improved significantly.
肥厚型心肌病（HCM）是发病率最高的遗传性心肌病。其主要病理改变为室间隔心肌肥厚和心肌紊乱，易发生致命性心律失常和心力衰竭。若合并左心室流出道（LVOT）梗阻，则称为梗阻性肥厚型心肌病（oHCM）。目前尚无关于使用MitraClip联合经皮经腔间隔支微球栓塞术（PTSBME）治疗合并严重二尖瓣反流（MR）的oHCM患者的报道。
本报告描述了一名51岁男性患者，因“反复胸闷、气短2年，加重6个月”入院。超声心动图、左心室造影（LVA）和左心导管检查确诊为oHCM合并中度MR。我们使用MitraClip联合PTSBME同时缓解了患者的LVOT梗阻和MR。
传统上，室间隔和二尖瓣病变均通过手术干预同时治疗。然而，手术条件相对严格，许多患者无法接受手术治疗，导致病情延误。对于此类患者，可采用微创干预同时治疗室间隔和二尖瓣病变，进一步降低手术风险，提高手术疗效。在本病例中，首次采用了MitraClip联合PTSBME。术后，患者的LVOT梗阻和MR同时得到缓解，临床症状明显改善。
