摘要
目的:回顾性总结分析改良扩大Morrow手术(室间隔心肌切除术)治疗儿童肥厚型梗阻性心肌病(HOCM)的临床经验。方法:2010-01至2017-07期间在我院接受治疗的儿童HOCM患者(年龄<14岁)50例,其中男性31例,女性19例,平均年龄(84.4±57.7)个月(6个月~14岁),体重(28.4±20.7)kg(4.3~92.0 kg)。
Objectives: Modified extended Morrow procedure for treatment of children with hypertrophic obstructive cardiomyopathy(HOCM) is a complicated and challenging procedure. Our study sought to assess the effect and outcome of modified extended Morrow procedure in children with HOCM.Methods: From January 2010 to July 2017, 50 consecutive pediatric(age≤14 years) patients with HOCM underwent transaortic modified extended Morrow procedure in Fuwai Hospital. Clinical data of these patients were analyzed retrospectively. Pre-operative and post-operative echocardiography data were analyzed, including left atrial size, left ventricular end diastolic diameter, left ventricular ejection fraction, left ventricular outflow tract peak pressure, ventricular septal thickness, mitral systolic anterior motion and grade of mitral regurgitation.Results: Mean age at the time of operation was(84.4±57.7) month(6 month-14 year). Mean body weight at the time of surgery was(28.4±20.7) kg(4.3-92.0) kg. There were 2 deaths after the operation. Three patients had postoperative complete heart block and received permanent pacemaker implantation. After myectomy, left ventricular outflow tract gradient decreased from(74.8±25.0) mmHg to(19.6±17.3) mmHg(P<0.001); the postoperative thickness of ventricular septum decreased from(21.2±9.7) mm to(14.3±6.7) mm(P<0.001); mitral regurgitation degree reduced from 2.2±1.0 to 0.67±0.72, P<0.001). Concomitant surgical procedures were required in 22 patients(44.0%). There was no late death during a follow-up of(27.7±14.0) months. Patients’ symptoms were significantly improved post operation and all surviving patients were in NewYork Heart Association functional class I or II during follow-up.Conclusions: Modified extended Morrow procedure is safe and effective in children with HOCM, post-procedural clinical outcome is excellent, and this procedure can significantly improve the quality of 1 ife and the long-term prognosis in these patients.
出处
《中国循环杂志》
CSCD
北大核心
2018年第S01期59-60,共2页
Chinese Circulation Journal
关键词
肥厚型梗阻性心肌病
Morrow
临床研究
手术治疗
Pediatric
Hypertrophic obstructive cardiomyopathy
Modified extended Morrow procedure
