中国体外循环杂志Issue(4)：229-231,3.DOI:10.13498/j.cnki.chin.j.ecc.2015.04.10
外科治疗肥厚型梗阻性心肌病围术期处理
Perioperative treatment of hypertrophic obstructive cardiomyopathy
摘要
Abstract
Objective To summarise the clinical experience on the perioperative treatment of hypertrophic obstructive cardio⁃myopathy( HOCM) . Methods Forty six patients with HOCM who had undergone surgical treatment during the period of January 2010 to December 2014 were included in this study. Emergencyventricular septal myectomy was performed through the aortic incision under extracorporeal circulation( ECC) . The concomitant operations included mitral valve replacement( 11cases) ,mitral valvuloplasty ( 4 ca⁃ses),aortic valve replacement (4 cases),and tricuspid valvuloplasty (5 cases). Results The ECC and aortic occlusion time was (144.3±64.4)min and (91.2±36.4)min respectively.The endotracheal intubation time was (20.3±14.6) h and the postoperative inten⁃sive care unit(ICU)stay was (66.3±35.6) h. Two cases died and the mortality was 4.3%. The main causes of death included cerebro⁃vascular accident and multiple organs failure. The postoperative complications included supraventricular tachycardia in 7 cases (15.2%), ventricular arrhythmia in 4 cases (8.7%), complete left bundle branch block in 8 cases (17.4%), complete artioventricalblock in 1 cases (2.2%), intra-aortic balloon pump in 2 cases(4.3%) dueto low cardiac output syndrome, hemodialysis in 2 cases (4.3%) due⁃to acute renal failure, exploration for bleeding in 1 case(2.2%),reoperation in 1 case due to ventricular septal perforation. Postopera⁃tive echocardiography demonstrated a reduced LVOT gradient (12.8±10.9) mm Hg, P =0.002. Conclusion Concomitant ventricular septal myectomy is an effective and safe treatment for HOCM.The strengthened perioperative ECC management,and intensive care on the hemodynamic states after operation could reduce the complication and lower thesurgical risk.关键词
肥厚型梗阻性心肌病/心脏手术/治疗Key words
Hypertrophic obstructive cardiomyopathy/Cardiac surgery/Treatment引用本文复制引用
肖营凯,周成斌,熊卫萍,谢斌,黄焕雷,郭惠明..外科治疗肥厚型梗阻性心肌病围术期处理[J].中国体外循环杂志,2015,(4):229-231,3.基金项目
广东省医学科研基金 （）
