对阻塞性多变性心肌病的扩展性隔膜切除术及其对中枢功能影响
Antonio Lio1, Mariangela D'Ovidio2, Ilaria Chirichilli1
1Department of Cardiac Surgery and Transplantation, S. Camillo Hospital.
Journal of cardiovascular medicine (Hagerstown, Md.)
|January 22, 2024
概括
扩展性隔膜肌切除术有效治疗高增多性阻塞性心肌病 (HOCM) 和相关的中枢问题. 同时的 mitra 门手术很少需要,因为充足的 my ectomy 解决了大多数患者的潜在病理生理学.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 过高阻塞性心肌病 (HOCM) 通常需要手术干预.
- 伴心的缩前运动 (SAM) 导致二次吐发生在30-60%的HOCM患者中.
- 截面肌切除术是HOCM的黄金标准手术治疗方法.
研究的目的:
- 评估HOCM患者扩展隔膜肌切除术的结果.
- 评估在扩展性隔膜切除术期间同时进行 mitra 门手术的必要性和影响.
- 分析长期存活率,再住院率和需要植入心脏起器的需求.
主要方法:
- 从2008年到2022年,对84名接受隔膜肌切除术 (SM) 的患者进行了回顾性研究.
- 基于"扩展肌切除术"概念的手术技术.
- 随访包括存活率,心力衰竭/心心病入院,重新手术和心脏起器植入.
主要成果:
- 平均年龄为61岁;8%接受了同时进行的 mitra 门手术,主要是因内在门疾病.
- 住院死亡率为5%;5%的患者在出院时有残留的中度或严重的额头骨吐.
- 十二年生存率为78%;无需心脏再手术的情况为100%.
结论:
- 扩展性隔膜肌切除术为HOCM带来了良好的结果.
- 同时的 mitra 门手术很少需要,通常仅用于内在的 mitra 门疾病.
- 适当的隔膜肌切除术有效地解决了HOCM的病理生理学和相关的SAM诱导的反.
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