关键词: 肥厚型梗阻性心肌病, 室间隔心肌切除术, Morrow术, 二尖瓣关闭不全, 二尖瓣成形

Abstract: Objective To summarize the clinical characteristics of patients diagnosed with hypertrophic obstructive cardiomyopathy and analyze the therapeutic outcomes after septal myectomy in our center.
Methods From June 2018 to July 2021,there were 27 patients diagnosed with hypertrophic obstructive cardiomyopathy received septal myectomy in our center.Their demographic data,clinical characteristics,received surgical techniques,and therapeutic outcomes were retrospectively analyzed.
Results 14 patients recovered to no or mild mitral regurgitation after operation.Peak pressure gradient of left ventricle outflow tract was decreased from preoperative (65.9±47.5)mmHg to postoperative （13.8±10.2）mmHg,and the thickness of interventricular septum was decreased from preoperative （22.2±7.3）mm to postoperative （15.9±6.3）mm.The symptoms were improved after operation,with 25 patients recovered to class Ⅰ or Ⅱ heart failure of New York Hear Association.There were no conduction block,ventricular septal perforation or perioperative death occurred among these patients.
Conclusion Septal myectomy remains the gold standard for the treatment of hypertrophic obstructive cardiomyopathy.The mitral valve apparatus should be carefully inspected before and during operation.Most mitral regurgitation would recover upon thorough septal myectomy.Mitral valvuloplasty or mitral valve replacement would frequently unnecessary for mitral valve without intrinsic diseases.

Key words: hypertrophic obstructive cardiomyopathy, septal myectomy, Morrow procedure, mitral regurgitation, mitral valvuloplasty