目的应用超声心动图比较肥厚型梗阻性心肌病患者经皮经腔间隔心肌消融术与室间隔心肌切除术的疗效。方法分别于经皮经腔间隔心肌消融术及室间隔心肌切除术前、后测量肥厚型梗阻性心肌病患者左室流出道压差,比较术前及术后压差。结果肥厚型梗阻性心肌病患者在进行经皮经腔间隔心肌消融术与室间隔心肌切除术后,左室流出道压差均较术前明显减低。经皮经腔间隔心肌消融术肥厚型心肌病患者术前左室流出道压差(99±19)mm Hg(1 mm Hg=0.133 kPa),术后降至(36±20) mm Hg(P<0.05)。进行室间隔心肌切除术肥厚型心肌病患者术前左室流出道压差(117±32) mm Hg,术后降至(28±17) mm Hg(P<0.05)。经皮经腔间隔心肌消融术与室间隔心肌切除术患者术后左室流出道压差差异无统计学意义[(36±20)mm Hg比(28±17)mm Hg]。结论经皮经腔间隔心肌消融术可以明显减低肥厚型梗阻性心肌病患者左室流出道压差,且与室间隔心肌切除术疗效相似。
Objective To report our operative experience with aortic root replacement in 231 patients with aortic root aneurysm and discuss the current indications, methods, and surgical techniques、Methods Between January 1994...
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Objective To report our operative experience with aortic root replacement in 231 patients with aortic root aneurysm and discuss the current indications, methods, and surgical techniques、Methods Between January 1994 and August 1999, a group of 231 consecutive patients underwent aortic root replacement at our hospital, with 13 being treated on an emergency basis、 There were 189 men and 42 women, ranging in age from 14 to 69 years、 The diameter of the aneurysm varied from 4、5 to 11?cm、 Among this group, 145 had isolated aortic root aneurysms, 65 suffered from DeBakey type Ⅰ aortic dissection, and the remaining 21 were diagnosed as having DeBakey type Ⅱ aortic dissection、 Aortic valve regurgitation occurred in all cases、 Aortic root replacement was performed with composite valved graft in 229 patients, and in 2 patients the aortic valve was preserved、Results The hospital mortality rate was 3、03% (7 patients)、 Early complications included re-exploration for bleeding in 6 patients, pericardial effusion in 9, as well as cerebral infarction, pleural effusion, and pneumothorax in 2 patients each、 One hundred and seventy-five patients (78、12%) were followed up, with a mean follow-up time of 15、7±13、1 months (range, 2 weeks to 65 months)、 One patient died from lower-limb embolism and renal dysfunction 3 months postoperatively、 Three patients died from postoperative anticoagulation accidents、 The preoperative and postoperative mean left ventricular end-diastolic diameters were significantly different (68、1±9、4?mm, range 54 to 112?mm; vs 54、8±8、2?mm, range 38 to 88?mm; P<0、001)、Conclusions Once a diagnosis of acute aortic root dissecting aneurysm is made, the patient should undergo surgery as soon as possible if the general conditions permit、 Aortic aneurysm without dissection or with chronic dissection should be operated if the diameter of the aneurysm is greater than 5?cm
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