Application of Intro-operative Transesophageal Echocardiography for Extended Septal Myectomy in Patients With Obstructive Hypertrophic Cardiomyophathy
10.3969/j.issn.1000-3614.2014.08.010
- VernacularTitle:经食管超声心动图在梗阻性肥厚型心肌病扩大室间隔切除术中的应用
- Author:
Jiande WANG
;
Fujian DUAN
;
Panqing JIAO
;
Jingjin WANG
;
Hao WANG
;
Yunhu SONG
- Publication Type:Journal Article
- Keywords:
Echocardiography;
Transesophageal;
Hypertrophic cardiomyophathy;
Septal myectomy
- From:
Chinese Circulation Journal
2014;(8):594-597
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the intro-operative transesophageal echocardiography (TEE) for extended septal myectomy in patients with obstructive hypertrophic cardiomyophathy (HCM).
Methods: A total of 56 obstructive HCM patients with extended septal myectomy in our hospital from 2012-01 to 2012-12 were retrospectively studied. The results of pre-operative transthoracic echocardiography, intro-operative TEE and post-operative transthoracic echocardiography were analyzed and compared.
Results: There were 36 male and 20 female patients with the average age of (46.1 ± 11.3) years. The pre-operative width of inter ventricular septal was (26.1 ± 6.9) mm, left ventricular outlfow tract (LVOT) pressure gradient was (87.5 ± 12.5) mmHg. All patients received successful operation, no in-hospital death, no TEE related complication. The removed ventricular septal thickness was at (10.7 ± 2.1) mm, length at (39.1±5.5) mm. Compared with pre-operative transthoracic echocardiography, TEE indicated the immediate drop of post-operative LVOT peak velocity (4.57 ± 0.99)m/s vs (1.68±0.46)m/s and LVOT peak gradient (87.5 ± 34.4) vs (11.3 ± 7.0) mmHg, both P<0.001;signiifcant reduce of mitral regurgitation (MR) and mitral valve systotic onterior motion, both P<0.001. TEE showed that intra-operative LVOT peak velocity (r=0.63) and LVOT peak gradient (r=0.48) well related to post-operative transthoracic echocardiography. Post-operative TEE found that 2 patients had ventricular septal defect and 1 received surgical repair.
Conclusion: TEE is safe for extended septal myectomy in obstructive HCM patients. It may pre-operatively identify the cause and degree of MR, evaluate the post-operative improvement of LVOT obstruction and MR. Meanwhile, TEE may ifnd the surgical complication for in time correction in relevant patients.
