Clinical Efficacy and Outcome of Modified Extended Morrow Procedure in Children With Hypertrophic Obstructive Cardiomyopathy
10.3969/j.issn.1000-3614.2018.10.015
- VernacularTitle:改良扩大Morrow手术治疗儿童肥厚型梗阻性心肌病的临床研究
- Author:
Jing ZHANG
1
;
Hai-Tao XU
;
Liang CHEN
;
Shui-Yun WANG
;
Yun-Hu SONG
;
Qiang WANG
;
Shou-Jun LI
;
Jun YAN
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 小儿心脏外科中心
- Keywords:
Pediatric;
Hypertrophic obstructive cardiomyopathy;
Modified extended Morrow procedure
- From:
Chinese Circulation Journal
2018;33(10):1011-1015
- CountryChina
- Language:Chinese
-
Abstract:
Objectives: Modified extended Morrow procedure for treatment of children with hypertrophic obstructive cardiomyopathy (HOCM) is a complicated and challenging procedure. Our study sought to assess the effect and outcome of modified extended Morrow procedure in children with HOCM. Methods: From January 2010 to July 2017, 50 consecutive pediatric (age≤14 years) patients with HOCM underwent transaortic modified extended Morrow procedure in Fuwai Hospital. Clinical data of these patients were analyzed retrospectively. Pre-operative and post-operative echocardiography data were analyzed, including left atrial size, left ventricular end diastolic diameter, left ventricular ejection fraction, left ventricular outflow tract peak pressure, ventricular septal thickness, mitral systolic anterior motion and grade of mitral regurgitation. Results: Mean age at the time of operation was (84.4±57.7) month (6 month -14 year). Mean body weight at the time of surgery was (28.4±20.7) kg (4.3-92.0) kg. There were 2 deaths after the operation. Three patients had postoperative complete heart block and received permanent pacemaker implantation. After myectomy, left ventricular outflow tract gradient decreased from (74.8±25.0) mmHg to (19.6±17.3) mmHg (P<0.001); the postoperative thickness of ventricular septum decreased from (21.2±9.7) mm to (14.3±6.7) mm (P<0.001); mitral regurgitation degree reduced from 2.2±1.0 to 0.67±0.72, P<0.001). Concomitant surgical procedures were required in 22 patients (44.0%). There was no late death during a follow-up of (27.7±14.0) months. Patients' symptoms were significantly improved post operation and all surviving patients were in New York Heart Association functional class I or II during follow-up. Conclusions: Modified extended Morrow procedure is safe and effective in children with HOCM, post-procedural clinical outcome is excellent, and this procedure can significantly improve the quality of 1ife and the long-term prognosis in these patients.
