Objective To summarize the clinical efficacy of modified Morrow surgery in the treatment of hypertrophic obstructive cardiomyopathy. Methods A retrospective analysis was conducted on the clinical data of patients with hypertrophic obstructive cardiomyopathy treated with modified Morrow surgery at Zhongshan Hospital Affiliated to Fudan University from 2020 to 2023. Results A total of 318 patients were enrolled, including 156 males and 162 females, with an average age of (55.6±13.1) years. Preoperative echocardiography showed a mean interventricular septal thickness of (18.1±3.8) mm, peak left ventricular outflow tract pressure difference of (86.4±24.9) mm Hg. The surgery time was (162.3±51.0) min, extracorporeal circulation time was (80.9±31.0) min, and aortic occlusion time was (44.8±20.8) min. After the surgery, transesophageal echocardiography showed that the interventricular septal thickness was (11.0±1.8) mm and left ventricular outflow tract peak pressure difference was (9.4±5.1) mm Hg. The incidence rate of postoperative complete left bundle branch block was 45.3%, Ⅲ° atrioventricular block was 3.8%, and postoperative newly developed atrial fibrillation was 3.1%. The postoperative hospital stay was (6.6±4.9) days, and one perioperative death occurred, with a mortality rate of 0.3%. The follow-up time was (10.3±9.4) months, during which the transthoracic echocardiography revealed a ventricular septal thickness of (12.9±2.9) mm and a peak left ventricular outflow tract pressure difference of (13.9±10.0) mm Hg. Conclusion The modified Morrow procedure for the treatment of hypertrophic obstructive cardiomyopathy is safe and effective, with good results in the short and medium term.

AIM:To observe the effect of combined treatment(using intraocular pressure-lowering drugs + intravitreal injection of Lucentis + complex trabeculectomy + panretinal photocoagulation)for neovascular glaucoma(NVG).

METHODS: This was a prospective non-randomized clinical study. A total of 24 patients(24 eyes)with NVG were enrolled. After using intraocular pressure(IOP)-lowering drugs, the elevated IOP in 7 eyes was controlled within normal limits and 17 eyes within high levels. All patients were treated with intravitreal injection of Lucentis 0.50mg/0.05mL. Complex trabeculectomy were performed within 7d after injection. All patients were treated with panretinal photocoagulation after complex trabeculectomy. The regression of iris neovascularization, changes in IOP, best corrected visual acuity, intraoperative and postoperative complications and filtering bleb were analyzed after combined treatment. Patients were followed-up for 6-18mo.

RESULTS: Iris neovascularization completely regressed within 1wk in 24 eyes after intravitreal injection of Lucentis. The average IOP was 41.38±3.16mmHg before combined treatment,and 12.69±1.52mmHg in 6mo after combined treatment. The differences had statistically significant before and after combined treatment(F=25.592, P<0.05). Before combined treatment, the best-corrected visual acuity was >0.1 in 3 eyes, 0.01-0.1 in 10 eyes, non light perception(NLP)- finger counting(FC)in 11 eyes. After combined treatment, the best-corrected visual acuity was >0.1 in 5 eyes, 0.01-0.1 in 16 eyes, NLP～FC in 3 eyes, which showed statistically significant difference with the visual acuity before combined treatment(Z=-2.201, P<0.05).

CONCLUSION: Combined treatment could effectively control the IOP and preserve the visual function in patients with neovascular glaucoma.