The Feasibility of Modified Morrow Procedure by Total Thoracoscope Through Aortic Incision
Objective To explore the feasibility and early results of modified Morrow procedure through aortic incision with total thoracoscope. Method The clinical data of 13 patients with obstructive hypertrophic cardiomyopathy (HCM)who underwent modified Morrow procedure were retrospectively analyzed;there were 9 males and 4 females,aged (59.3±13.3)years (30-77 years),with apreoperative interventricular septal thickness of (1.83±0.21)mm and a left ventricular outflow tract peak pressure difference (LVOTGP)of (76.90±27.61)mmHg,all of whom had positive SAM signs. All patients un-derwent modified Morrow procedure through an aortic incision under thoracoscopy,and 3 cases underwent mitral valve two-port reconstruction during the same period. Result The surgery was successful in all groups,with no conversion to thoracotomy. The intraoperative aortic occlusion time was (93.00± 18.68)minutes,the extracorporeal circulation time was (137.70±20.49)minutes,and the postoperative endotracheal intubation time was (10.70±4.30)hours. The postoperative interventricular septal thick-ness was (1.18±0.26)mm,and the LVOTGP was (13.46±9.46)mmHg,both of which were lower than the preoperative ones (P<0.001). The postoperative mitral valves all had mild regurgitation,no more than moderate regurgitation,and systolic forward motion disappeared. Follow-up of 3-12 months showed improvement in clinical symptoms and no patient died. There was no ventricular septal perfora-tion,residual obstruction of the left ventricular outflow tract,or third-degree atrioventricular block. Conclusion Total thoracoscopic approach through aortic incision can better expose the obstructed inter-ventricular septal tissue,preserve thoracic integrity,and avoid damage to the anterior mitral lobe. It provides good early results,and is a good surgical approach.
万方数据
维普
