首页> 外文期刊>Innovations: technology and techniques in cardiothoracic and vascular surgery >Robotic Septal Myectomy and Mitral Valve Repair for Idiopathic Hypertrophic Subaortic Stenosis With Systolic Anterior Motion.
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Robotic Septal Myectomy and Mitral Valve Repair for Idiopathic Hypertrophic Subaortic Stenosis With Systolic Anterior Motion.

机译:机器人中隔肌切除术和二尖瓣修复术治疗收缩期前运动的特发性肥厚性主动脉瓣狭窄。

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摘要

Combined therapeutic approach with performing mitral valve repair may be necessitated for the treatment of idiopathic hypertrophic subaortic stenosis (IHSS) with systolic anterior motion. This report includes operative technique for combined robotic septal myectomy and mitral valve repair. A 45-year-old man with IHSS was admitted to our center for surgical intervention. The transthoracic echocardiography showed typical asymmetric ventricular hypertrophy. Left ventricle posterior wall thickness was 11 mm, and interventricular septum thickness was 21 mm. Mitral valve leaflets were found to be elongated. Mild-to-severe mitral regurgitation was detected with eccentric mitral jet. Aortic peak gradient was 128 mm Hg. Robotic mitral repair and septal myectomy through left atrial exposure was performed. The anterior leaflet was detached, and the septal muscle in a mass of 1 × 0.7 × 0.5 cm was resected. Next, the anterior leaflet was reattached with continuous suture. The plication of the posterior leaflet with transverse incision was performed to diminish the length of posterior leaflet. After the magic suture for posteromedial commissure was performed, a 34 Medtronic Future ring was implanted for mitral annuloplasty. Postoperative course was uneventful. The patient was discharged on the sixth postoperative day. Combined robotic septal myectomy and mitral valve repair for IHSS with systolic anterior motion may be feasible.
机译:对于伴有收缩性前移的特发性肥厚性主动脉瓣下狭窄(IHSS),可能需要将治疗方法与二尖瓣修复相结合。该报告包括机器人隔膜中隔肌切除术和二尖瓣修复的手术技术。一名患有IHSS的45岁男子被送入我们的外科手术中心。经胸超声心动图显示典型的不对称心室肥大。左心室后壁厚度为11毫米,室间隔厚度为21毫米。发现二尖瓣小叶拉长。偏心二尖瓣射流可检测到轻度至重度二尖瓣反流。主动脉峰梯度为128 mm Hg。通过左心房暴露进行机器人二尖瓣修复和间隔肌切除术。分离前小叶,切除1×0.7×0.5 cm肿块的中隔肌。接下来,用连续缝合将前小叶重新连接。进行横向切口的后小叶褶皱术以减少后小叶的长度。在进行后内侧连合的魔术缝合后,植入34 Medtronic Future环进行二尖瓣瓣环成形术。术后过程平稳。该患者在术后第六天出院。结合机械手间隔肌切除术和二尖瓣修复治疗IHSS并伴有收缩性前移是可行的。

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