ABSTRACT
Objective:
To compare the preliminary clinical effect of
mitral valve replacement and mitral valvuloplasty on
hypertrophic obstructive cardiomyopathy with
mitral regurgitation.
Methods:
From January 2010 to December 2013, the
patients undergoing
cardiac surgery at Bakulev Cardiovascular
Surgery Research Center in
Russia were randomly divided into two groups Forty-one
patients received left ventricular outflow tract
hypertrophy myocardial resection (Morrow operation) combined with
mitral valve replacement (MVR) as MVR group; Forty-seven
patients received Morrow
surgery combined with
mitral valve repair (MVr) as MVr group.The primary end point
death,
secondary end point
thrombosis complications (
cerebral infarction, peripheral arterial
embolism),
recurrence of
mitral regurgitation and left ventricular outflow tract
pressure difference were compared between the two groups.
Results:
In the MVr group, 6 cases were converted to MVR and were excluded from the study.The
survival rates of MVR group and MVR group were 78.9% and 96.6%, respectively , and the thromboembolic free
survival rates of MVR group and MVr group were 83.2% and 100%, respectively. The differences were statistically significant( P=0.034, 0.026, respectively). There was no significant difference in
mitral regurgitation and left ventricular outflow tract
pressure difference between MVR group and MVR group 24 months after operation( P=1.000, 0.934, respectively).
Conclusion:
Operation combined with MVR or MVr is an effective
method to relieve
left ventricular outflow tract obstruction and
mitral regurgitation. Morrow operation combined with MVr can improve
survival rate and reduce
thrombosis complications.