Therapeutic measure _'s treatment of the plump type obstructing myocardium disease

Therapeutic measure _'s treatment of the plump type obstructing myocardium disease
[Treat the measure ]
Symptom that plump type obstructing myocardium disease can appear at any age, age of morbidity seen at most is around 20 years old. The careful conduit checks the case diagnosed clearly, under 10 years old only 10% present serious symptom, rise to 70% over 50. Some case conditions can have stabilized or developed continuously more seriously for many years. It is congestive and in heart failure that the atrium happens to often appear after quivering or systemic circulation thromboembolism. Present clinical symptom and arrhythmia and does not undergo in the therapeutic case of surgery, about 15% die after 5 year, 25% die after 10 year. The unexpected death of most patients, only a few cases die from membrane inflammation in the infective heart in heart failure. Clinical symptom obvious, internal medicine department it is effective for drug therapy to fail, the intersection of left ventricle and flow out dishes of the intersection of systolic pressure and difference, exceed 6 at the quiet interest. 6kPa( 50mmHg) Person should implement not to be surgical treatment,last interventricular septum plump cardiac muscle in order to relieving to obstruct.
The commonly used operation method is as follows,
(1) Jointly cut-out the cardiac muscle to excise the centre of brestbone of skill to cut-out through aorta and left ventricle, employ extracorporal circulatory system combine low temperature, put, reduce pressure drainage tube in the atrium sinistrum, block, rise aorta, inject cold heart into, park, fight liquid and part lowers the myocardium temperature in pressurize by root its, cut, rise the intersection of aorta and root horizontally, with draw hook preceded right one draw forward, excise the intersection of Model U and cardiac muscle with round the intersection of edge and knife from the intersection of heart and the intersection of interventricular septum and the front, cut-out, preceded below the petal beginning and extending to right preceded from right to left side petal preceded petals of the intersection of juncture and below with Left deviation Can't cut-out the interventricular septum of heart to extend towards right side, so as not to damage the left room room bunch and cause complete block. Heart interventricular septum rectangle cardiac muscle is at direct-view in slice to below extend,but can't cut more darkly. Another the intersection of wall and underpart make with most low oblique angle propping up to crab and cut-outing parallel long about 4cm in front of left ventricle, left ventricle of the lower side of skin of papilla before entering, a leaf will be drawn to the left side of the interventricular septum of heart through cut-outing, from playing and excising the plump cardiac muscle of interventricular septum of heart upwards with the knife, link with cardiac muscle slice excised by the aorta, then wipe out whole stretch of plump cardiac muscle and it is that 15- 20mm prunes the myocardium chip to cut-out the depth so as not to thromboembolism happen. The cardiac muscle of disconnected stitch cut-outs the whole layer, sew up the aorta to cut-out. Discharging left room and aorta remains the gas, remove the aorta and block pincerses and raise the body temperature, the heartbeat and then stops the extracorporal circulatory system effectively.
(2) Cut-out the intersection of heart and the intersection of interventricular septum and cardiac muscle, excise and cut skill, set up extracorporal circulatory system and take the myocardium protective measure by aorta, block the main arterial blood and flow through and promote the crosscut mouth of aorta root, draw right and preceded one appears in interventricular septum of heart, top of interventricular septum of heart does two and cut-outs parallelly to preceded in right below one with the small round knife, can oppress the free wall of right ventricle while cutting the underpart of interventricular septum of heart, make the interventricular septum of heart move toward the left ventricle in order to improving and appearing, then excise two pieces of parallel plump cardiac muscle of rectangle while cut-outing to organize. Press the interventricular septum of heart to cut-out with the finger, increase depth and width of the groove of interventricular septum of heart, remove the myocardium fragment, sew up the aorta to cut-out, discharge and inner gas of aorta of left ventricle, remove the aorta and block pincerses. Reply warm to reach over 35 to body temperature, after heartbeat effectively, stop the extracorporal circulatory system, substantially as thinking the interventricular septum of heart plump cardiac muscle excise still enough satisfied, can another cut-out route, excise completely by left ventricle.
Therapeutic effect: The mortality of operation is about 10%. The common death reason is that the low heart arranges blood volume and left ventricle to cut-out and bleed. Postoperative about 5% of the cases erupt complete block simultaneously, it is taller that bunch props up a bunch of incidence of propping up block of right on the left. In addition a few patients erupt simultaneously and enclose a myocardial infarction of skill, the interventricular septum of heart is pierced through, left ventricle the intersection of room and the intersection of wall and tumour and person who cure source the intersection of aorta and one or bicuspid valve close completely.
The plump cardiac muscle of interventricular septum of heart excises the thorough postoperative symptom of case and disappears or lightens notably, the difference of systolic pressure disappears, the wave form of the aorta pressure returns to normal. Reexamine revealing the left ventricle increases in ultrasonic heart cardon and alternative left ventricle radiography, move and disappear before a leaf before the bicuspid valve of systolic phase, but the atrium quivers and still exists. Improving to 1- 2 grades in postoperative heart functions of the patients of about 90%.
Examine, survive over 10 o'clock, 50% survive more than 15 years by 70% case at the same time for a long time while being postoperative. The main death reason is the congestive serious arrhythmia in heart failure, the atrium quivers and causes cerebral embolism or myocardial infarction. The incidence of dying suddenly is about 25%, not than through surgery the therapeutic patient reduce notably.
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