To explore the therapeutic effect of modified Morrow operation in the treatment of patients with obstructive hypertrophic cardiomyopathy (HOCM) and main points of perioperative nursing.

Thirty-five patients undergoing modified Morrow operation in the Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, from January 2016 to January 2017 were selected. Psychological care for the patient before the operation was carried out, related examinations were improved and the patient to perform breathing exercises were guided. During the operation, the nurse should not leave the operating room. After the operation, the patients′ ECG changes was closely observed, the temporary pacemaker was fixed, and the temporary pacemaker function was checked to make sure whether it was in a normal state, the health education and safety guidance of patients using pacemakers were strengthened. Routine ECG monitoring after surgery, blood gas analysis, blood routine, liver and kidney function and other related checks were performed, and maintaining the stability of the patient′s internal environment and electrolyte balance should be paid attention. Patient′s lung care and sputum expectoration were strengthened and encouraged. Nurses should visited the ward frequently and asked patients if they felt unwell. The intraoperative complications, extracorporeal circulation time, aortic block time, and the presence of secondary rotation were detected; whether the patients were successfully weaned from the ventilator and tracheal intubation in ICU, whether there was bradycardia and needed temporary pacemaker or permanent pacemaker implantation were obserbed; the hospitalization time were recorded; the ultrasound indexes before discharge and whethwe there were any serious complications or death after operation were recorded.

All the 35 patients underwent modified Morrow operation, including mitral valvuloplasty in 5 cases (14.3%), tricuspid valvuloplasty in 5 cases (14.3%), and radiofrequency ablation of atrial fibrillation in 1 case (2.9%). No patients underwent mitral value replacement or aortic value replacement at the same time. The mean cardiopulmonary bypass time was (115.7±44.3) min, and the mean aortic occlusion time was (72.3±25.4) min, and no secondary transfer occurred. Immediately after the operation, the esophageal ultrasound showed the left ventricular outflow tract pressure difference 8.7(5.9, 11.7) mmHg (1 mmHg=0.133 kPa). All patients were successfully removed from the ventilator in the ICU and the tracheal intubation was removed. The ICU stay time was 58.9(47.6, 71.5) h and the mechanical ventilation time was 18.0(17.0, 24.5) h. Transient atrioventricular block occurred in 2 patients (5.7%) after operation, and sinus rhythm was restored afterwords. The average hospital stay of all patients was (8.5±3.8) d. The ultrasound results before discharge showed that there were 32 patients with mild mitral regurgitation, 3 patients with moderate regurgitation and no aortic regurgitation. The left ventricular outflow tract pressure of all patients before discharge was 9.2(6.8, 12.3) mmHg. In addition, one patient occoured third degree atrioventricular block and received permanent pacemaker implantation. The rest patients were cured and discharged after active treatment and careful nursing. No serious complications occurred and no patient died.

The modified Morrow operation can effectively relieve left ventricular outflow tract obstruction in patients with HOCM, and careful and patient perioperative nursing plays an important role in ensuring the success of operation, and improving the prognosis.