摘要心尖肥厚型心肌病常表现为心尖部局限性肥厚，可引起明显心功能不全症状，部分患者还可合并二尖瓣中-重度反流。本文报道1例69岁女性患者，因活动后胸闷、呼吸困难、胸痛加重入院。超声心动图检查提示左心室心尖部显著增厚，频谱多普勒测得心尖部压差达80 mmHg，彩色多普勒提示二尖瓣中-重度反流。患者在经食管超声心动图（TEE）实时引导下，成功接受了经心尖小切口心脏不停跳心尖部心肌切除术联合ValveClamp系统行经心尖二尖瓣夹合术。术中经食管超声精准引导手术操作并实时评估治疗效果，术后左心室腔容积显著改善，心尖部压差降低，二尖瓣反流改善至轻度，患者症状明显缓解。该病例提示，在TEE引导下实施经心尖一站式微创手术可安全、有效地治疗心尖肥厚型心肌病合并二尖瓣反流，具备创伤小、恢复快、疗效确切等优势。

abstractsApical hypertrophic cardiomyopathy is characterized by localized hypertrophy of the left ventricular（LV）apex. Some patients may present with heart failure symptoms，and some may develop significant mitral regurgitation（MR）. We report a case of a 69-year-old woman who was admitted with progressive chest tightness，dyspnea，and chest pain. Echocardiography revealed marked thickening of the LV apex and a peak systolic gradient of 80 mmHg at the apex，and color Doppler revealed moderate-to-severe MR. Under real-time transesophageal echocardiography（TEE）guidance，the patient successfully underwent transapical beating-heart apical myectomy，combined with transapical mitral edge-to-edge repair using the ValveClamp system. TEE provided precise intraoperative navigation and real-time evaluation. Postoperatively，