Surgical Septal Myectomy for Hypertrophic cardiomyopathy. The Iranian Experience

被引:1
作者
Ghavidel, Alireza Alizadeh [1 ]
Alizadehasl, Azin [2 ]
Khalilipur, Ehsan [3 ]
Amirghofran, Ahmadali [4 ]
Nezhadbahram, Hanieh [5 ]
Azarfarin, Rasoul [6 ]
机构
[1] Iran Univ Med Sci, Heart Valve Dis Res Ctr, Rajaie Cardiovasc Med & Res Ctr, Tehran, Iran
[2] Iran Univ Med Sci, Rajaie Cardiovasc Med & Res Ctr, Dept & Res Ctr Cardiooncol, Tehran, Iran
[3] Iran Univ Med Sci, Cardiovasc Intervent Res Ctr, Rajaie Cardiovasc Med & Res Ctr, Tehran, Iran
[4] Shiraz Univ Med Sci, Dept Cardiac Surg, Shiraz, Iran
[5] Iran Univ Med Sci, Rajaie Cardiovasc Med & Res Ctr, Tehran, Iran
[6] Iran Univ Med Sci, Cardiooncol Res Ctr, Rajaie Cardiovasc Med & Res Ctr, Tehran, Iran
关键词
HOCM; myectomy; less invasive surgery < general < aortic; outcomes < cardiac; mitral systolic anterior motion; SAM < cardiac; mitral regurgitation < cardiac; OBSTRUCTIVE CARDIOMYOPATHY; SUBAORTIC STENOSIS; SURVIVAL; ABLATION;
D O I
10.1177/02184923211044582
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction Hypertrophic obstructive cardiomyopathy (HOCM) is a hereditary heart muscle disorder characterized by significant myocardial hypertrophy. we assessed perioperative and long-term follow-up data of Iranian HOCM patients who underwent SM in 2 pioneering centers. Methods Clinical data of patients with HOCM septal myectomy are collected. Thirty-day outcome and long-term follow-up data for recurrence of gradient and mortality are reported. Results Ninety-six patients in two different centers enrolled in the study. Most patients of 52 patients in center 1 were male (34/52 [65.3%]).and the mean age was of 36.7 +/- 19 years. Syncope before admission was reported in 5.7%, the mean left ventricular ejection fraction on admission was 53 +/- 8%, the mean left ventricular outflow tract gradient was 66.3 +/- 20.4 mm Hg, and the mean preoperativeseptal thickness was 25.4 +/- 6.7 mm. A redo SM was performed in 3 patients (5.8%), mitral valve repair in 5 patients (9.6%), and atrioventricular repair in 5 patients (9.6%). A residual systolic anterior motion was detected in 4 patients (7.7%), the mean postoperative septal thickness was 19 +/- 6 mm (25.1% septal thickness reduction), and in-hospital mortality was 5.8% (n = 3). A longer-term follow-up showed death in 3 patients (5.8%) and late recurrent left ventricular outflow tract obstruction in 1 patient. Conclusions Transaortic myectomy is an effective surgery with acceptable early and late mortality rates. Improvements in functional status are seen in almost all patients. Appropriate SM is crucial to a good clinical outcome. Long-term survival is excellent and cardiac sudden death is extremely rare after a good surgical treatment.
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收藏
页码:64 / 73
页数:10
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