Shuiyun Wang1, Hao Cui2, Qinjun Yu3, Haibo Chen2, Changsheng Zhu2, Jingjin Wang4, Minghu Xiao4, Yanbo Zhang5, Rong Wu2, Shengshou Hu2. 1. Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address: wsymd@sina.com. 2. Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 3. Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 4. Department of Echocardiography, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 5. Intensive Care Unit, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Abstract
OBJECTIVE: This study aims to report our preliminary experience and anatomic findings in the surgical treatment and postoperative management of hypertrophic obstructive cardiomyopathy. METHODS: This study included 277 patients with hypertrophic obstructive cardiomyopathy (168 [60.65%] were male), with a median age of 47 years (interquartile range, 35-54 years), who underwent surgical myectomy performed by 1 surgeon in Fuwai Hospital between May 2010 and April 2015. The median follow-up was 14 months (interquartile range, 7-24 months). RESULTS: A total of 127 patients (45.85%) underwent concomitant procedures, and 2 patients (0.72%) died in the early perioperative days. The left ventricular outflow gradient decreased from 78 mm Hg (interquartile range, 61-100 mm Hg) to 11 mm Hg (interquartile range, 8-15 mm Hg) when discharged (P < .001). Of the 228 patients with well-documented anatomic description, more than 80% had various intraventricular anomalies. The cumulative survival was 99.28% (95% confidence interval, 97.15-99.82) at 1 year and 96.98% (95% confidence interval, 92.56-98.79) at 5 years. Of the surviving 272 patients, 268 (98.53%) were categorized with functional class I and II of the New York Heart Association classification at the latest evaluation. CONCLUSIONS: Anomalous muscle bundles are common in hypertrophic obstructive cardiomyopathy, and they may lead to middle-apical obstruction. Surgical myectomy provides excellent clinical outcomes with low risk for sufficient relief of obstruction and radical correction of intraventricular anomalies in patients with hypertrophic obstructive cardiomyopathy.
OBJECTIVE: This study aims to report our preliminary experience and anatomic findings in the surgical treatment and postoperative management of hypertrophic obstructive cardiomyopathy. METHODS: This study included 277 patients with hypertrophic obstructive cardiomyopathy (168 [60.65%] were male), with a median age of 47 years (interquartile range, 35-54 years), who underwent surgical myectomy performed by 1 surgeon in Fuwai Hospital between May 2010 and April 2015. The median follow-up was 14 months (interquartile range, 7-24 months). RESULTS: A total of 127 patients (45.85%) underwent concomitant procedures, and 2 patients (0.72%) died in the early perioperative days. The left ventricular outflow gradient decreased from 78 mm Hg (interquartile range, 61-100 mm Hg) to 11 mm Hg (interquartile range, 8-15 mm Hg) when discharged (P < .001). Of the 228 patients with well-documented anatomic description, more than 80% had various intraventricular anomalies. The cumulative survival was 99.28% (95% confidence interval, 97.15-99.82) at 1 year and 96.98% (95% confidence interval, 92.56-98.79) at 5 years. Of the surviving 272 patients, 268 (98.53%) were categorized with functional class I and II of the New York Heart Association classification at the latest evaluation. CONCLUSIONS: Anomalous muscle bundles are common in hypertrophic obstructive cardiomyopathy, and they may lead to middle-apical obstruction. Surgical myectomy provides excellent clinical outcomes with low risk for sufficient relief of obstruction and radical correction of intraventricular anomalies in patients with hypertrophic obstructive cardiomyopathy.
Authors: Hassan Rastegar; Griffin Boll; Ethan J Rowin; Noreen Dolan; Catherine Carroll; James E Udelson; Wendy Wang; Philip Carpino; Barry J Maron; Martin S Maron; Frederick Y Chen Journal: Ann Cardiothorac Surg Date: 2017-07
Authors: Mihaela Octavia Popa; Ana Maria Irimia; Mihai Nicolae Papagheorghe; Elena Miruna Vasile; Simona Andreea Tircol; Raluca Andreea Negulescu; Catalina Toader; Robert Adam; Lucian Dorobantu; Cristina Caldararu; Maria Alexandrescu; Sebastian Onciul Journal: Discoveries (Craiova) Date: 2016-06-30