title: [Long term results of the surgical treatment of obstructive hypertrophic cardiomyopathies].
abstract: Between January 1973 and December 1993, 66 patients underwent surgery in our department for hypertrophic obstructive cardiomyopathy; mean basal outflow gradient was 48.4 +/- 36 mmHg, 20 patients had mitral valve lesions. Thirty six patients underwent myotomy-myomectomy alone, 13 mitral valve replacement alone, and 17 both myotomy-myomectomy and mitral valve replacement. The 30-day mortality rate was 7.5% for all patients; predominant risk factors were gender (female), greater cardiothoracic ratio, preoperative episodes of atrial fibrillation and lack of syncope. Overall survival rate (operative mortality included) was 65.3 +/- 8.6% at 13 years. Predominant risk factors for late mortality were the same than above, plus mitral valve replacement; so mitral valve repair, whenever feasible should be undertaken. Forty nine patients are still followed up: 46 are asymptomatic; Doppler mean basal outflow gradient was reduced to 10 +/- 1.4 mmHg. In conclusion, surgery relieves symptoms and outflow obstruction, and allows mitral valve reconstruction.
authors: Service de chirurgie thoracique et cardiovasculaire, höpital de la Pitié, Paris.
authors: F
authors: F
authors: Jault
authors: I
authors: I
authors: Gandjbakhch
authors: A
authors: A
authors: Rama
authors: P
authors: P
authors: Nataf
authors: R
authors: R
authors: Dorent
authors: V
authors: V
authors: Bors
authors: A
authors: A
authors: Pavie
authors: C
authors: C
authors: Cabrol
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000401:mortality / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D012086:Reoperation; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
vernacular_title: Résultats à long terme du traitement chirurgical des cardiomyopathies hypertrophiques obstructives.