title: Treatment modalities in hypertrophic obstructive cardiomyopathy: surgical myectomy versus percutaneous septal ablation.
abstract: BACKGROUND
  The aim of this study was to compare the results of percutaneous septal myocardial ablation (PSMA) and surgical myectomy (SM) for decreasing the left ventricular outflow tract (LVOT) gradient, septal thickness, ventricular dimensions, and mitral regurgitation (MR) in patients with symptomatic hypertrophic obstructive cardiomyopathy.
  
  
  METHODS
  We treated 40 patients (mean age, 24.4 +/- 6.8 years; 34 male and 6 female patients) between June 2002 and April 2006. Twenty-four patients underwent SM, and 16 patients underwent PSMA. All patients were symptomatic despite maximal medical treatment and had an LVOT gradient higher than 65 mm Hg. Their echocardiographic data were recorded before and after the procedure and then compared. The patients were followed up postoperatively for a mean of 13 months.
  
  
  RESULTS
  There was no mortality in either group. One year after the procedure, the LVOT gradients for the 2 groups were not statistically different. During the follow-up, moderate MR was found in 4 patients (25%) in the ablation group and in 2 patients (8.3%) in the myectomy group. Exercise capacity and New York Heart Association class improved after PSMA, whereas postoperative MR severity and effort capacity were better in the surgical group.
  
  
  CONCLUSIONS
  The 2 approaches yielded similar results with regard to reducing the LVOT gradient. We conclude that SM is preferable to PSMA in cases with MR.
authors.affiliation: Department of Cardiovascular Surgery, Bursa Yüksek Ihtisas Education and Research Hospital, Bursa, Turkey. ahvural@gmail.com
authors.forename: A Hakan
authors.initials: AH
authors.lastname: Vural
authors.forename: Osman
authors.initials: O
authors.lastname: Tiryakioğlu
authors.forename: Tamer
authors.initials: T
authors.lastname: Türk
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Ata
authors.forename: Hasan
authors.initials: H
authors.lastname: Ari
authors.forename: Serhat
authors.initials: S
authors.lastname: Yalçinkaya
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Erkut
authors.forename: Tahsin
authors.initials: T
authors.lastname: Bozat
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozyazicioğlu
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome