title: [Surgical treatment for hypertrophic obstructive cardiomyopathy: a report of 118 cases].
abstract: OBJECTIVE
  To assess the clinical outcomes of transaortic extended septal myectomy on early and midterm survival of patients with hypertrophic obstructive cardiomyopathy (HOCM).
  
  
  METHODS
  From October 2009 to April 2012, 118 consecutive patients underwent extended Morrow's procedure for HOCM. There were 69 males and 49 females with an average age of (46 ± 13) years. Their clinical data were analyzed retrospectively. Preoperative transthoracic, intraoperative transoesophageal and postoperative transthoracic echocardiography was performed to assess septal thickness, left ventricular outflow tract (LVOT) gradient, mitral valve function and systolic anterior motion (SAM) of anterior mitral valve leaflet, etc. Concomitant surgical procedures were performed if other cardiac diseases required surgical interventions. Follow-up study was carried out during subsequent clinic visits at outpatient department and through telephone interviews with patients and their relatives.
  
  
  RESULTS
  The septal thickness was (25 ± 7) mm. SAM was detected in all. The in-hospital mortality was 0.8% (1/118) since one patient died of multiple organs failure one week later. Postoperative echocardiography demonstrated marked reduction in LVOT gradient (92 ± 22 vs 13 ± 10 mm Hg (1 mm Hg = 0.133 kPa), P = 0.000), New York Heart Association (NYHA) class (2.9 ± 0.6 vs 1.2 ± 0.4, P = 0.000) and significant improvement in mitral regurgitation. Concomitant surgical procedures were performed in 45 cases (38.1%, all for preexisting conditions). Complications included complete atrioventricular block (n = 3), first degree atrioventricular block (n = 6), complete left bundle branch block (n = 51), intraventricular conduction delay or left anterior division block (n = 26), transient renal dysfunction (n = 2) and intra-aortic-balloon-pumping (n = 2). No other severe complication was observed. During a follow-up period of 1 - 27 (7 ± 6) months, there was no readmission or death. All patients reported significant increase in physical ability and obvious decrease in limiting symptoms. At the latest follow-up, the NYHA functional class maintained grade I-II in all. And mitral regurgitation remained absent or mild.
  
  
  CONCLUSIONS
  Surgical procedure for HOCM patients is both safe and efficacious. It provides an excellent relief of LVOT obstruction.
authors: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China.
authors: Ming-yao
authors: MY
authors: Luo
authors: Shui-yun
authors: SY
authors: Wang
authors: Yun-hu
authors: YH
authors: Song
authors: Chao-hua
authors: CH
authors: Yin
authors: Hong-tao
authors: HT
authors: Sun
authors: Xin
authors: X
authors: Sun
authors: Nan
authors: N
authors: Xu
authors: Jian-ping
authors: JP
authors: Xu
authors: Wei
authors: W
authors: Wang
authors: Sheng-shou
authors: SS
authors: Hu
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures; D002312:Cardiomyopathy, Hypertrophic / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000601:surgery*