Single-Centre Experience of Surgical Myectomy for Hypertrophic Obstructive Cardiomyopathy.

Autor: Afanasyev AV; Heart Valve Surgery Department, Meshalkin National Medical Research Center, Novosibirsk, Russian Federation. Electronic address: av.afanasyev@icloud.com., Bogachev-Prokophiev AV; Heart Valve Surgery Department, Meshalkin National Medical Research Center, Novosibirsk, Russian Federation., Ovcharov MA; Heart Valve Surgery Department, Meshalkin National Medical Research Center, Novosibirsk, Russian Federation., Pivkin AN; Heart Valve Surgery Department, Meshalkin National Medical Research Center, Novosibirsk, Russian Federation., Zalesov AS; Heart Valve Surgery Department, Meshalkin National Medical Research Center, Novosibirsk, Russian Federation., Budagaev SA; Heart Valve Surgery Department, Meshalkin National Medical Research Center, Novosibirsk, Russian Federation., Sharifulin RM; Heart Valve Surgery Department, Meshalkin National Medical Research Center, Novosibirsk, Russian Federation., Zheleznev SI; Heart Valve Surgery Department, Meshalkin National Medical Research Center, Novosibirsk, Russian Federation., Karaskov AM; Heart Valve Surgery Department, Meshalkin National Medical Research Center, Novosibirsk, Russian Federation.
Jazyk: angličtina
Zdroj: Heart, lung & circulation [Heart Lung Circ] 2020 Jun; Vol. 29 (6), pp. 949-955. Date of Electronic Publication: 2019 Aug 08.
DOI: 10.1016/j.hlc.2019.07.009
Abstrakt: Background: Septal myectomy is the gold standard treatment for hypertrophic obstructive cardiomyopathy. This study aimed to evaluate the results from patients with hypertrophic cardiomyopathy who had undergone septal myectomy.
Methods: Data were analysed that has been prospectively collected over 7 years from 345 patients with hypertrophic cardiomyopathy who underwent septal myectomy at Meshalkin National Medical Research Center.
Results: Six (6) patients (1.7%) died within 30 days of surgery. The mean (standard deviation, SD) resting left ventricular outflow tract gradients reduced from 83.4 (24.2) mmHg preoperatively to 16.2 (8.5) mmHg at discharge (p < 0.001). Of the 345 patients, 329 (95.4%) attended the most recent follow-up assessments, and of these, 254 (77.2%) were categorised as New York Heart Association (NYHA) class I, 64 (19.5%) class II, and 11 (3.3%) class III. The mean overall long-term survival rate after septal myectomy was 95.7% (SD 1.7%) (95% CI, 90.0-97.9). This did not differ from the age-matched and gender-matched general population (log-rank, p = 0.109). At the last follow-up assessments, six of 67 patients who had undergone concomitant Cox-Maze IV procedures had late atrial tachyarrhythmia recurrences. A preoperative short-axis view of left atrial diameter of 57.5 mm (hazard ratio, 1.30 (95% CI, 1.03-1.65), p < 0.001) predicted late atrial tachyarrhythmias (p < 0.002).
Conclusions: At this hypertrophic cardiomyopathy centre, septal myectomy is associated with low operative and early mortality rates (<2%), a low risk of early adverse events, and acceptable intermediate-term clinical and haemodynamic results.
(Copyright © 2019 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: