Midterm postoperative follow-up after surgical correction of hypertrophic cardiomyopathy in infancy and childhood
| Autor: | Mohamed Abdullah, Hesham Abd El Fattah Shawky, Yasser Menaissy, Tarek Salah, Mohamed Abdel-Raouf Khalil |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Alcohol septal ablation lcsh:Diseases of the circulatory (Cardiovascular) system Mean pressure lcsh:Surgery 030204 cardiovascular system & hematology Mid-term outcome 03 medical and health sciences 0302 clinical medicine Refractory Internal medicine Hypertrophic obstructive cardiomyopathy medicine Young adult Left ventricular outflow tract obstruction business.industry Hypertrophic cardiomyopathy lcsh:RD1-811 Surgical correction Septal myectomy medicine.disease University hospital Surgery 030228 respiratory system lcsh:RC666-701 Systolic anterior motion Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the Egyptian Society of Cardio-Thoracic Surgery, Vol 25, Iss 2, Pp 133-141 (2017) |
| Popis: | Background Surgical septal myectomy has been considered the gold-standard therapeutic option for symptomatic drug refractory patients with hypertrophic obstructive cardiomyopathy (HOCM) for over 50 years. However, it is being challenged by less- invasive interventional tools in the last 2 decades. The late effects of myocardial scar from alcohol septal ablation are unknown and, therefore, are not recommended in children and young adults. Methods A total of 9 patients underwent surgical interventions for HOCM. All patients were below 12 years of age. The patients were operated upon in Cairo University Hospitals, Egypt; in the period between April 2014 and February 2016. Pre-operative and operative data were collected and analyzed statistically. Post-operative evaluation was documented at different periods and data collected and analyzed in comparison with pre-operative data as well as at these different follow up periods. Results Mean age of all patients was 6.1 ± 2.6 years. 77.8% were males. All the patients were symptomatic. Preoperative mean pressure gradient (PG) was 95.4 ± 15.2 mmHg. Mean septal wall thickness (SWT) was 1.52 + 0.45 cm, mean degree of mitral regurge (MR) was 1.7 ± 0.83. Immediate postoperative assessment showed significant clinical improvement and significant reduction of PG to 20.0 ± 14 mmHg, SWT to 0.98 ± 0.38 cm, and mean degree of MR to 0.89 ± 0.33. Short-term and mid-term follow up showed sustained improvement. There were no deaths. Conclusions Surgical procedures for HOCM are generally safe and effective for improvement of symptoms, LVOT gradient, mitral regurge. Early surgical intervention is advocated to prevent progression of valve disease. |
| Databáze: | OpenAIRE |
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