Short- and Mid-term Effect of Surgical Treatment for Hypertrophic Obstructive Cardiomyopathy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YANGJian-guo ,  TAOLiang , CHENXu-fa , HEYa-feng

Department of Cardiovascular Surgery, Wuhan Asia Heart Hospital, Wuhan 430022, P. R. China;

Corresponding author：

TAOLiang, Email: 979638260@qq.com

Keywords：

Hypertrophic obstructive cardiomyopathy; Modified extended Morrow procedure; Septal myectomy

DOI：

10.7507/1007-4848.20150209

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the surgical procedures and clinical effects of surgical treatment for patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods We retrospectively analyzed the clinical data of sixty-five consecutive patients with HOCM who underwent modified Morrow procedure in Wuhan Asia Heart Hospital between June 2010 and December 2013. There were 40 males and 25 females with mean age of 48.4±11.5 years (ranged 18-70 years). Results There was no in-hospital mortality. There was no valve injury or ventricular septal perforation occurred during operation. Postoperative LVOT gradient, interventricular septum (IVS), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and mitral regurgitation (MR) were significantly lower than preoperative values (P<0.05). Complete atrioventricular block occurred in 3 patients, complete left bundle branch block occurred in 7 patients, and left anterior division block occurred in 3 patients. All patients were followed up for 6-35 months. During the following-up time, the clinical symptoms diminished in 55 patients and ameliorated significantly in other 10 patients. All patients had a NewYork Heart Association functional class Ⅰ/Ⅱ during the follow-up. Conclusion Surgical septal myectomy can eliminate obstruction of left ventricular outflow tract and relief symptoms obviously. The early and mid-term outcomes are satisfactory.

Citation： YANGJian-guo, TAOLiang, CHENXu-fa, HEYa-feng. Short- and Mid-term Effect of Surgical Treatment for Hypertrophic Obstructive Cardiomyopathy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(9): 837-840. doi: 10.7507/1007-4848.20150209 Copy

1.	Maron BJ. Hypertrophic cardiomyopathy:an important global disease. Am J Med, 2004, 116:63-65.
2.	Braunwald E, Lambrew CT, Rock off SD, et al. Idiopathic hypertrophic subaortic stenosis. I. A description of the disease based upon analysis of 64 patients. Circulation, 1964, 30(SUPPL 4):3-119.
3.	Dilsizian V, Bonow RO, Epstein SE, et al. Myocardial ischemia detected by thallium scintigraphy is frequently related to cardiacarrest and syncope in young patients with hypertrophic cardiomyopathy. J Am Coll Cardiol, 1993, 22(3):796-804.
4.	王水云, 崔彬, 孙寒松, 等. 肥厚梗阻性心肌病的外科治疗. 中华医学杂志, 2009, 89(39):2776-2778.
5.	Elliott P, McKenna WJ. Hypertrophic eardiomyopathy. Lancet. 2004, 363(9424):1881-1891.
6.	Maron BJ, MaronMS, Wigle ED, et al. The 50-year history, controversy and clinical implications of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy:from idiopathic hypertrophic subaortic stenosis to hypertrophic cardiomyopathy. J Am Coll Cardiol, 2009, 54(3):191-200.
7.	2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy:executive summary:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg, 2011, 142(6):1303-1338.
8.	然鋆, 宋云虎, 胡盛寿, 等. 室间隔心肌切除术治疗肥厚梗阻性心肌病的远期效果. 中华胸心血管外科杂志, 2013, 29(1):12-14.
9.	McCully RB, Nishimura RA, Tajik AJ, et al. Extent of clinical improvement after surgical treatment of hypertrophic obstructive cardiomyopathy. Circulation, 1996, 94(3):467-471.
10.	Robbins RC, Stinson EB. Long-term results of left ventricular myotomy and myectomy for obstructive hypertrophic cardiomyopathy. J Thorac Cardiovasc Surg, 1996, 111(3):586-594.
11.	崔彬, 许建屏. 王巍, 王水云, 等. 肥厚梗阻型心肌病合并二尖瓣病变的外科治疗. 中华胸心血管外科杂志, 2010, 26(6):368-370.
12.	Brown ML, Schaff HV. Surgical management of obstructive hypertrophic cardiomyopathy:the gold standard. Expert Rev cardiovase Ther, 2008, 6(5):715-722.
13.	Maron BJ. Controversies in/cardiovascular medicine.Surgical myectomy remains the primary treatment option for severely symptomatic patients with obstructive hypertrophic cardiomyopathy. Circulation, 2007, 116(2):196-206.
14.	乔树宾, 袁建松. 肥厚梗阻性心肌病的治疗进展. 中国循环杂志, 2012, 27(1):3-5.
15.	崔彬, 许建屏. 王巍, 等. 心肌间隔切除术矫治肥厚梗阻型心肌病及围术期治疗策略. 中国胸心血管外科临床杂志, 2010, 17(1):6-9.
16.	Wang S, Luo M, Sun H, et al. A retrospective clinical study of transaortic extended septal myectomy for obstructive hypertrophic cardiomyopathy in China. Eur J Cardiothorac Surg, 2013, 43(3):534-540.
17.	孙宏涛. 王水云, 罗明尧, 等. 隐匿性肥厚梗阻性心肌病的外科治疗. 中国分子心脏病学杂志, 2012, 12(2):65-67.
18.	尹朝华, 王水云, 赵振华, 等. 肥厚型梗阻性心肌病合并二尖瓣自身病变致二尖瓣关闭不全的外科治疗. 中国心血管病研究,2010, 8(6):405-407.
19.	罗明尧,王水云,尹朝华, 等. 合并感染性心内膜炎肥厚梗阻性心肌病的外科治疗. 中国胸心血管外科杂志, 2012, 19(6):597-601.
20.	Louahabi T, Drighil A, Habbal R, et al. Infective endocarditis complicating hypertrophic obstructive cardiomyopathy.Eur J Echocardiogr, 2006, 7(6):468-470.
21.	Fyfe B, Ianosi-Irimie M, Motavalli L. Infective endocarditis complicating hypertrophic obstructive cardiomyopathy:an unusual mural pattern.Cardiovasc Pathol, 2010, 19(1):e5-e7.
22.	Ashikhmina EA, Schnff HV, Ommen SR, et al. Intraoperative direct measurement of left ventficular outflow tract gradients to guide surgical myectomy for hypertrophic cardiomyopathy. J Thorac Cardiovasc Surg, 2011, 142(1):53-59.

1. Maron BJ. Hypertrophic cardiomyopathy:an important global disease. Am J Med, 2004, 116:63-65.
2. Braunwald E, Lambrew CT, Rock off SD, et al. Idiopathic hypertrophic subaortic stenosis. I. A description of the disease based upon analysis of 64 patients. Circulation, 1964, 30(SUPPL 4):3-119.
3. Dilsizian V, Bonow RO, Epstein SE, et al. Myocardial ischemia detected by thallium scintigraphy is frequently related to cardiacarrest and syncope in young patients with hypertrophic cardiomyopathy. J Am Coll Cardiol, 1993, 22(3):796-804.
4. 王水云, 崔彬, 孙寒松, 等. 肥厚梗阻性心肌病的外科治疗. 中华医学杂志, 2009, 89(39):2776-2778.
5. Elliott P, McKenna WJ. Hypertrophic eardiomyopathy. Lancet. 2004, 363(9424):1881-1891.
6. Maron BJ, MaronMS, Wigle ED, et al. The 50-year history, controversy and clinical implications of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy:from idiopathic hypertrophic subaortic stenosis to hypertrophic cardiomyopathy. J Am Coll Cardiol, 2009, 54(3):191-200.
7. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy:executive summary:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg, 2011, 142(6):1303-1338.
8. 然鋆, 宋云虎, 胡盛寿, 等. 室间隔心肌切除术治疗肥厚梗阻性心肌病的远期效果. 中华胸心血管外科杂志, 2013, 29(1):12-14.
9. McCully RB, Nishimura RA, Tajik AJ, et al. Extent of clinical improvement after surgical treatment of hypertrophic obstructive cardiomyopathy. Circulation, 1996, 94(3):467-471.
10. Robbins RC, Stinson EB. Long-term results of left ventricular myotomy and myectomy for obstructive hypertrophic cardiomyopathy. J Thorac Cardiovasc Surg, 1996, 111(3):586-594.
11. 崔彬, 许建屏. 王巍, 王水云, 等. 肥厚梗阻型心肌病合并二尖瓣病变的外科治疗. 中华胸心血管外科杂志, 2010, 26(6):368-370.
12. Brown ML, Schaff HV. Surgical management of obstructive hypertrophic cardiomyopathy:the gold standard. Expert Rev cardiovase Ther, 2008, 6(5):715-722.
13. Maron BJ. Controversies in/cardiovascular medicine.Surgical myectomy remains the primary treatment option for severely symptomatic patients with obstructive hypertrophic cardiomyopathy. Circulation, 2007, 116(2):196-206.
14. 乔树宾, 袁建松. 肥厚梗阻性心肌病的治疗进展. 中国循环杂志, 2012, 27(1):3-5.
15. 崔彬, 许建屏. 王巍, 等. 心肌间隔切除术矫治肥厚梗阻型心肌病及围术期治疗策略. 中国胸心血管外科临床杂志, 2010, 17(1):6-9.
16. Wang S, Luo M, Sun H, et al. A retrospective clinical study of transaortic extended septal myectomy for obstructive hypertrophic cardiomyopathy in China. Eur J Cardiothorac Surg, 2013, 43(3):534-540.
17. 孙宏涛. 王水云, 罗明尧, 等. 隐匿性肥厚梗阻性心肌病的外科治疗. 中国分子心脏病学杂志, 2012, 12(2):65-67.
18. 尹朝华, 王水云, 赵振华, 等. 肥厚型梗阻性心肌病合并二尖瓣自身病变致二尖瓣关闭不全的外科治疗. 中国心血管病研究,2010, 8(6):405-407.
19. 罗明尧,王水云,尹朝华, 等. 合并感染性心内膜炎肥厚梗阻性心肌病的外科治疗. 中国胸心血管外科杂志, 2012, 19(6):597-601.
20. Louahabi T, Drighil A, Habbal R, et al. Infective endocarditis complicating hypertrophic obstructive cardiomyopathy.Eur J Echocardiogr, 2006, 7(6):468-470.
21. Fyfe B, Ianosi-Irimie M, Motavalli L. Infective endocarditis complicating hypertrophic obstructive cardiomyopathy:an unusual mural pattern.Cardiovasc Pathol, 2010, 19(1):e5-e7.
22. Ashikhmina EA, Schnff HV, Ommen SR, et al. Intraoperative direct measurement of left ventficular outflow tract gradients to guide surgical myectomy for hypertrophic cardiomyopathy. J Thorac Cardiovasc Surg, 2011, 142(1):53-59.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Short- and Mid-term Effect of Surgical Treatment for Hypertrophic Obstructive Cardiomyopathy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content