The Diagnosis And Treatment Of Hypertrophic Cardiomyopathy Surgical Treatment For Hypertrophic Obstructive Cardiomyopathy

Background:Hypertrophic cardiomyopathy (HCM) is the most common hereditary disease of the heart.Methods:In this article, we summarize the current state of the diagnosis and treatment of HCM on the basis of a selective review of publications with relevance to clinical practice.Results:Several hundred mutations are associated with the HCM phenotype. There are two types of HCM, obstructive type (HOCM) and on-obstructive type (HNCM). The symptoms of HCM include dyspnea, angina pectoris, palpitations, dizziness, and occasionally syncope. In HOCM, the patient’s symptoms and the obstructive gradient are the guide to treatment with beta-blockers or verapamil. For patients with drug-resistant disease, surgical myectomy and percutaneous septal ablation are now standard treatments.Conclusion:A near-normal life expectancy and a highly satisfactory quality of life are now realistic treatment goals for patients with HCM. Objective:To evaluate clinical and echocardiography results of surgical treatment in patients with hypertrophic obstructive cardiomyopathy.Methods:We retrospectively examined163consecutive patients with Hypertrophic obstructive cardiomyopathy operated in our institution from1996-10to2011-12。Male95cases (58.3%)、age41.0±15.5(6～74) years、 all the patients had drug-refractory symptoms and a left ventricular outflow tract gradient of89.6±31.4(61～150) mmHg by Doppler echocardiography. All patients underwent septal myectomy and57patients (34.9%) combined with coronary artery bypass grafting or valvular surgery.Results:The hospital mortality was2.5%(n=4), the overall mortality was3.7%(n=6). Complete atrioventricular block occurred in9patients (5.5%) and complete left bundle branch block occurred in75patients (46.0%), AF occurred in39patients (23.4%).The mean follow-up time was3.1±2.7years, Follow-up rate was85.3%. The left ventricular outflow tract gradient was eliminated in most patients. The late symptom-free rate was77.0%and82.7%of the patient had a New York Heart Association functional class Ⅰ.Conclusion:Surgical septal myectomy can be performed safely, with excellent survival, eliminate left ventricular outflow tract obstruction and relief symptoms. The early benefits were remained at long term.