Clinical features and outcomes of surgical therapy in 14 patients with hypertrophic obstructive cardiomyopathy and subaortic membrane

Abstract

Objective To analyze the clinical features and surgical outcomes of patients with hypertrophic obstructive cardiomyopathy (HOCM) and subaortic membrane. Methods We evaluated the surgical outcomes of ventricular septal myectomy and resection of subaortic membrane in patients with HOCM and subaortic membrane by comparing pre-operative, post-operative and follow-up echocardiography and monitoring prognosis in Fuwai hospital from January 2012 to December 2017. Results A total of 14 patients were enrolled into the study.The mean age was (48.1±11.9) years old.There were 11 patients with New York Heart Association (NYHA) class Ⅲ-Ⅵ, and 3 with NYHA class Ⅱ.There were 4 patients with atrial fibrillation, 5 patients with pulmonary hypertension.The post-operative echocardiography showed a significant reduction in ventricular septal thickness [(13.9±5.3) mm vs (18.1±4.5) mm], resting left ventricular outflow tract gradients [(11.6±7.9) mmHg (1 mmHg=0.133 kPa) vs (94.2±37.3) mmHg], left atrial diameters [(38.1±6.9) mm vs (44.4±6.6) mm] and left ventricular ejection fraction [(63.2±4.2)% vs (69.0±8.6)%] compared with preoperative echocardiography.There were no morality and other adverse cardiovascular events during the (5.6±0.9) months follow-up.The follow-up echocardiography showed the ventricular septal thickness, left ventricular outflow tract gradient and left atrial diameter were still significantly lower than pre-operation except ventricular septal hypertrophy recurred in one patient. Conclusions The comorbidities were more common in patients with HOCM and subaortic membrane. Surgical therapy is safe and efficient for the patients with HOCM and subaortic membrane. Key words: Cardiomyopathy, hypertrophic; Subaortic membrane; Ventricular septal myectomy