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Eur J Cardiothorac Surg 2002;22:206-210
© 2002 Elsevier Science NL

Long term follow-up of surgical treatment of hypertrophic obstructive cardiomyopathy (HOCM): the role of concomitant cardiac procedures

Department of Thoracic and Cardiovascular Surgery, Heart Center NRW, University of Bochum, Georgstr. 11, 325 45 Bad Oeynhausen, Germany

Received 25 October 2001; received in revised form 5 April 2002; accepted 17 April 2002.

* Corresponding author. Tel.: +49-5731-97-1235; fax: +49-5731-97-1300
e-mail: kminami{at}hdz-nrw.de

Background: In patients who underwent transaortic myectomy for hypertrophic obstructive cardiomyopathy (HOCM), we evaluated the role of concomitant procedures for short and long term outcome. Methods: From 1985 to 2000, in 125 patients a myectomy according to Morrow was performed. A total of 75 patients (group I) had isolated HOCM: 37 females, 38 males, mean age 52.1 years (14–79). The 50 patients of group II – 22 females, 28 males, mean age 62.4 years (36–77)-had concomitant procedures: coronary artery bypass grafting (36), mitral valve repair (15), DeVega-plasty (1), ventricular septal infarction-closure (1). Follow-up data of a total of 680.9 years (mean 5.4) were analyzed. Results: Postoperatively, left ventricular outflow tract gradients at rest and after ventricular premature beats were significantly reduced (P<0.001). Mean performance of survivors (112/125=89.6%) improved significantly (P<0.001). Perioperative complication rates: 10.7/12.0% (groups I/II), early lethality: 1.3/2.0%. Survival rates after 5/10 years were 93±3/87±6 and 80±7/80±7% for groups I and II, respectively. Conclusion: Long term results after surgical treatment of HOCM are convincing also if concomitant procedures are performed.

Key Words: Hypertrophic obstructive cardiomyopathy • Mitral insufficiency • Concomitant procedures