Long-term follow-up in hypertrophic obstructive cardiomyopathy after septal myectomy

Objective To evaluate clinical and echocardiography long-term results of septal myectomy surgery in patients with hypertrophic obstructive cardiomyopathy (HOCM).Methods We examined retrospectively 86 consecutive patients [age(37 ± 16)years] with HOCM operated on in our institution from 1996 to 2009.With a left ventricular outflow tract gradient of(98 ±27) mmHg by Doppler echocardiography.54 patients (63％) were in New York Heart Association (NYHA) functional class Ⅲ-Ⅳ.54 patients (63％) underwent isolated septal myectomy and others combined with additional procedures.The surgical technique used in all patients was septal myectomy performed through an aortomy.Mean follow-up was(4.8 ±3.3) years.Results The perioperative mortality rate was 4.7％ (n =4).The cumulative survival rate at 3 month,1 year,and 5 years was 94.7％,93.4％,and 92.1％ respectively,and late symptom-free rate was 85％.The left ventricular outflow tract gradient was nearly eliminated in most patients,85 ％ of the patient has a Ⅰ-Ⅱ NYHA functional class.Conclusion Surgical septal myectomy can be performed safely,with excellent survival,improvement from symptoms and relief for LVOT obstruction in patients with HOCM.The early benefits were remained at long term.