Key result
Biventricular obstruction surgery in pediatric HCM achieves similar functional outcomes to isolated LVOT correction.
Why the study?
The effectiveness and safety of surgical treatment of biventricular obstruction in children with obstructive hypertrophic cardiomyopathy were not well established.
Does surgical correction of biventricular obstruction improve echocardiographic parameters and provide safe outcomes compared to LVOT obstruction correction alone in children with obstructive HCM?
Cohort (n=40)
Does surgical correction of biventricular obstruction improve echocardiographic parameters and provide safe outcomes compared to LVOT obstruction correction alone in children with obstructive HCM?
Surgical elimination of biventricular obstruction in children with obstructive hypertrophic cardiomyopathy is safe and effective, serving as a viable alternative to heart transplantation.
Supports equivalent post-op echo outcomes for biventricular versus LVOT-only correction in pediatric obstructive HCM; leaves open long-term benefits.
Objective. To analyze the effectiveness of surgical treatment of biventricular obstruction in children with obstructive hypertrophic cardiomyopathy (HCM). Material and methods. A retrospective analysis enrolled 12 patients after elimination of biventricular obstruction in 2010—2024. The control group included patients with LVOT obstruction alone (n=28). We analyzed echocardiography parameters before surgery, in early and mid-term postoperative period. Results. Age of patients was 3.9 [2.4; 13.6] years. Genetically confirmed Noonan syndrome was registered in 5 (42%) children. Drug therapy was required in 11 (92%) patients. In preoperative period, z-index of LV end-diastolic dimension (p=0.03) and volume (p=0.04), sphericity index (p=0.01), ejection fraction (p=0.03) and stroke index (p=0.02) significantly differed in children with biventricular obstruction. After surgery, the main echocardiography parameters did not differ significantly in both groups. Pressure gradients in LVOT and RVOT significantly decreased in postoperative period. The follow-up period was 3.0 [2.9; 3.2] years. There were no fatal outcomes. Drug therapy was administered to all patients (n=10). Functional class of heart failure did not change — 1.2±0.4 and 1.3±0.5, respectively (p=0.152). Conclusion. Elimination of biventricular obstruction did not increase the risk of complications and deaths. This procedure was an effective alternative to heart transplantation according to immediate and mid-term follow-up data.
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Kozhanov et al. (2026) conducted a cohort in obstructive hypertrophic cardiomyopathy (n=40). Surgical correction of biventricular obstruction vs. Surgical correction of LVOT obstruction alone was evaluated on Functional class of heart failure (p=0.152). Surgical correction of biventricular obstruction in children with hypertrophic cardiomyopathy was safe, with 0 fatal outcomes at 3 years and similar postoperative heart failure functional class compared to LVOT obstruction alone (1.2 vs 1.3; p=0.152).
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