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Revista chilena de cardiología

On-line version ISSN 0718-8560

Abstract

PAREDES, Federico et al. Video assisted myectomy for relief of left ventricular tract obstruction in patients with Obstructive Hypertrophic Cardiomyopathy. Rev Chil Cardiol [online]. 2013, vol.32, n.2, pp.97-103. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602013000200002.

Aim: To report a clinical experience and to evaluate early and mid term results of video assisted myec-tomy for relief of left ventricular tract obstruction (LVOTO) in patients with Obstructive Hypertrophic Cardiomyopathy. Methods: 52 patients with Obstructive Car-diomyopathy and a mean age 56.2 years (12 - 83) carrying a Euro score risk of 4.1 ± (SD 1.92), were consecutively operated on in a single center. Relief of LVOTO was performed with video assisted myec-tomy. Clinical and echocardiographic follow up to 1 year postoperatively was carried out. Results: Apart from the Obstructive Cardiomyo-pathy, 11 patients had aortic valve disease, 2 mitral valve disease, 3 ischemic heart disease, 1 an ascending aortic aneurysm and 1 a patent foramen ovale. All these lesions were surgically repaired in the same surgical act. In hospital mortality was 5.8% (3 patients). Pre-operatively 15.4% of patients were in NYHA Class II, 80.8% in Class III and 3.8% in Class IV. After surgery peak sub aortic gradient decreased from 80.7±29.43mmHg to 19.0 ± 15.57 (p<0.001). Corresponding values were 14.6 ± 8.88 at 1month and 13.9 ± 7.69 at 1 year post operatively. Interven-tricular septal thickness in diastole decreased from 19.4 ± 3.78 mm to 12.9 ± 2.35 mm after surgery (p<0.001). All patients were Class I or II at the end of follow up. Conclusion: Video assisted myectomy is safe and effective for relief of LVOTO in patients with hypertrophic cardiomyopathy. Good results are maintained one year after surgery.

Keywords : Obstructive Hypertrophic Cardiom-yopathy; Cardiac Surgery; video assisted myectomy.

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