Tactics of surgical treatment of patients with the generalized form of obstructive hypertrophic cardiomyopathy

• V.V. Raskin
• Frolova Yu.V.
• M.S. Malikova
• A.S. Dzemeshkevich
• Dombrovskaya A.V.
• A.N. Shapievа
• Svetlana V. Fedulova
• Sergey L. Dzemeshkevich

Abstract

To evaluate the surgical treatment of patients with the generalized form of hypertrophic cardiomyopathy by performing extended ventricular septal myectomy, longitudinal parietal resection of hypertrophied papillary muscles and universal chord-preserving mitral valve replacement.

From October, 2009 to January, 2014 we have performed 11 cardiac surgeries in patients with a generalized form of obstructive hypertrophic cardiomyopathy. Median age was 48±10,9 years (6 males and 5 females). 8 patients received implantable cardioverterdefibrillators (ICD) due to the underlying disease and a high risk of life-threatening arrhythmias in the pre- or postoperative period.

Cardiopulmonary bypass time did not exceed 112±8,6 min, ischemia 70,9±13,3 min. The postoperative period was uneventful. In-hospital mortality was 0%. In the late postoperative period (2 years), 1 patient died: the cause of death is unknown (presumably fatal continuously recurrent ventricular tachyarrhythmia).

The received results indicate that surgical treatment of the generalized form of HCM is the effective procedure that gives good functional results in the mid-term postoperative period.

Keywords:hypertrophic cardiomyopathy, generalized form, extended myectomy

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