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

Background: In patients who underwent transaortic myectomy for hypertrophic obstructive cardiomyopathy (HOCM), we evaluated the role of concomitant procedures for short and lone term outcome. Methods: From 1985 to 2000, in 125 patients a myectomy according to Morrow was performed. A total of 75 patients (group 1) 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. (C) 2002 Elsevier Science B.V. All rights reserved.