Septal myectomy for obstructive hypertrophic cardiomyopathy:the gold standard

VernacularTitle:室间隔切除术:治疗梗阻性肥厚型心肌病的金标准
Author: Dearani A JOSEPH ¹ ; Schaff V HARTZELL ; Ommen R STEVE
Author Information

1. Minnesota 55905,Division of Cardiovascular Surgery,Mayo Clinic and Foundation
From: Chinese Journal of Cardiology 2009;37(4):307-311
CountryChina
Language:Chinese
Abstract: Septal myectomy effectively and definitively relieves LVOT obstruction and cardiac symptoms in adults and children with obstructive hypertrophic cardiomyopathy(HCM).Abnormalities of the mitral valve can be addressed without the need for mitral valve replacement in almost all circumstances.Concomitant mitral valve repair for myxomatous disease requires minor modifications when performed in conjunction with septal myectomy;mitral valve replacement is rarely necessary.In experienced centers,early mortality for isolated septai myectomy is low(～1%)and overall results are excellent and continue to improve in the current era.Symptomatic improvement with myectomy is expected for most;90% of patients improve by at least one functional class,and most remain improved on late follow-up.Late survivorship is improved compared to nonopereted patients with obstructive HCM,and myectomy may be associated with reduced risk of sudden cardiac death.These results should serve as the gold standard and a basis for comparison with newer nonsurgical medalities,i.e.,septal alcohol ablation.