Medium-long Term Outcomes of Ventricular Septal Myectomy for Treating the Patients With Hypertrophic Obstructive Cardiomyopathy-A Single Center Experience
10.3969/j.issn.1000-3614.2016.06.012
- VernacularTitle:单中心室间隔心肌切除术治疗肥厚型梗阻性心肌病中远期结果分析
- Author:
Haojie LI
;
Yunhu SONG
;
Xiaodong ZHU
;
Shengshou HU
;
Zhe ZHENG
;
Shuiyun WANG
;
Hansong SUN
;
Wei WANG
;
Jianping XU
;
Hui XIONG
;
Xin WANG
;
Jun YAN
;
Xiaoqi WANG
;
Yun LIU
;
Jun RAN
;
Yajie TANG
- Publication Type:Journal Article
- Keywords:
Cardiomyopathy,hypertrophic;
Ventricular outlfow tract obstruction;
Surgical procedures;
Survival rates
- From:
Chinese Circulation Journal
2016;31(6):573-577
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To report the medium-long term survival rates of ventricular septal myectomy for treating the patients with hypertrophic obstructive cardiomyopathy and to analyze the predictive factors affecting the outcomes. Methods: A total of 655 consecutive patients who received ventricular septal myectomy in our hospital from 1984-10 to 2014-12 were retrospectively summarized. The cohort study was conducted with questionnaires by cardiovascular nurses. Result: The operative mortality was 1.4% (9/655). The mean follow-up time was (30.8 ± 30.9, from 3 to 213) months, there were 52/646 (7.9%) patients lost contact and 583 patients having NYHA classification at I or II during that period. The overall survival rates for 1 year, 5-year and 8-year were 98.3%, 90.5% and 88.3% respectively. There were 80 patients suffered from end point events including HCM-related death, heart transplantation, repeated myectomy, permanent pacemaker implantation and re-admission for ischemic stroke, tachyarrhythmia, myocardial ischemia or infarction, congestive heart failure. The end point events free survival rates for 1 year, 5-year and 8-year were 94.2%, 76.7% and 65.9% respectively. Multivariable Cox regression analysis presented that age>50 years (HR=2.16, 95% CI 1.36-3.46,P=0.001) and pre-operative atrial ifbrillation (FA) (HR=2.31, 95% CI 1.35-3.94,P=0.002) were the independent predictors for end point events occurrence. Conclusion: Ventricular septal myectomy may achieve good medium-long term survival rate with less adverse event in patients with hypertrophic obstructive cardiomyopathy. Elder than 50 years of age and with pre-operative FA were the independent predictors for adverse events occurrence.
