PMID- 11738306
OWN - NLM
STAT- MEDLINE
DCOM- 20020102
LR  - 20191210
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 38
IP  - 7
DP  - 2001 Dec
TI  - Outcome of patients with hypertrophic obstructive cardiomyopathy after 
      percutaneous transluminal septal myocardial ablation and septal myectomy surgery.
PG  - 1994-2000
AB  - OBJECTIVES: This study was conducted to evaluate follow-up results in patients 
      with hypertrophic obstructive cardiomyopathy (HOCM) who underwent either 
      percutaneous transluminal septal myocardial ablation (PTSMA) or septal myectomy. 
      BACKGROUND: Controversy exists with regard to these two forms of treatment for 
      patients with HOCM. METHODS: Of 51 patients with HOCM treated, 25 were treated by 
      PTSMA and 26 patients via myectomy. Two-dimensional echocardiograms were 
      performed before both procedures, immediately afterwards and at a three-month 
      follow-up. The New York Heart Association (NYHA) functional class was obtained 
      before the procedures and at follow-up. RESULTS: Interventricular septal 
      thickness was significantly reduced at follow-up in both groups (2.3 +/- 0.4 cm 
      vs. 1.9 +/- 0.4 cm for septal ablation and 2.4 +/- 0.6 cm vs. 1.7 +/- 0.2 cm for 
      myectomy, both p < 0.001). Estimated by continuous-wave Doppler, the resting 
      pressure gradient (PG) across the left ventricular outflow tract (LVOT) 
      significantly decreased immediately after the procedures in both groups (64 +/- 
      39 mm Hg vs. 28 +/- 29 mm Hg for PTSMA, 62 +/- 43 mm Hg vs. 7 +/- 7 mm Hg for 
      myectomy, both p < 0.0001). At three-month follow-up, the resting PG remained 
      lower in the PTSMA and myectomy groups (24 +/- 19 mm Hg and 11 +/- 6 mm Hg, 
      respectively, vs. those before procedures, both p < 0.0001). The NYHA functional 
      class was also significantly improved in both groups (3.5 +/- 0.5 vs. 1.9 +/- 0.7 
      for PTSMA, 3.3 +/- 0.5 vs. 1.5 +/- 0.7 for myectomy, both p < 0.0001). 
      CONCLUSIONS: Both myectomy and PTSMA reduce LVOT obstruction and significantly 
      improve NYHA functional class in patients with HOCM. However, there are benefits 
      and drawbacks for each therapeutic method that must be counterbalanced when 
      deciding on treatment for LVOT obstruction.
FAU - Qin, J X
AU  - Qin JX
AD  - Cardiovascular Imaging Center, Department of Cardiology, The Cleveland Clinic 
      Foundation, Cleveland, Ohio 44195, USA.
FAU - Shiota, T
AU  - Shiota T
FAU - Lever, H M
AU  - Lever HM
FAU - Kapadia, S R
AU  - Kapadia SR
FAU - Sitges, M
AU  - Sitges M
FAU - Rubin, D N
AU  - Rubin DN
FAU - Bauer, F
AU  - Bauer F
FAU - Greenberg, N L
AU  - Greenberg NL
FAU - Agler, D A
AU  - Agler DA
FAU - Drinko, J K
AU  - Drinko JK
FAU - Martin, M
AU  - Martin M
FAU - Tuzcu, E M
AU  - Tuzcu EM
FAU - Smedira, N G
AU  - Smedira NG
FAU - Lytle, B
AU  - Lytle B
FAU - Thomas, J D
AU  - Thomas JD
LA  - eng
GR  - R01 HL56688-01A1/HL/NHLBI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Cardiac Catheterization
MH  - Cardiomyopathy, Hypertrophic/diagnostic imaging/*surgery
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Septum/diagnostic imaging/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Minimally Invasive Surgical Procedures
MH  - Outcome and Process Assessment, Health Care
MH  - Postoperative Complications/diagnostic imaging
MH  - Ventricular Outflow Obstruction/diagnostic imaging/surgery
OTO - NASA
OT  - NASA Discipline Cardiopulmonary
OT  - Non-NASA Center
FIR - Thomas, J D
IR  - Thomas JD
IRAD- Cleveland Clinic Found, OH
EDAT- 2001/12/12 10:00
MHDA- 2002/01/05 10:01
CRDT- 2001/12/12 10:00
PHST- 2001/12/12 10:00 [pubmed]
PHST- 2002/01/05 10:01 [medline]
PHST- 2001/12/12 10:00 [entrez]
AID - S0735109701016564 [pii]
AID - 10.1016/s0735-1097(01)01656-4 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2001 Dec;38(7):1994-2000. doi: 10.1016/s0735-1097(01)01656-4.