PMID- 19049745
OWN - NLM
STAT- MEDLINE
DCOM- 20090205
LR  - 20161124
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 86
IP  - 5
DP  - 2008 Nov
TI  - Resection-plication-release for hypertrophic cardiomyopathy: clinical and 
      echocardiographic follow-up.
PG  - 1539-44; discussion 1544-5
LID - 10.1016/j.athoracsur.2008.07.048 [doi]
AB  - BACKGROUND: Abnormal positioning and size of the mitral valve contribute to the 
      systolic anterior motion and mitral-septal contact that are important components 
      of obstructive hypertrophic cardiomyopathy (HCM). The RPR repair (resection of 
      the septum, plication of the anterior leaflet, and release of papillary muscle 
      attachments) addresses all aspects of this complex pathology. This study reports 
      outcomes regarding effectiveness of the RPR repair. METHODS: Fifty consecutive 
      unselected patients (average age, 55.8 years) undergoing RPR repair for 
      obstructive HCM from 1997 to 2007 were studied. Each patient underwent 
      preoperative and postoperative transthoracic echocardiograms to document 
      gradient, ejection fraction, degree of mitral regurgitation, and systolic 
      anterior motion. Intraoperative transesophageal echocardiogram was used to guide 
      all surgical repairs. Clinical follow-up included patient interviews to determine 
      New York Heart Association (NYHA) status. RESULTS: Concomitant operations were 
      performed in 25 patients (50%). Postoperative mortality was 0%. Average mean left 
      ventricular outflow tract gradients decreased from 134 +/- 40 to 2.8 +/- 8.0. 
      Mitral regurgitation improved from a mean of 2.5 to 0.1 (p < 0.001). Average 
      length of stay was 6.9 +/- 2.7 days. NYHA class improved from 3.0 +/- 0.6 to 1.2 
      +/- 0.5. Follow-up was 100%, with a mean of 2.5 +/- 1.8 years. Average mitral 
      regurgitation at follow-up was 0.9, with no residual systolic anterior motion. 
      CONCLUSIONS: The RPR repair is safe and effective for symptomatic obstructive 
      HCM. Our data support repair of the mitral valve that results in good 
      intermediate outcomes with respect to gradient, mitral regurgitation, and 
      clinical status.
FAU - Balaram, Sandhya K
AU  - Balaram SK
AD  - Division of Cardiothoracic Surgery, St. Luke's-Roosevelt Hospital Center, 
      Columbia University College of Physicians and Surgeons, New York, New York 10025, 
      USA. sbalaram@chpnet.org
FAU - Tyrie, Leslie
AU  - Tyrie L
FAU - Sherrid, Mark V
AU  - Sherrid MV
FAU - Afthinos, John
AU  - Afthinos J
FAU - Hillel, Zak
AU  - Hillel Z
FAU - Winson, Glenda
AU  - Winson G
FAU - Swistel, Daniel G
AU  - Swistel DG
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiomyopathy, Hypertrophic/*diagnostic imaging/*surgery
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
EDAT- 2008/12/04 09:00
MHDA- 2009/02/06 09:00
CRDT- 2008/12/04 09:00
PHST- 2008/01/31 00:00 [received]
PHST- 2008/07/16 00:00 [revised]
PHST- 2008/07/16 00:00 [accepted]
PHST- 2008/12/04 09:00 [pubmed]
PHST- 2009/02/06 09:00 [medline]
PHST- 2008/12/04 09:00 [entrez]
AID - S0003-4975(08)01572-5 [pii]
AID - 10.1016/j.athoracsur.2008.07.048 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2008 Nov;86(5):1539-44; discussion 1544-5. doi: 
      10.1016/j.athoracsur.2008.07.048.