PMID- 25678500
OWN - NLM
STAT- MEDLINE
DCOM- 20150609
LR  - 20191210
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 99
IP  - 4
DP  - 2015 Apr
TI  - Short and medium term outcomes of surgery for patients with hypertrophic 
      obstructive cardiomyopathy.
PG  - 1213-9
LID - S0003-4975(14)02137-7 [pii]
LID - 10.1016/j.athoracsur.2014.11.020 [doi]
AB  - BACKGROUND: We report one surgeon's experience of corrective surgery for 
      hypertrophic obstructive cardiomyopathy (HOCM) over a 10-year span and comment on 
      factors that influence longer term outcomes. Septal myectomy (SM) and adjunctive 
      procedures, including shortening of the aorta, a novel technique in HOCM 
      patients, are described. METHODS: Perioperative data were obtained by 
      retrospective review of institutional surgical databases between 2001 and 2011. 
      Review of most recent echocardiogram and clinical status by telephone interview 
      was performed. RESULTS: A total of 211 patients underwent SM for HOCM. There was 
      a bimodal age distribution related to sex; mean age for males and females was 46 
      +/- 13 and 54 +/- 14 years, respectively (p < 0.001). Functional New York Heart 
      Association (NYHA) class improved significantly after surgery; 79% were in class 
      III-IV preoperatively and 84% were in class I-II at follow-up (p < 0.001). Sixty 
      percent had angina of Canadian Cardiovascular Society (CCS) grade III-IV 
      preoperatively and 89% were in CCS I-II at follow-up (p < 0.001). There were 
      significant improvements in resting left ventricular outflow tract gradient (64 +/- 
      36 to 5 +/- 5 mm Hg, p < 0.001), right ventricular systolic pressure (36 +/- 7.3 to 
      32 +/- 8 mm Hg, p < 0.001), left atrial size (4.6 +/- 0.7 to 4.3 +/- 0.6 cm, p < 
      0.001), and grade of mitral regurgitation (moderate to severe mitral 
      regurgitation 28% to 3.5%, p < 0.001). In-hospital mortality was 0.5%, 1 year 
      survival 98.6%, and 5-year survival 98.1%. Predictors of worse clinical outcomes 
      were preoperative NYHA and CCS class III-IV (p < 0.001, p = 0.05), new onset 
      atrial fibrillation (p < 0.001), and female sex (p = 0.03). CONCLUSIONS: Septal 
      myectomy in patients with obstructive HOCM offers excellent symptom relief and 
      minimal operative risk.
CI  - Copyright (c) 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Parry, Dominic J
AU  - Parry DJ
AD  - Department of Cardiovascular Surgery, Peter Munk Cardiac Center, Toronto General 
      Hospital, University Health Network, Toronto, Ontario, Canada. Electronic 
      address: dparry@mcmaster.ca.
FAU - Raskin, Robert E
AU  - Raskin RE
AD  - Department of Cardiovascular Surgery, Peter Munk Cardiac Center, Toronto General 
      Hospital, University Health Network, Toronto, Ontario, Canada.
FAU - Poynter, Jeffery A
AU  - Poynter JA
AD  - The Hospital for Sick Children, Division of Cardiovascular Surgery and Labatt 
      Family Heart Centre, University of Toronto, Toronto, Ontario, Canada.
FAU - Ribero, Igo B
AU  - Ribero IB
AD  - Department of Cardiovascular Surgery, Peter Munk Cardiac Center, Toronto General 
      Hospital, University Health Network, Toronto, Ontario, Canada.
FAU - Bajona, Pietro
AU  - Bajona P
AD  - Department of Cardiovascular Surgery, Peter Munk Cardiac Center, Toronto General 
      Hospital, University Health Network, Toronto, Ontario, Canada.
FAU - Rakowski, Harry
AU  - Rakowski H
AD  - Division of Cardiology, Peter Munk Cardiac Center, Toronto General Hospital, 
      Toronto, Ontario, Canada.
FAU - Woo, Anna
AU  - Woo A
AD  - Division of Cardiology, Peter Munk Cardiac Center, Toronto General Hospital, 
      Toronto, Ontario, Canada.
FAU - Ralph-Edwards, Anthony
AU  - Ralph-Edwards A
AD  - Department of Cardiovascular Surgery, Peter Munk Cardiac Center, Toronto General 
      Hospital, University Health Network, Toronto, Ontario, Canada.
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
DEP - 20150210
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Surgical Procedures/*methods/mortality
MH  - Cardiomyopathy, Hypertrophic/diagnostic imaging/mortality/*surgery
MH  - Cohort Studies
MH  - Databases, Factual
MH  - *Echocardiography, Transesophageal
MH  - Education, Medical, Continuing
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Septum/diagnostic imaging/*surgery
MH  - Hospital Mortality
MH  - Humans
MH  - Intraoperative Complications/mortality/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Ontario
MH  - Postoperative Complications/mortality/physiopathology
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Sex Factors
MH  - *Stroke Volume
MH  - Survival Rate
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2015/02/14 06:00
MHDA- 2015/06/10 06:00
CRDT- 2015/02/14 06:00
PHST- 2014/03/13 00:00 [received]
PHST- 2014/11/11 00:00 [revised]
PHST- 2014/11/17 00:00 [accepted]
PHST- 2015/02/14 06:00 [entrez]
PHST- 2015/02/14 06:00 [pubmed]
PHST- 2015/06/10 06:00 [medline]
AID - S0003-4975(14)02137-7 [pii]
AID - 10.1016/j.athoracsur.2014.11.020 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2015 Apr;99(4):1213-9. doi: 10.1016/j.athoracsur.2014.11.020. 
      Epub 2015 Feb 10.