PMID- 2766539
OWN - NLM
STAT- MEDLINE
DCOM- 19891011
LR  - 20121115
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 80
IP  - 3 Pt 1
DP  - 1989 Sep
TI  - Septal myotomy-myomectomy versus mitral valve replacement in hypertrophic 
      cardiomyopathy. Ten-year follow-up in 185 patients.
PG  - I57-64
AB  - Between 1963 and 1985, 185 patients with hypertrophic cardiomyopathy (HCM) were 
      treated with septal myotomy-myomectomy (MM) or mitral valve replacement (MVR) at 
      our institution; 127 of these underwent septal MM, and 58 underwent MVR alone. 
      The 1-month mortality was 4.7% for the septal MM group and 6.9% for the MVR group 
      (p = NS). The mean time of postoperative follow-up was 118 months, ranging 
      between 1 and 196 months. The annual mortality was 0.7% for the septal MM group 
      and 1.3% for the MVR group (p = NS). In the MVR group, 98% of patients had been 
      assigned to New York Heart Association (NYHA) functional classes III and IV 
      before surgery; only 24% were classified as such at 10-year follow-up (p less 
      than 0.001). In the septal MM group, 90% were in NYHA functional classes III and 
      IV before surgery whereas only 27% were in these two classes postoperatively (p 
      less than 0.001). A comparison of preoperative and postoperative hemodynamic 
      findings revealed a significant reduction in left ventricular outflow gradient at 
      rest: from 69 +/- 41 mm Hg preoperatively to 10 +/- 22 mm Hg postoperatively (p 
      less than 0.001) in the septal MM group and from 75 +/- 45 mm Hg preoperatively 
      to 10 +/- 21 mm Hg postoperatively (p less than 0.001) in the MVR group. In 
      addition, the MVR group had a significant postoperative reduction in mean left 
      ventricular end-diastolic pressure, from 21 mm Hg preoperatively to 15 mm Hg 
      postoperatively (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Krajcer, Z
AU  - Krajcer Z
AD  - Division of Cardiology, Texas Heart Institute, Houston.
FAU - Leachman, R D
AU  - Leachman RD
FAU - Cooley, D A
AU  - Cooley DA
FAU - Coronado, R
AU  - Coronado R
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Cardiac Catheterization
MH  - Cardiomyopathy, Hypertrophic/complications/mortality/physiopathology/*surgery
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/epidemiology
MH  - Heart Septum/*surgery
MH  - *Heart Valve Prosthesis
MH  - Heart Ventricles/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve
MH  - Postoperative Complications/epidemiology
EDAT- 1989/09/01 00:00
MHDA- 1989/09/01 00:01
CRDT- 1989/09/01 00:00
PHST- 1989/09/01 00:00 [pubmed]
PHST- 1989/09/01 00:01 [medline]
PHST- 1989/09/01 00:00 [entrez]
PST - ppublish
SO  - Circulation. 1989 Sep;80(3 Pt 1):I57-64.