PMID- 29408870 OWN - NLM STAT- MEDLINE DCOM- 20180402 LR - 20181113 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 13 IP - 2 DP - 2018 TI - Mid-term outcomes of biventricular obstruction and left ventricular outflow tract obstruction after surgery correction in child and adolescent patients with hypertrophic cardiomyopathy. PG - e0192218 LID - 10.1371/journal.pone.0192218 [doi] LID - e0192218 AB - BACKGROUND: Data on the outcomes of hypertrophic cardiomyopathy (HCM) with biventricular obstruction are limited. OBJECTIVE: Our aim is to compare mid-term outcomes of biventricular outflow tract obstruction (BVOTO) HCM, left ventricular outflow tract obstruction (LVOTO) HCM and nonobstructive hypertrophic cardiomyopathy (NO-HCM) in children and adolescents who were treated with standard medication or surgical resection. METHODS: This retrospective study identified 21 BVOTO patients and recruited 27 LVOTO and 24 NO-HCM patients younger than 18 years presenting at our institution. The primary endpoint was all-cause death, and secondary endpoints were cardiovascular events. RESULTS: More BVOTO patients (61.9%) than LVOTO (19.2%) and NO-HCM patients (25%) exhibited New York Heart Association (NYHA) III/IV status (p < 0.01). Fourteen BVOTO and 16 LVOTO patients obtained a significant reduction of outflow tract pressure gradients after surgery (vs. preoperative baseline, p < 0.001). One of the 14 BVOTO patients died, whereas no deaths occurred among LVOTO patients. Three of 14 BVOTO surgery patients had complete heart block (CHB) and 4 had new right bundle branch block (RBBB), while no CHB or RBBB occurred in the LVOTO surgery patients. The BVOTO patients had a longer duration of aortic cross-clamping and postoperative hospital days than the LVOTO patients (p < 0.05). During a median 42-month follow-up, no deaths occurred among the remaining patients. The primary and secondary endpoint-free survival rates of the BVOTO group were comparable to those of the LVOTO and NO-HCM groups. CONCLUSIONS: In children and adolescents, BVOTO patients were associated with more severe symptoms than LVOTO and NO-HCM patients; however, good mid-term outcomes similar to those of the LVOTO and NO-HCM groups can be achieved with the application of contemporary cardiovascular treatment strategies. Notably, BVOTO surgery was associated with an increased risk of CHB and RBBB compared to LVOTO surgery. FAU - Zhai, Shanshan AU - Zhai S AD - Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Xu, Haitao AU - Xu H AD - Department of Pediatric Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Fan, Chaomei AU - Fan C AD - Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Yang, Yinjian AU - Yang Y AD - Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Hang, Fei AU - Hang F AD - Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Guo, Xiying AU - Guo X AD - Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Wang, Hongyue AU - Wang H AD - Departments of Pathology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Duan, Fujian AU - Duan F AD - Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Yan, Jun AU - Yan J AD - Department of Pediatric Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. LA - eng PT - Journal Article DEP - 20180206 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - Adolescent MH - Cardiomyopathy, Hypertrophic/physiopathology/*surgery MH - Child MH - Child, Preschool MH - Female MH - Heart Defects, Congenital/physiopathology/*surgery MH - Heart Ventricles/diagnostic imaging/physiopathology/*surgery MH - Humans MH - Male MH - Retrospective Studies MH - Treatment Outcome PMC - PMC5800690 COIS- Competing Interests: The authors have declared that no competing interests exist. EDAT- 2018/02/07 06:00 MHDA- 2018/04/03 06:00 PMCR- 2018/02/06 CRDT- 2018/02/07 06:00 PHST- 2017/04/18 00:00 [received] PHST- 2018/01/19 00:00 [accepted] PHST- 2018/02/07 06:00 [entrez] PHST- 2018/02/07 06:00 [pubmed] PHST- 2018/04/03 06:00 [medline] PHST- 2018/02/06 00:00 [pmc-release] AID - PONE-D-17-13708 [pii] AID - 10.1371/journal.pone.0192218 [doi] PST - epublish SO - PLoS One. 2018 Feb 6;13(2):e0192218. doi: 10.1371/journal.pone.0192218. eCollection 2018.