PMID- 33376603 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220419 IS - 2090-8016 (Print) IS - 2090-0597 (Electronic) IS - 2090-0597 (Linking) VI - 2020 DP - 2020 TI - Characteristics and Surgical Results of Patients with Hypertrophic Obstructive Cardiomyopathy without Intrinsic Mitral Valve Diseases Undergoing Mitral Subvalvular Procedures during Myectomy. PG - 8875405 LID - 10.1155/2020/8875405 [doi] LID - 8875405 AB - BACKGROUND: Mitral subvalvular procedures have acquired a major role during hypertrophic obstructive cardiomyopathy (HOCM) surgery. However, few studies have focused on characterizing the clinical feature of HOCM patients without intrinsic mitral valve (MV) diseases undergoing mitral subvalvular procedures in addition to myectomy. Additionally, scant data about the results of mitral subvalvular procedures during HOCM surgery are available. This single-center study aims to characterize the clinical feature and surgical results of HOCM patients without intrinsic MV diseases undergoing mitral subvalvular procedures in addition to myectomy in comparison with those receiving myectomy alone. METHODS: Among 181 eligible patients, 50 (27.6%) patients undergoing myectomy plus mitral subvalvular procedures were entered into the combined group, and the remaining 131 patients receiving myectomy alone were included in the alone group. Baseline and surgical characteristics were investigated, and surgical results were compared. RESULTS: Comparatively, the combined group was younger (52.9 +/- 11.2 years vs. 56.8 +/- 11.8 years, p=0.045) and had a better New York Heart Association (NYHA) class (p=0.034) and less septal hypertrophy (16.4 +/- 2.3 mm vs. 18.5 +/- 3.2 mm, p < 0.001). Septal thickness was independently associated with combined procedures in multivariable logistic regression analysis (OR = 0.887, 95% CI 0.612-0.917). No surgical death or iatrogenic septal perforation occurred in the combined group. Two (6.5%) patients in the combined group developed complete atrioventricular block and required permanent pacemaker implantation. During a median follow-up of 10 months, no deaths or reoperations were observed with the symptom of relief and NYHA class I or II in either group. Patients in the combined group as compared to the alone group had lower outflow tract gradients and a lower incidence of residual systolic anterior motion (SAM) syndrome. CONCLUSIONS: For HOCM patients without intrinsic MV diseases who are scheduled for surgery, a less pronounced septal hypertrophy may be closely associated with myectomy with concomitant mitral subvalvular procedures instead of myectomy alone. Mitral subvalvular procedures during myectomy are safe and allow the reduction of outflow tract gradients and freedom from SAM more effectively in comparison with myectomy alone. CI - Copyright (c) 2020 Qiang Ji et al. FAU - Ji, Qiang AU - Ji Q AUID- ORCID: 0000-0002-1769-6118 AD - Department of Cardiovascular Surgery of Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai 200032, China. FAU - Wang, YuLin AU - Wang Y AD - Department of Cardiovascular Surgery of Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai 200032, China. FAU - Yang, Ye AU - Yang Y AD - Department of Cardiovascular Surgery of Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai 200032, China. FAU - Xia, LiMin AU - Xia L AD - Department of Cardiovascular Surgery of Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai 200032, China. AD - Department of Cardiovascular Surgery of Xiamen Branch of Zhongshan Hospital Fudan University, 668 Jinhu Road, Huli District, Xiamen 510530, China. FAU - Ding, WenJun AU - Ding W AD - Department of Cardiovascular Surgery of Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai 200032, China. FAU - Song, Kai AU - Song K AUID- ORCID: 0000-0002-9500-0200 AD - Department of Cardiovascular Surgery of Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai 200032, China. AD - Department of Cardiovascular Surgery of Xiamen Branch of Zhongshan Hospital Fudan University, 668 Jinhu Road, Huli District, Xiamen 510530, China. FAU - Wang, ChunSheng AU - Wang C AUID- ORCID: 0000-0002-6745-458X AD - Shanghai Institute of Cardiovascular Diseases, 1609 Xietu Road, Shanghai 200032, China. LA - eng PT - Journal Article DEP - 20201209 PL - United States TA - Cardiol Res Pract JT - Cardiology research and practice JID - 101516542 PMC - PMC7744219 COIS- The authors declare that they have no conflicts of interest in this work. EDAT- 2020/12/31 06:00 MHDA- 2020/12/31 06:01 PMCR- 2020/12/09 CRDT- 2020/12/30 05:21 PHST- 2020/09/20 00:00 [received] PHST- 2020/12/02 00:00 [accepted] PHST- 2020/12/30 05:21 [entrez] PHST- 2020/12/31 06:00 [pubmed] PHST- 2020/12/31 06:01 [medline] PHST- 2020/12/09 00:00 [pmc-release] AID - 10.1155/2020/8875405 [doi] PST - epublish SO - Cardiol Res Pract. 2020 Dec 9;2020:8875405. doi: 10.1155/2020/8875405. eCollection 2020.