Mitral valve replacement or repair: choosing optimal surgical treatment of hypertrophic obstructive cardiomyopathy
<p>Objective. The purpose of this study was to compare clinical and hemodynamic efficacy of different surgical approaches to correct outflow tract obstruction and mitral insufficiency in patients with hypertrophic cardiomyopathy.<br />Methods. Over a period from November 2010 to August 2...
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| Format: | Article |
| Language: | English |
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Meshalkin National Medical Research Center
2016-01-01
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| Series: | Патология кровообращения и кардиохирургия |
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| Online Access: | http://journalmeshalkin.ru/index.php/heartjournal/article/view/262 |
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| author | Богачев-Прокофьев А. В. С. И. Железнев М. С. Фоменко А. В. Афанасьев Р. М. Шарифулин В. М. Назаров О. Ю. Малахова А. М. Караськов |
| author_facet | Богачев-Прокофьев А. В. С. И. Железнев М. С. Фоменко А. В. Афанасьев Р. М. Шарифулин В. М. Назаров О. Ю. Малахова А. М. Караськов |
| author_sort | Богачев-Прокофьев А. В. |
| collection | DOAJ |
| description | <p>Objective. The purpose of this study was to compare clinical and hemodynamic efficacy of different surgical approaches to correct outflow tract obstruction and mitral insufficiency in patients with hypertrophic cardiomyopathy.<br />Methods. Over a period from November 2010 to August 2013, 146 patients with hypertrophic obstructive cardiomyopathy (HOCM) underwent surgical treatment. 88 patients met the inclusion criteria and were randomized in two groups: Group I – extended myomectomy and MV replacement; Group II – extended myomectomy and MV repair. Mean age in Group I and Group II was 51.4±14.4 and 47.9±14.1 years respectively (p = 0.262). Mean peak gradient in Group I and Group II was 89.9±27.2 mm Hg. and 96.6±28.1 mm Hg. (p = 0.168). Pronounced MR was observed in 24 (58.5%) and 23 (56.1%) cases, moderate one in 17 (41.5%) and 18 (43.9%) cases in Group I and Group II respectively (p = 0.823). All patients demonstrated SAM syndrome. <br />Results. There was one (2.4%) early death in Group I (p = 0.314). In both groups such complications as AV block, ventricular septal defect and rupture of the left ventricle (p = 1.0) didn’t differ significantly. Average follow-up was 23.2 months for Group 1 and 25.8 months for Group 2. The survival rate in group I and group II was 78.9% and 96.6% respectively (Log-rank test = 0.034). Freedom from thromboembolic events was 83.2% and 100% respectively (Log-rank test = 0.026).<br />Conclusion. MV replacement and MV repair during extended septal myomectomy in patients with HOCM can be an effective method to eliminate MR and outflow tract obstruction. MV repair in patients with HOCM reduces thromboembolic events and provides better mid-term survival.</p> |
| first_indexed | 2024-03-12T08:14:52Z |
| format | Article |
| id | doaj.art-67d0681db0b844e7b03fd9e1746a30fc |
| institution | Directory Open Access Journal |
| issn | 1681-3472 2500-3119 |
| language | English |
| last_indexed | 2024-03-12T08:14:52Z |
| publishDate | 2016-01-01 |
| publisher | Meshalkin National Medical Research Center |
| record_format | Article |
| series | Патология кровообращения и кардиохирургия |
| spelling | doaj.art-67d0681db0b844e7b03fd9e1746a30fc2023-09-02T18:58:58ZengMeshalkin National Medical Research CenterПатология кровообращения и кардиохирургия1681-34722500-31192016-01-01194263310.21688/1681-3472-2015-4-26-33973Mitral valve replacement or repair: choosing optimal surgical treatment of hypertrophic obstructive cardiomyopathyБогачев-Прокофьев А. В.0С. И. Железнев1М. С. Фоменко2А. В. Афанасьев3Р. М. Шарифулин4В. М. Назаров5О. Ю. Малахова6А. М. Караськов7Новосибирский научно-исследовательский институт имени академика Е.Н. Мешалкина Министерства здравоохранения Российской Федерации, 630055, Новосибирск, ул. Речкуновская, 15Новосибирский научно-исследовательский институт имени академика Е.Н. Мешалкина Министерства здравоохранения Российской Федерации, 630055, Новосибирск, ул. Речкуновская, 15Новосибирский научно-исследовательский институт имени академика Е.Н. Мешалкина Министерства здравоохранения Российской Федерации, 630055, Новосибирск, ул. Речкуновская, 15Новосибирский научно-исследовательский институт имени академика Е.Н. Мешалкина Министерства здравоохранения Российской Федерации, 630055, Новосибирск, ул. Речкуновская, 15Новосибирский научно-исследовательский институт имени академика Е.Н. Мешалкина Министерства здравоохранения Российской Федерации, 630055, Новосибирск, ул. Речкуновская, 15Новосибирский научно-исследовательский институт имени академика Е.Н. Мешалкина Министерства здравоохранения Российской Федерации, 630055, Новосибирск, ул. Речкуновская, 15Новосибирский научно-исследовательский институт имени академика Е.Н. Мешалкина Министерства здравоохранения Российской Федерации, 630055, Новосибирск, ул. Речкуновская, 15Новосибирский научно-исследовательский институт имени академика Е.Н. Мешалкина Министерства здравоохранения Российской Федерации, 630055, Новосибирск, ул. Речкуновская, 15<p>Objective. The purpose of this study was to compare clinical and hemodynamic efficacy of different surgical approaches to correct outflow tract obstruction and mitral insufficiency in patients with hypertrophic cardiomyopathy.<br />Methods. Over a period from November 2010 to August 2013, 146 patients with hypertrophic obstructive cardiomyopathy (HOCM) underwent surgical treatment. 88 patients met the inclusion criteria and were randomized in two groups: Group I – extended myomectomy and MV replacement; Group II – extended myomectomy and MV repair. Mean age in Group I and Group II was 51.4±14.4 and 47.9±14.1 years respectively (p = 0.262). Mean peak gradient in Group I and Group II was 89.9±27.2 mm Hg. and 96.6±28.1 mm Hg. (p = 0.168). Pronounced MR was observed in 24 (58.5%) and 23 (56.1%) cases, moderate one in 17 (41.5%) and 18 (43.9%) cases in Group I and Group II respectively (p = 0.823). All patients demonstrated SAM syndrome. <br />Results. There was one (2.4%) early death in Group I (p = 0.314). In both groups such complications as AV block, ventricular septal defect and rupture of the left ventricle (p = 1.0) didn’t differ significantly. Average follow-up was 23.2 months for Group 1 and 25.8 months for Group 2. The survival rate in group I and group II was 78.9% and 96.6% respectively (Log-rank test = 0.034). Freedom from thromboembolic events was 83.2% and 100% respectively (Log-rank test = 0.026).<br />Conclusion. MV replacement and MV repair during extended septal myomectomy in patients with HOCM can be an effective method to eliminate MR and outflow tract obstruction. MV repair in patients with HOCM reduces thromboembolic events and provides better mid-term survival.</p>http://journalmeshalkin.ru/index.php/heartjournal/article/view/262Гипертрофическая кардиомиопатияМиоэктомияСердечная недостаточностьМитральная регургитация |
| spellingShingle | Богачев-Прокофьев А. В. С. И. Железнев М. С. Фоменко А. В. Афанасьев Р. М. Шарифулин В. М. Назаров О. Ю. Малахова А. М. Караськов Mitral valve replacement or repair: choosing optimal surgical treatment of hypertrophic obstructive cardiomyopathy Патология кровообращения и кардиохирургия Гипертрофическая кардиомиопатия Миоэктомия Сердечная недостаточность Митральная регургитация |
| title | Mitral valve replacement or repair: choosing optimal surgical treatment of hypertrophic obstructive cardiomyopathy |
| title_full | Mitral valve replacement or repair: choosing optimal surgical treatment of hypertrophic obstructive cardiomyopathy |
| title_fullStr | Mitral valve replacement or repair: choosing optimal surgical treatment of hypertrophic obstructive cardiomyopathy |
| title_full_unstemmed | Mitral valve replacement or repair: choosing optimal surgical treatment of hypertrophic obstructive cardiomyopathy |
| title_short | Mitral valve replacement or repair: choosing optimal surgical treatment of hypertrophic obstructive cardiomyopathy |
| title_sort | mitral valve replacement or repair choosing optimal surgical treatment of hypertrophic obstructive cardiomyopathy |
| topic | Гипертрофическая кардиомиопатия Миоэктомия Сердечная недостаточность Митральная регургитация |
| url | http://journalmeshalkin.ru/index.php/heartjournal/article/view/262 |
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