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Hypertrophic obstructive cardiomyopathy with a basal septal thickness of 16 mm or less: clinical characteristics and surgical results

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Abstract

Purposes

To characterize the clinical features and surgical outcomes of symptomatic hypertrophic obstructive cardiomyopathy (HOCM) in patients with only mild septal hypertrophy.

Methods

The clinical characteristics and surgical outcomes of 53 HOCM patients with a basal septal thickness ≤ 16 mm (mild group) were compared with those of 128 HOCM patients with a basal septal thickness > 16 mm (control group).

Results

The mild group had a greater prevalence of mitral subvalvular anomalies than the control group (79.2% vs. 6.3%, p < 0.001). Neither iatrogenic septal perforation nor inadequate septal myectomy was observed after myectomy in the mild group. There were no deaths during a median follow-up of 10 months. Transthoracic echocardiography 6 months after myectomy revealed a significant decrease in maximum gradients in both groups, from baseline 90.5 ± 21.5 mmHg to 10.3 ± 4.4 mmHg in the mild group (p < 0.001) and from 95.0 ± 22.0 mmHg to 12.0 ± 5.9 mmHg (p < 0.001) in the control group. Neither residual obstruction nor residual mitral regurgitation was recorded in the mild group.

Conclusions

Symptomatic patients with hypertrophic obstructive cardiomyopathy and mild septal hypertrophy may have a higher prevalence of mitral subvalvular abnormalities. Mitral subvalvular management during myectomy can achieve outstanding results for these patients.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery of Zhongshan Hospital Fudan University, Shanghai, China

    Qiang Ji, YuLin Wang, Ye Yang, Hao Lai & LiMin Xia

  2. Shanghai Municipal Institute for Cardiovascular Diseases, 1609 Xietu Road, Shanghai, 200032, China

    ChunSheng Wang

  3. Department of Cardiovascular Surgery of Xiamen Branch of Zhongshan Hospital Fudan University, Xiamen, China

    LiMin Xia

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  1. Qiang Ji
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  2. YuLin Wang
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  3. Ye Yang
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  4. Hao Lai
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  5. LiMin Xia
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  6. ChunSheng Wang
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Correspondence to ChunSheng Wang.

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Ji, Q., Wang, Y., Yang, Y. et al. Hypertrophic obstructive cardiomyopathy with a basal septal thickness of 16 mm or less: clinical characteristics and surgical results. Surg Today 52, 1170–1177 (2022). https://doi.org/10.1007/s00595-021-02441-z

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  • DOI: https://doi.org/10.1007/s00595-021-02441-z

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