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Revista Uruguaya de Cardiología

On-line version ISSN 1688-0420


SOCA, GERARDO et al. Evaluación de resultados quirúrgicos de la miectomía como tratamiento de la miocardiopatía hipertrófica obstructiva: Experiencia de un centro en Uruguay. Rev.Urug.Cardiol. [online]. 2010, vol.25, n.1, pp.05-10. ISSN 1688-0420.

SUMMARY Introduction: surgical septum myectomy remains the gold standard for the treatment of obstructive hypertrophic cardiomyopathy requiring surgery for symptomatic relief. Wasn’t found in the literature, any series of patients underwent myectomy in Uruguay. Our objetive was the analysis of our center series, assessing variables for comparison with reference series. Materials and methods: were included all patients with myectomy from january 2001 to 2008. Demographics and ultrasonographics variables, and survival at 18 and 72 months were consignated. Results: Were included 23 patients, 14 women. Mean age 59 years. Seven with a first grade relative affected of hypertrophic cardiomyopathy (HM). Six with coronary lessions. The mean maximum intraventricular gradient was 96,32 mmHg, dyastolic interventricular septum wide 21,4 mm, EF 66%. 17 with systolic anterior motion, 15 with severe mitral insufficience. Before surgery, 14 shows NYHA functional class (FC) III, and 9 FC IV. 20 with one additional surgical procedure. Operative mortality was 8,7% (two patients). The mean maximum intraventricular gradient after surgery was 12 mmHg, dyastolic interventricular septum wide 16,65 mm and EF 64%. At 18 months, survival was 20 patients, all in FC I. Actuarial survival at 6 years was 76,7%. Conclussions: 20 of 23 patients with an additional procedure, mainly mitral valve substitution. Myectomy improved intraventricular gradients, DIVS wide and symptoms in all patients (p<0,0001). Operative mortality was 8,7% (two patients), and actuarial survival at 6 years was 76,7%. This results are comparable with reference series.


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