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The Journal of Thoracic and Cardiovascular Surgery, Vol 106, 709-717, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
HD Schulte, WH Bircks, B Loesse, EA Godehardt and B Schwartzkopff
A complete clinical study was performed for 364 patients with hypertrophic
obstructive cardiomyopathy who were operated on in the years 1963 to 1991
(217 male, 146 female, mean age 40 years, range 5 months to 76 years).
Transaortic subvalvular myectomy was performed in 272 patients (hospital
mortality 2.9%), and 92 patients needed additional cardiac procedures
simultaneously (hospital mortality 10.9%). A complete follow-up study
(100%) included 346 patients who survived the operation. The shortest
follow-up time was 2 months and the longest 25.2 years (mean 8.2 years).
Most of the patients improved clinically by one to three classes (New York
Heart Association). During the observation period 38 patients (10.4%) died.
The death of 17 patients was closely related to the original disease
(4.9%). Other causes, unrelated to hypertrophic obstructive cardiomyopathy,
were responsible for the death of 21 patients (5.8%). In consideration of
these data, the yearly total death rate was 2.2%; in close relation to
hypertrophic obstructive cardiomyopathy it was about 0.6%. The cumulative
survivals were 88% after 10 years and 72% after 20 years. In our long-term
clinical experience it is increasingly evident, despite the restrictions of
a retrospective study, that patients with symptomatic hypertrophic
obstructive cardiomyopathy and failing medical therapy benefit from
transthoracic subvalvular myectomy.
ARTICLES
Prognosis of patients with hypertrophic obstructive cardiomyopathy after transaortic myectomy. Late results up to twenty-five years
University Hospital Heart Center, Heinrich Heine-University Hospital, Dusseldorf, Germany.
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