The obstructive hypertrophic cardiomyopathy surgical treatment experience in patients with SAM-syndrome and severe mitral insufficiency

You Yuanbing, Kosenkov Alexander Nikolaevich, Ye Haoran, Belov Yuri Vladimirovich

Objective: to analyze the results of the hypertrophic cardiomyopathy obstructive form surgical treatment in patients with SAM-syndrome and severe mitral insufficiency. Materials and methods. 42 patients aged 33 to 78 years (average age 52 ± 9.8 years) underwent surgical treatment in the Russian Scientific Center of Surgery named after Acad. B.V. Petrovsky. (Moscow) at the department of Federal State Autonomous Educational Institution of Higher Education First MGMU named by Sechenov of the Ministry of Health of Russia (Sechenov University). Statistical processing of the obtained research results was carried out in Microsoft Excel 2017 software. Reliability was determined using Student's criterion, and its critical level in this study was taken equal to 0.05. Results. The weight of the excised obstructive substrate varied from 1.23 g up to 12.16 g and averaged was 3.31 ± 0.37 g. We found a left ventricular mass decrease by 17.0%, and a left ventricular mass index by 16.9%. A significant left ventricle end-diastolic volume increase was revealed after surgical treatment. The average value of the pressure gradient in LVOT after surgical correction was 14.5 ± 1.36 mm Hg, which was 8.7 times significantly lower than the preoperative indicator (77.7 ± 4.7 mm Hg, p <0.05). SAM-syndrome elimination was observed in all patients (n = 42, 100%). No cases of hospital mortality have been established. The complications in the form of paroxysm of atrial fibrillation were documented in 2 cases. Conclusion. The presented data indicate good results of the hypertrophic cardiomyopathy obstructive form and mitral insufficiency surgical correction, and the chosen method and resection volume of the obstructive substrate is optimal for adequate hemodynamics restoration.

Keywords:obstructive hypertrophic cardiomyopathy, SAM-syndrome, left ventricle outflow tract gradient, septal myectomy, mitral valve repair.