Methods: Thirty-two patients with HOCM (13 males, 19 females; mean age 35.1±17.6 years; range 7 to 68 years) who were operated on between September 1985 and September 2008 were included in the study. The main presenting symptoms were chest pain, palpitation and dyspnea. Echocardiography was performed in all patients both preoperatively and postoperatively and 27 had catheterization preoperatively. We performed septal myectomy in all cases under general anesthesia. Concomitantly mitral valve reconstruction in two (6.3%), mitral valve replacement in six (18.8%), aortic valve replacement in two (6.3%) and aortic valve replacement + coronary artery bypass in one (3.1%) were performed.
Results: Three patients (9.4%) required permanent pacemaker implantation postoperatively due to complete heart block. In the follow-up one patient has arrhythmia and another one has congestive heart failure. In the postoperative period, early mortality was 6.3% with two cases and the late term mortality was 6.3% with two cases with a total four cases. The five-year survival rate was 95.2%±2.4.
Conclusion: Concomitant procedures increase the mortality and morbidity in hypertrophic obstructive cardiomyopathy surgery. However, in patients unresponsive to medical treatment septal myectomy is a procedure which can be performed with low morbidity and mortality.