Midterm postoperative follow-up after surgical correction of hypertrophic cardiomyopathy in infancy and childhood

Background: Surgical septal myectomy has been considered the gold-standard therapeutic option for symptomatic drug refractory patients with hypertrophic obstructive cardiomyopathy (HOCM) for over 50 years. However, it is being challenged by less- invasive interventional tools in the last 2 decades. The late effects of myocardial scar from alcohol septal ablation are unknown and, therefore, are not recommended in children and young adults.Methods: A total of 9 patients underwent surgical interventions for HOCM. All patients were below 12 years of age. The patients were operated upon in Cairo University Hospitals, Egypt; in the period between April 2014 and February 2016. Pre-operative and operative data were collected and analyzed statistically. Post-operative evaluation was documented at different periods and data collected and analyzed in comparison with pre-operative data as well as at these different follow up periods.Results: Mean age of all patients was 6.1 ± 2.6 years. 77.8% were males. All the patients were symptomatic. Preoperative mean pressure gradient (PG) was 95.4 ± 15.2 mmHg. Mean septal wall thickness (SWT) was 1.52 + 0.45 cm, mean degree of mitral regurge (MR) was 1.7 ± 0.83. Immediate postoperative assessment showed significant clinical improvement and significant reduction of PG to 20.0 ± 14 mmHg, SWT to 0.98 ± 0.38 cm, and mean degree of MR to 0.89 ± 0.33. Short-term and mid-term follow up showed sustained improvement. There were no deaths.Conclusions: Surgical procedures for HOCM are generally safe and effective for improvement of symptoms, LVOT gradient, mitral regurge. Early surgical intervention is advocated to prevent progression of valve disease