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Childhood Hypertrophic Obstructive Cardiomyopathy and Its Relevant Surgical Outcome

Changsheng Zhu1, Shuiyun Wang1, Yi Ma1

  • 1Department of Cardiovascular Surgery and Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

The Annals of Thoracic Surgery
|December 1, 2019
PubMed

Insights

Childhood hypertrophic obstructive cardiomyopathy (HOCM) presents with diverse anatomical issues. Septal myectomy surgery offers favorable outcomes for carefully selected pediatric HOCM patients, with high survival and reoperation-free rates.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Cardiovascular Research

Background:

  • Limited contemporary data exists on childhood hypertrophic obstructive cardiomyopathy (HOCM).
  • Understanding HOCM's clinical presentation and surgical outcomes in children is crucial.

Purpose of the Study:

  • To describe the clinical presentation of childhood HOCM.
  • To evaluate the surgical outcomes of septal myectomy in pediatric patients with HOCM.

Main Methods:

  • Retrospective review of 117 pediatric patients (0.6-17.5 years) undergoing septal myectomy for HOCM.
  • Data collected included patient demographics, clinical characteristics, and surgical outcomes between February 2009 and December 2018.

Main Results:

  • Significant reductions in outflow tract gradients, septal thickness, and mitral regurgitation post-surgery.
  • High survival rates (100% at 1 year, 96.5% at 3 years) and reoperation-free rates (99.1% at 1 year, 98.0% at 3 years).
  • Frequent co-occurrence of biventricular obstruction, myocardial bridging, and intraventricular abnormalities.

Conclusions:

  • Childhood HOCM exhibits complex phenotypes including biventricular obstruction and intraventricular abnormalities.
  • Septal myectomy is a safe and effective treatment for carefully selected pediatric HOCM patients, yielding favorable long-term results.
Abstract

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