[Late results of surgery in muscular subvalvular aortic stenosis]

Pre- and postoperative clinical and hemodynamic findings of 35 patients operated for hypertrophic obstructive cardiomyopathy are presented. One early death and three av-blocks necessitating a permanent pacemaker have to be mentioned as surgical complications. In all cases, an outflow tract obstruction was abolished or greatly diminished and symptoms disappeared or were considerably improved. Two patients died after recurrence of congestive heart failure during the late follow-up. Furthermore, the occurrence of reappearance of different arrhythmias up to 10 years postoperatively are evidence of the progression of the disease despite of surgical treatment. Sudden death has not occurred in a total of 150 patient-years of postoperative follow-up. Thus, the operation abolishes the stenosis and relieves symptoms; on the other hand, it cannot be stated to what degree surgery improves the prognosis.