[Prevalence of congestive heart failure after ventriculomectomy in patients with obstructive hypertrophic cardiomyopathy]

Abstract

Purpose: To assess the prevalence of congestive heart failure in the late post-operative follow-up in patients with hypertrophic obstructive cardiomyopathy (HOCM) submitted to ventriculomectomy (VM).

Methods: Thirty six patients with HOCM, all of them with basal intraventricular systolic pressure gradient (BPG) > or = 50 mmHg, were studied. Sixteen (group I) were submitted to VM and 20 (group II) remained under clinical treatment. At group I the ages were 1 month to 61 years (28.25 +/- 15.39), 10 male (62.5%); BPG ranged from 50 to 192 mmHg (98.09 +/- 42.76) with mean follow-up of 13.06 +/- 7.19 years. At group II the age ranged from 2 months to 58 years (31.01 +/- 18.61); 12 male (60%); BPG ranged from 52 to 185 mmHg (83.47 +/- 35.08) with mean follow-up of 9.6 +/- 4.93 years.

Results: At group I the follow-up was good in 4 patients (25%), stable in 2 (12.5%) and poor in 3 (18%). Seven patients (43.75%) developed congestive heart failure at mean time of 7.53 +/- 8.44 years; there was one operative death and the follow-up control was lost in 7 patients. In group II, the follow-up was good in 3 patients (15%), stable in a 6 (30%) and poor in a 9 (45%); no deaths occurred. Two patients had heart failure within 3 years after the onset of the disease. The follow-up control was lost in 8 patients (40%).

Conclusion: 1) congestive heart failure was more frequent in patients submitted to VM rather than the non-operated ones (p < 0.05); 2) the short-term follow-up was better in operated patients rather than in non-operated ones.