Raushan Sadykova, Tuleutaev R and Ibragimov T
National Scientific Center of Surgery (NSCS) named after A.N. Syzganov, Republic of Kazakhstan
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Research objective: To evaluate early and mid-term results of treatment of hypertrophic obstructive cardiomyopathy with Morrow myectomy procedure and interventions on the sub-valvular structures of the mitral valve. Methods: Between May 2015 and May 2017, in the Department of Cardiac Surgery NSC by A.N. Syzganov, performed 13 operations of Morrow expanded myectomy in patients with obstructive form of hypertrophic cardiomyopathy. The mean age was - 41, in all patients the leading symptoms were shortness of breath associated with physical activity associated with dizziness and lipotimy. EDV LV -112.2ml, ESV LV-32.2 ml, IVS-2.4 sm, average pressure gradient at LVOT – 58 mm Hg. Mitral regurgitation of the 2nd degree in 7 patients, EF - 70.4%. SAM syndrome was observed in 11 patients. The isolated extended myectomy was performed in 11 patients, myectomy with mitral valve replacement in one patient with biological prosthesis, supra-coronary ascending aortic replacement in one case. The average follow-up period was 295 days. Results: Intraoperative TEE showed- mean LVOT gradient was 13 mmHg. In 12 patients the early post-operative period proceeded without complications. In one case – was intraoperative aortic dissection, therefore was performed hemiarch procedure. On the 5th postoperative day, the patient died, due to progression of the multiple organ failure. In the other case, on 7-10 days echocardiography showed good hemodynamic results. The mean LVOT gradient was 7 + 2 mm Hg. Mortality cases were not observed in the long-term. EDV - 124.2 ml., ESV - 46.4 ml., IVS - 1.6., PWS - 0.95. The average pressure gradient was 8 + 2 mmHg. Return of symptoms was not observed in 12 patients. Conclusions: Surgical treatment is a "gold standard" in the treatment of hypertrophic cardiomyopathy. Early and mid-term results showed good clinical and hemodynamic results. Long term results should be evaluated in single center experience.
Raushan Sadykova graduated from the Kazakh National Medical University in 2009. In 2016, she completed residency in cardiology at the Meshalkin Clinic, the Russian Federation. She works as a cardiologist in the cardiology department of the National Surgical Center named after A. Syzganov, in Almaty. My work includes examination, treatment in pre-operative and post-operative period, observation of patients in the long-term postoperative period, checkup in dynamics. She is interested by the results of early and long-term follow-up of patients with hypertrophic obstructive cardiomyopathy. Her heart team includes: the head of the department, cardiac surgeons and cardio-anesthetists. The department performs all types of cardiac surgery. We follow the latest information of the world experience of surgical, drug treatment of cardiac patients. The work of our team is constantly analyzed by an individual approach to the diagnosis, observation and treatment of each patient. The experience of European countries is interesting for us too. This conference will be the first experience of international speech.
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