| Abstract: | The authors offer an original technique of surgical correction of pediatric hypertrophic obstructive cardiomyopathy (HOCM), which allows excision of the hypertrophied area and elimination of the obstruction from the cone part of the right ventricle (RV) without penetrating into the LV cavity. 15 children aged 5 to 15 years have been operated on in Bakulev Scientific Center for Cardiovascular Surgery using this technique. 8 of the patients had simultaneous obstruction of the left and right ventricular outflow tract (LVOT and RVOT), 1 patient had RV obstruction. Medical therapy had failed in all cases. The follow-up period was 28 +/- 7 months. EchoCG examination, performed after the surgical treatment, found a decrease of the intraventricular gradient in LV from 72.9 +/- 8.9 to 12.7 +/- 5.5 mmHg; the mean gradient in RVOT also reduced from 43.6 +/- 5.7 to 4.3 +/- 2.7 mmHg. According to the EchoCG, septal thickness reduced from 31.5 +/- 6.5 to 16.5 +/- 4.1 mm. Sinus rhythm was noted in all the patients after the surgery and during the follow-up. The method proposed by the authors is preferable in surgical treatment of children with various forms of hypertrophic cardiomyopathy unresponsive to medical treatment and is a method of choice in a significant number of cases. |
