[Transaortic myectomy for hypertrophic obstructive cardiomyopathy--efficacy of intraoperative pressure measurement].

The many aspects of postoperative course of hypertrophic obstructive cardiomyopathy (HOCM) have been apparent, while many studies concerning long-term follow up have been published in recent years. Many surgical approaches have been performed but recently transaortic subvalvular myectomy is most common. This study reviews 22 patients with HOCM operated on between 1984 and 1989. Transaortic approach was used for all adult patients. One patient had a complication with an iatrogenic VSD, which was closed by Dacron patch during the procedure. There was one hospital death; She is a 67 year-old woman who died due to an acute abdomen. All 14 patients followed up over 3 months had significant functional improvement. Our retrospective study suggests that myectomy in patient with HOCM seems to be not only palliative but curative operative method. Left atrial- and left ventricular dimension tended to normalize in the postoperative course. The intraoperative estimation of Brockenbrough phenomenon is effective to assess the release of left ventricular outflow obstruction.