We have undertaken a study over a period of 5 years on 35
hypertrophic obstructive cardiomyopathy (HOCM) patients with severe
hypertrophy in the age range between 8 and 15 years. The indication for surgery was based on the diagnosis of severe myocardial
hypertrophy in association with serious
cardiac failure (New York Heart Association class III or IV) or elevated intraventricular pressure gradients refractory to medical
therapy. Furthermore, patients were considered for operation if they met a history of
sudden death within their families. A new technique of HOCM surgical correction in pediatric patients with severe
hypertrophy was proposed. Conceptually, this approach offers a number of advantages: it affords the excision of the asymmetrically hypertrophied area of the ventricular septum without penetration into the left ventricle cavity; it avoids mechanical damage to the heart conduction system and aortic valve; and for the surgeon, it improves visual inspection of the area to be resected. Here, we describe the disease history of 35 patients, their diagnostic evaluations, the
surgical procedure, and the postoperational observations as well as the results of follow-up assessments. We state that the surgery was successful in all 35 cases. There were no early or late deaths. Acute postoperative
pericarditis developed in three patients early after surgery. The follow-up period was 38 +/- 7 months, and complications were not observed so far.