Long-Term Benefit of Myectomy and Anterior Mitral Leaflet Extension in Obstructive XXXX .

@entity1 @entity1121 @entity339
UNASSIGNED: Severely symptomatic @entity1 with @entity1121 (HC) may benefit from surgical myectomy. In @entity1 with enlarged mitral leaflets and @entity339 , myectomy can be combined with anterior mitral leaflet extension (AMLE) to stiffen the midsegment of the leaflet. The aim of this study was to evaluate the long-term results of myectomy combined with AMLE in @entity1 with obstructive HC. This prospective, observational, single-center cohort study included 98 @entity1 (49    14  years, 37% female) who underwent myectomy combined with AMLE from 1991 to 2012. End points included all-cause mortality and change in clinical and echocardiographic characteristics. Mortality was compared with age- and gender-matched @entity1 with nonobstructive HC and subjects from the general population. Long-term follow-up was 8.3    6.1  years. There was no operative mortality, and New York Heart Association class was reduced from 2.8    0.5 to 1.3    0.5 (p <0.001), left ventricular outflow tract gradient from 93    25 to 9    8  mm Hg (p <0.001), @entity339 from grade 2.0    0.9 to 0.5    0.8 (p <0.001), and systolic anterior motion of the mitral valve from grade 2.4    0.9 to 0.1    0.3 (p <0.001). The 1-, 5-, 10-, and 15-year cumulative survival rates were 98%, 92%, 86%, and 83%, respectively, and did not differ from the general population (99%, 97%, 92%, and 85%, respectively, p  = 0.3) or @entity1 with nonobstructive HC (98%, 97%, 88%, and 83%, respectively, p  = 0.8). In conclusion, in selected @entity1 with obstructive HC, myectomy combined with AMLE is a low-risk surgical procedure. It results in long-term symptom relief and survival similar to the general population.
