APPEARANCE OF OR PERSISTENCE OF SEVERE MITRAL REGURGITATION WITHOUT LEFT-VENTRICULAR OUTFLOW OBSTRUCTION AFTER PARTIAL VENTRICULAR SEPTAL MYOTOMY-MYECTOMY IN HYPERTROPHIC CARDIOMYOPATHY

At the National Heart, Lung, and Blood Institute from 1959 through October 1989, 626 patients underwent operative treatment of obstructive hypertrophic cardiomyopathy: ventricular septal myotomy-partial myectomy alone in 539 patients; mitral valve replacement alone in 68 patients; and both procedures, not necessarily simultaneously, in 27 patients. The septal myotomy-myectomy procedure in most patients provided clinical improvement, but in some patients the results of this procedure have been unsatisfactory and reoperation has been performed.1 In the 27 patients who underwent reoperation after septal myotomy-myectomy, the indication was persistent left ventricular outflow obstruction in 24 patients2 and pure mitral regurgitation, without outflow obstruction, in 3 patients. This report describes certain clinical and morphologic features in the latter 3 patients. © 1991.