Immediate and mid-term postoperative outcomes after surgical correction of biventricular obstruction in children with hypertrophic cardiomyopathy

Objective. To analyze the effectiveness of surgical treatment of biventricular obstruction in children with obstructive hypertrophic cardiomyopathy (HCM). Material and methods. A retrospective analysis enrolled 12 patients after elimination of biventricular obstruction in 2010—2024. The control group included patients with LVOT obstruction alone (n=28). We analyzed echocardiography parameters before surgery, in early and mid-term postoperative period. Results. Age of patients was 3.9 [2.4; 13.6] years. Genetically confirmed Noonan syndrome was registered in 5 (42%) children. Drug therapy was required in 11 (92%) patients. In preoperative period, z-index of LV end-diastolic dimension (p=0.03) and volume (p=0.04), sphericity index (p=0.01), ejection fraction (p=0.03) and stroke index (p=0.02) significantly differed in children with biventricular obstruction. After surgery, the main echocardiography parameters did not differ significantly in both groups. Pressure gradients in LVOT and RVOT significantly decreased in postoperative period. The follow-up period was 3.0 [2.9; 3.2] years. There were no fatal outcomes. Drug therapy was administered to all patients (n=10). Functional class of heart failure did not change — 1.2±0.4 and 1.3±0.5, respectively (p=0.152). Conclusion. Elimination of biventricular obstruction did not increase the risk of complications and deaths. This procedure was an effective alternative to heart transplantation according to immediate and mid-term follow-up data.