[Surgical treatment of hypertropic obstructive cardiomyopathy].

The clinical picture of hypertrophic obstructive cardiomyopathy and the pathogenesis of its hemodynamic alterations are discussed. Dynamic systolic obstruction of the left ventricular outflow-tract, i.e. muscular subaortic stenosis, may or may not be accompanied by hindrance of diastolic filling of the left ventricle and vice versa. It cannot yet be assessed to what extent the reduction of compliance is caused by the pressure load in subaortic stenosis through secondary hypertrophy of the left ventricle. Study of the late course in 28 patients who had undergone surgery reveals that surgery abolishes the pressure gradient in the left ventricular outflow tract and provides year-long relief of symptoms. Complications of obstructive hypertrophic cardiomyopathy, such as mitral incompetence, may be cured by the operation. On the other hand, although progression of the cardiomyopathy is apparently slowed, it can not be abolished by surgical treatment.