The natural history of @entity1121 is characterized, in particular, in younger @entity1 by @entity1164 , in the majority of @entity1 by progressive @entity712 [14, 26, 27, 33-36]. With the aid of beta-adrenergic receptor blockers, @entity460 channel blockers and antiarrhythmic agents the clinical outlook for most of the @entity1 can be improved [17, 19, 23, 28]. @entity1 who do not respond to medical treatment can be regarded as possible candidates for surgical revision of the left ventricular outflow tract. In consideration of surgical treatment, two morphologic and hemodynamic forms of the disease must be differentiated: the typical subaortic muscular @entity1184 in the region of the outflow tract and the atypical, more mid-ventricular muscular @entity1184 with systolic entrapment of a distal portion of the ventricle in which frequently a typical subaortic @entity1184 also may be present [15, 43]. As a result of @entity1184 which may substantially compromise left ventricular ejection during systolic contraction, in @entity1121 there is a deviation of the left ventricular major @entity2270 , @entity2055 in the sequence of contraction, @entity1184 of the left ventricular walls, diminished diastolic compliance and, to a varying extent, @entity339 . Diagnostically useful findings are a mid-systolic murmur at the aortic valve, bisferiens carotis pulse, systolic pressure gradient between the left ventricle and the aorta and a postextrasystolic paradoxical pressure response. Echocardiographically, @entity14087 , systolic anterior motion of the anterior mitral valve leaflet, premature mid-systolic closure of the aortic valve and an enlarged left atrium will be detected. Surgical intervention is indicated for @entity1 with class III clinical symptoms (NYHA) not amenable to medical treatment and pressure gradients between left ventricle and aorta, at rest or postextrasystolically, in excess of 50 mm Hg. An overview of the variety of surgical approaches and procedures employed for @entity1121 is provided by Table 1. From initial attempts to eliminate the outflow tract obstruction by myotomy, the @entity3888 was developed in which an about 1 cm wide section of muscle is resected; this procedure can be carried out from a transaortic, transatrial or transventricular approach [4, 9, 21, 22, 24, 38, 39, 47]. Under the assumption that the anterior motion of the anterior mitral valve leaflet contributes to systolic obstruction, some authors recommended reconstructive procedures or replacement of the mitral valve.(ABSTRACT TRUNCATED AT 400 WORDS)

[ XXXX : surgical treatment and results].

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1164 :: ('MESH:D016757', 'Disease') :: ['sudden cardiac death'] @entity712 :: ('MESH:D006333', 'Disease') :: ['congestive heart failure'] @entity339 :: ('MESH:D008944', 'Disease') :: ['mitral regurgitation'] @entity1184 :: ('MESH:D006984', 'Disease') :: ['hypertrophy', 'septal subvalvular hypertrophy'] @entity3888 :: ('MESH:D011662', 'Disease') :: ['subvalvular myectomy'] @entity460 :: ('MESH:D002118', 'Chemical') :: ['calcium'] @entity2270 :: ('MESH:C566610', 'Disease') :: ['axis'] @entity1121 :: ('MESH:D002312', 'Disease') :: ['hypertrophic obstructive cardiomyopathy'] @entity2055 :: ('MESH:D001259', 'Disease') :: ['dyscoordination'] @entity14087 :: ('MESH:C566005', 'Disease') :: ['asymmetric septal hypertrophy']
@entity1121 :: (MESH:D002312,Disease) :: ['Hypertrophic obstructive cardiomyopathy']
