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British surgeon Brock and pathologist Teare described the clinical and pathological characteristics of hypertrophic obstructive cardiomyopathy(HOCM) in 1957, which is considered the 1st year of HOCM study. We aim to commemorate the 60th year of the history of surgical treatment for HOCM and to express our sincere respect to those who contribute a lot to this disease at this conference.
By searching the key words of ‘Hypertrophic Obstructive Cardiomyopathy' ‘myectomy' ‘myotomy' ‘idiopathic hypertrophic subaortic stenosis' ‘Andrew Glenn Morrow' in PUBMED, corresponding with Professor Braunwald and Derani etc. we gained the literatures about HOCM from 1957 to 2017, analyzing the evolution of our cognition and surgical treatment to HOCM
In 1957, 100 years before the coming of cardiac catheterization, surgeon and pathologist from Britain reported Hypertrophic cardiomyopathy simultaneously by the results of surgery and autopsy respectively. In 1959, British surgeon Cleland tried to partially resect the hypertrophied septum for patients with HOCM as a pioneer. In 1960, doctor A.G Morrow completed his first morrow procedure. Kirklin from mayo clinic tried myectomy via a 2 cm incision of left anterior ventricular wall in two case in 1961, by which he could get a better surgical vision. In 1963, professor Lillehei considered the transatrial approach was an better way to expose the septum. In 1971, Cooley raised his view of mitral replacement for dealing with this kind of left ventricular obstruction while Konno believed the ventriculoaortoplasty was a better way to solve this problem. When it came to 1990, Germany surgeon Messmer published his surgical strategy of extended myectomy by broadening and deepening the resection and separating the abnormal links between septum and mitral apparatus, by which he could eliminate the SAM related mitral regurgitation completely. However, some controversies about concomitant mitral valvuloplasty merged later. In 1992, Mclntosh thought longitudinal mitral plication was an optional procedure for abolishing mitral regurgitation during surgery while Kofflard believed that the augmentation to anterior mitral leaflet by autogenous pericardial patch could effectively reduce the mitral insufficiency during surgery. In 2007, professor Dearani from the Mayo Clinic summarized the surgical experience of his team by emphasizing the extended myectomy and dividing anomalous muscles and chordea in left ventricle. In 2016, professore Song from Fuwai Hospital published his research, in which he believed that no concomitant mitral procedure should be exerted in myectomy for eliminating SAM related mitral regurgitation, because only if a satisfying myectomy was completed, there should no SAM and mitral regurgitation remained.
After the 60 years development, HOCM has evolved from a less known disease to a relatively begin disease via the appropriate clinical management(optimal medication, surgical septal reduction therapy, septal alcohol ablation, etc.). In the forthcoming years, multidiscipline management and international communication and collaboration can be the vital factors to promote the development of HOCM.