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Encyclopedia > Septal myectomy

Septal myectomy is a cardiac surgery treatment for hypertrophic cardiomyopathy (HCM). Cardiac surgery is surgery on the heart, typically to treat complications of ischemic heart disease (e. ... Hypertrophic cardiomyopathy, or HCM, is a disease of the myocardium (the muscle of the heart) in which a portion of the myocardium is hypertrophied (thickened) without any obvious cause. ...

Contents

History

Has been sucessfully performed for more than 25 years.


Outcomes

Septal myectomy is associated with a low perioperative mortality and a high late survival rate. A study at the Mayo Clinic found surgical myectomy performed to relieve outflow obstruction and severe symptoms in HCM was associated with long-term survival equivalent to that of the general population, and superior to obstructive HCM without operation. The results are shown below:[1] Main campus in downtown Rochester, Minnesota. ...

Survival (all-cause mortality) *
Years With surgery Without surgery
1 98% 90%
5 96% 79%
10 83% 61%
Survival (HCM-related death)
Years With surgery Without surgery
1 99% 94%
5 98% 89%
10 95% 73%
Survival (sudden cardiac death)
Years With surgery Without surgery
1 100% 97%
5 99% 93%
10 99% 89%

* Includes 0.8% operative mortality.

Comparison with alcohol ablation

Either alcohol ablation or myectomy offers substantial clinical improvement for patients with hypertrophic obstructive cardiomyopathy. Hemodynamic resolution of the obstruction and its sequelae is more complete with myectomy.[2]


See also

References

  1. ^ Ommen S, Maron B, Olivotto I, Maron M, Cecchi F, Betocchi S, Gersh B, Ackerman M, McCully R, Dearani J, Schaff H, Danielson G, Tajik A, Nishimura R (2005). "Long-term effects of surgical septal myectomy on survival in patients with obstructive hypertrophic cardiomyopathy". J Am Coll Cardiol 46 (3): 470-6. PMID 16053960. 
  2. ^ Ralph-Edwards A, Woo A, McCrindle B, Shapero J, Schwartz L, Rakowski H, Wigle E, Williams W (2005). "Hypertrophic obstructive cardiomyopathy: comparison of outcomes after myectomy or alcohol ablation adjusted by propensity score". J Thorac Cardiovasc Surg 129 (2): 351-8. PMID 15678046. 

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