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Surgery for hypertrophic cardiomyopathy

James J Wu1,2,3, Michael Seco1,2,3, Caroline Medi4,5

  • 1Sydney Medical School, The University of Sydney, Sydney, Australia.

Biophysical Reviews
|May 17, 2017
PubMed

Insights

Septal myectomy effectively treats hypertrophic cardiomyopathy (HCM) by relieving left ventricular outflow tract obstruction. This surgery offers excellent long-term survival and symptom relief for HCM patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Genetics

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic heart condition causing unexplained left ventricular hypertrophy.
  • HCM is a leading cause of sudden cardiac death in young adults, often due to arrhythmias.
  • Left ventricular outflow tract obstruction can occur in HCM patients.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of septal myectomy for treating symptomatic hypertrophic cardiomyopathy with outflow tract obstruction.
  • To assess the safety, long-term survival, and symptom relief provided by surgical intervention in HCM patients.

Main Methods:

  • Septal myectomy involves surgically removing a portion of the hypertrophied interventricular septum.
  • Surgical access is achieved through transaortic, transapical, or transmitral approaches.
  • Data from large, contemporary series of experienced centers were analyzed.

Main Results:

  • Septal myectomy demonstrated a low early mortality rate of less than 2%.
  • Patients experienced excellent long-term survival, comparable to the general population.
  • The procedure provided durable relief of symptoms associated with outflow tract obstruction.

Conclusions:

  • Septal myectomy is a safe and effective surgical treatment for hypertrophic cardiomyopathy with moderate to severe outflow tract obstruction.
  • The procedure offers significant long-term benefits, including improved survival and sustained symptom resolution.
  • It is indicated for patients with severe symptoms unresponsive to medical management.

Keywords:
Alcohol septal ablationHypertrophic cardiomyopathyLeft ventricular outflow tract obstructionSeptal myectomy

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