Related Experiment Video
Updated: Feb 22, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Hypertrophic obstructive cardiomyopathy-the Leipzig experience
Jawad Khalil1, Michael Kuehl2, Pirose Davierwala1
1Department of Cardiac Surgery, Heart Centre, University of Leipzig, Leipzig, Germany.
Insights
Surgical septal myectomy effectively reduces left ventricular outflow tract obstruction in hypertrophic obstructive cardiomyopathy (HOCM) patients, improving cardiac function and quality of life with low operative risk.
Area of Science:
- Cardiology
- Cardiac Surgery
- Hypertrophic Cardiomyopathy Research
Background:
- Management of hypertrophic obstructive cardiomyopathy (HOCM) involves medical therapy and surgical septal myectomy (SM) for left ventricular outflow tract obstruction (LVOTO).
- The Leipzig Heart Center reports its experience in surgical HOCM management.
Purpose of the Study:
- To evaluate the effectiveness and outcomes of surgical management for LVOTO in HOCM patients.
- To analyze patient characteristics, surgical results, and long-term follow-up data.
Main Methods:
- Retrospective analysis of 115 HOCM patients undergoing surgical treatment for LVOTO between 1997 and 2016.
- Data collected from a surgical database, excluding patients with incomplete information.
Main Results:
- The study included 115 patients (1.1:1 male:female ratio, mean age 60.8 years).
- Dyspnea was the most common symptom (n=102), with 50% in NYHA class III.
- Surgery reduced mean septal thickness by 15 mm and LVOT gradient by 9.7 mmHg, significantly improving NYHA classification, especially in class III patients.
Conclusions:
- Surgical treatment for LVOTO in HOCM is effective in improving cardiac function and quality of life.
- The procedure is associated with a low operative risk and favorable long-term outcomes.
Background:
Management of hypertrophic obstructive cardiomyopathy (HOCM) has evolved considerably over the last fifty years, and includes medical treatment as well as septal myectomy (SM) to relief symptoms caused by left ventricular outflow tract obstruction (LVOTO). We report the Leipzig Heart Center experience in the surgical management of patients with HOCM.
Methods:
We collected data from all patient treated surgically with a myectomy for LVOTO in patients with HOCM between 1997 and 2016. Patients with absent data were excluded from our analysis. All data were obtained from our surgical database and analyzed retrospectively.
Results:
We identified 115 patients who underwent surgical treatment for HOCM, where a male:female ratio of 1.1:1, a mean age of 60.8±14.6 years and a body mass index of 27.7±4.5 were observed. The most common symptom was dyspnea (n=102). Of all patients, 50% had New York Heart Association (NYHA) III class symptoms. Arterial hypertension was the most common comorbidity (n=80). Preoperative transthoracic echocardiography showed a mean ejection fraction (EF) of 65.9%±9.7%, median septal thickness of 21.1±5.3 mm, systolic anterior motion of the mitral valve (MV) in 61.7% of patients, and mean LVOT gradient of 70.1±45.2 mmHg. Surgery resulted in a mean decrease of the septal thickness by 15±3.7 mm and LVOT gradient by 9.7±8.5 mmHg. Isolated SM was carried out on 20 patients. Postoperatively, we were able to notice a significant improvement in NYHA classification, in which patients with NYHA III benefitted most from SM. Long-term follow-up data up to 11.3±0.7 years were available for 114 patients. During follow-up, 16 patients died, and one patient was lost to follow up.
Conclusions:
Surgical treatment of LVOT in patients with HOCM is an effective intervention that improves cardiac function and quality of life (QoL) and is associated with a low operative risk.
