Extended Myectomy for Hypertrophic Cardiomyopathy: Early Outcomes From a Nascent Centre of Excellence in Canada

Area of Science:

• Cardiology
• Genetics
• Cardiac Surgery

Background:

• Hypertrophic cardiomyopathy (HCM) is a prevalent inherited cardiac condition characterized by unexplained left ventricular thickening.
• While often benign, HCM can lead to sudden cardiac death, particularly in young individuals, underscoring the need for early diagnosis and management.
• A dedicated HCM center was established at the University of Ottawa Heart Institute to address the growing need for specialized care.

Purpose of the Study:

• To describe the early experience and outcomes of surgical myectomy for adult patients with hypertrophic cardiomyopathy.
• To evaluate the safety and efficacy of myectomy in managing HCM, especially in patients with left ventricular outflow tract obstruction.

Main Methods:

• Retrospective review of 27 adult patients with HCM who underwent surgical myectomy between January 2018 and December 2020.
• Analysis of patient survival and outcomes at discharge and 6 months postdischarge.
• Emphasis on the role of preoperative and perioperative imaging and a multidisciplinary heart team approach.

Main Results:

• All 27 patients survived the myectomy procedure and were discharged.
• All patients remained alive at the 6-month follow-up mark.
• The study highlights the successful implementation of surgical myectomy within a specialized HCM center.

Conclusions:

• Surgical myectomy is a safe and effective treatment option for carefully selected adult patients with hypertrophic cardiomyopathy.
• The establishment of specialized HCM centers and the collaboration of a dedicated heart team are crucial for optimal patient management.
• Advanced imaging techniques play a vital role in the preoperative planning and perioperative care of HCM patients undergoing myectomy.