Major adverse cardiovascular events after modified morrow surgery in hypertrophic obstructive cardiomyopathy: A...

Area of Science:

• Cardiology
• Cardiovascular Surgery

Background:

• Hypertrophic obstructive cardiomyopathy (HOCM) is a significant cause of heart failure and sudden cardiac death.
• Modified Morrow surgery is a key intervention for HOCM, but carries risks of major adverse cardiovascular events (MACE).

Purpose of the Study:

• To determine the incidence of MACE in HOCM patients post-modified Morrow surgery.
• To identify independent risk factors associated with MACE in this patient cohort.
• To develop a predictive model for MACE to enhance clinical risk stratification and perioperative management.

Main Methods:

• A retrospective cohort study involving 292 HOCM patients who underwent modified Morrow surgery.
• MACE was the primary endpoint, with univariate and multivariate logistic regression analyses employed to identify risk factors.
• A predictive model for MACE was constructed and evaluated.

Main Results:

• The incidence of MACE was 39.04%, with significant rates of low cardiac output syndrome (19.2%) and atrial fibrillation (18.2%).
• Key independent risk factors for MACE included older age, lower estimated glomerular filtration rate (eGFR), preoperative pulmonary hypertension, increased interventricular septal thickness, and postoperative leukocytosis.
• The developed predictive model showed strong performance with an AUC of 0.815.

Conclusions:

• Modified Morrow surgery in HOCM patients is associated with a substantial risk of MACE.
• Age, eGFR, pulmonary artery pressure, septal thickness, MRI delayed enhancement, and postoperative leukocytosis are critical risk factors.
• The predictive model offers a valuable tool for tailoring perioperative care and improving risk assessment in HOCM patients.