Definitions

myectomy

Septal myectomy

Septal myectomy is a cardiac surgery treatment for hypertrophic cardiomyopathy (HCM). Septal myectomies have been successfully 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:

 
 
 |-
 ! Years
 ! With surgery
 ! Without surgery
 |-
 | 1
 | 98%
 | 90%
 |-
 | 5
 | 96%
 | 79%
 |-
 | 10
 | 83%
 | 61%
Survival (all-cause mortality) *
 
 
 |-
 ! Years
 ! With surgery
 ! Without surgery
 |-
 | 1
 | 99%
 | 94%
 |-
 | 5
 | 98%
 | 89%
 |-
 | 10
 | 95%
 | 73%
Survival (HCM-related death)
 
 
 |-
 ! Years
 ! With surgery
 ! Without surgery
 |-
 | 1
 | 100%
 | 97%
 |-
 | 5
 | 99%
 | 93%
 |-
 | 10
 | 99%
 | 89%
Survival (sudden cardiac death)
* Includes 0.8% operative mortality.

Comparison with alcohol ablation

Either alcohol septal ablation or myectomy offers substantial clinical improvement for patients with hypertrophic obstructive cardiomyopathy. One non-randomized comparison suggested that hemodynamic resolution of the obstruction and its sequelae are more complete with myectomy. Whether one or the other treatment is preferable for certain patient types is debated among cardiovascular scientists.

See also

References

External links

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