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Septal myectomy is a cardiac surgery treatment for hypertrophic cardiomyopathy (HCM). Septal myectomies have been successfully performed for more than 25 years.
[edit] 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:[1]
Survival (all-cause mortality) *
| Years |
With surgery |
Without surgery |
| 1 |
98% |
90% |
| 5 |
96% |
79% |
| 10 |
83% |
61% |
|
Survival (HCM-related death)
| Years |
With surgery |
Without surgery |
| 1 |
99% |
94% |
| 5 |
98% |
89% |
| 10 |
95% |
73% |
|
Survival (sudden cardiac death)
| Years |
With surgery |
Without surgery |
| 1 |
100% |
97% |
| 5 |
99% |
93% |
| 10 |
99% |
89% |
|
* Includes 0.8% operative mortality.
[edit] 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.[2] Whether one or the other treatment is preferable for certain patient types is debated among cardiovascular scientists.[3]
[edit] See also
[edit] References
- ^ Ommen S, Maron B, Olivotto I, Maron M, Cecchi F, Betocchi S, Gersh B, Ackerman M, McCully R, Dearani J, Schaff H, Danielson G, Tajik A, Nishimura R (2005). "Long-term effects of surgical septal myectomy on survival in patients with obstructive hypertrophic cardiomyopathy". J Am Coll Cardiol 46 (3): 470–6. doi:10.1016/j.jacc.2005.02.090. PMID 16053960.
- ^ Ralph-Edwards A, Woo A, McCrindle B, Shapero J, Schwartz L, Rakowski H, Wigle E, Williams W (2005). "Hypertrophic obstructive cardiomyopathy: comparison of outcomes after myectomy or alcohol ablation adjusted by propensity score". J Thorac Cardiovasc Surg 129 (2): 351–8. doi:10.1016/j.jtcvs.2004.08.047. PMID 15678046.
- ^ Heldman AW, Wu KC, Abraham TP, Cameron DE. Myectomy or Alcohol Septal Ablation: Surgery and Percutaneous Intervention Go Another Round. J Am Coll Cardiol. 2007 Jan 23;49(3):358-60. PMID 17239718.
[edit] External links
