Septal myectomy

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Septal myectomy is a cardiac surgery treatment for hypertrophic cardiomyopathy (HCM).

1 History
2 Outcomes
3 Comparison with alcohol ablation
4 See also
5 References
6 External links

[edit] History

Has 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 ablation or myectomy offers substantial clinical improvement for patients with hypertrophic obstructive cardiomyopathy. Hemodynamic resolution of the obstruction and its sequelae is more complete with myectomy.^[2]

[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. 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. PMID 15678046.