Septal myectomy: Difference between revisions

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#REDIRECT [[Hypertrophic cardiomyopathy septal myectomy]]
{{CMG}}
 
==Overview==
 
'''Septal myectomy''' is a [[cardiac surgery|surgical]] 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:<ref name="Ommen 2005">{{cite journal | author = 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 | title = Long-term effects of surgical septal myectomy on survival in patients with obstructive hypertrophic cardiomyopathy | journal = J Am Coll Cardiol | volume = 46 | issue = 3 | pages = 470-6 | year = 2005 | id = PMID 16053960}}</ref>
 
<center>
{| border="0"
|
  {| class="wikitable"
  |+ Survival (all-cause mortality) *
  |-
  ! Years
  ! With surgery
  ! Without surgery
  |-
  | 1
  | 98%
  | 90%
  |-
  | 5
  | 96%
  | 79%
  |-
  | 10
  | 83%
  | 61%
  |}
|
  {| class="wikitable"
  |+ Survival (HCM-related death)
  |-
  ! Years
  ! With surgery
  ! Without surgery
  |-
  | 1
  | 99%
  | 94%
  |-
  | 5
  | 98%
  | 89%
  |-
  | 10
  | 95%
  | 73%
  |}
|
  {| class="wikitable"
  |+ Survival (sudden cardiac death)
  |-
  ! Years
  ! With surgery
  ! Without surgery
  |-
  | 1
  | 100%
  | 97%
  |-
  | 5
  | 99%
  | 93%
  |-
  | 10
  | 99%
  | 89%
  |}
|}
<nowiki>*</nowiki> Includes 0.8% operative mortality.
</center>
 
==Comparison with alcohol ablation==
 
Either [[alcohol septal 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.<ref name="Ralph-Edwards 2005">{{cite journal | author = Ralph-Edwards A, Woo A, McCrindle B, Shapero J, Schwartz L, Rakowski H, Wigle E, Williams W | title = Hypertrophic obstructive cardiomyopathy: comparison of outcomes after myectomy or alcohol ablation adjusted by propensity score | journal = J Thorac Cardiovasc Surg | volume = 129 | issue = 2 | pages = 351-8 | year = 2005 | id = PMID 15678046}}</ref>
 
==Related Chapters==
* [[Hypertrophic cardiomyopathy interventional cardiology|Hypertrophic cardiomyopathy]]
* [[Alcohol septal ablation]]
 
==References==
{{reflist|2}}
 
{{SIB}}
 
{{cardiac surgery}}
 
[[Category:Cardiac Surgery]]
[[Category:Cardiology]]
 
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Latest revision as of 17:01, 11 February 2012