Journal article
The first 200 septal myectomies: Ensuring gold standard outcomes
Asian cardiovascular & thoracic annals, v 30(1), pp 28-34
01 Jan 2022
PMID: 34730015
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives
Septal myectomy remains the gold standard treatment for symptomatic left ventricular outflow tract obstruction refractory to medical treatment. It is recommended that this operation be performed in dedicated hypertrophic obstructive cardiomyopathy centres by experienced surgeons. The septal myectomy option remains unavailable to many patients based solely on geography, including those who would clearly benefit more substantially from surgery than other therapeutic options. Here, we share our experience in starting new hypertrophic cardiomyopathy programmes.
Methods
We retrospectively reviewed initial septal myectomy experiences at two hypertrophic cardiomyopathy programmes starting in 2014. Results
Two-hundred septal myectomies were performed. Mean age was 58.8 years and 51% were females. Advanced heart failure symptoms were present in 95.5% of patients and 23.5% had experienced syncope. Mean maximal intraventricular gradient was 89 mmHg and 48.5% underwent concomitant procedures at the time of septal myectomy. There was no perioperative (in-hospital or 30 days) mortality. Ninety-two per cent had provoked left ventricular gradients of <= 15 mmHg and 97% had none/mild mitral regurgitation at post-operative assessment. In our contemporary cohort, there were 2 (1%) intraoperative ventricular septal defects and 5% required a permanent pacemaker.
Conclusions
Our early septal myectomy experience targeted a complex population, frequently in need of concomitant procedures. Abolition of left ventricular obstruction and resolution of systolic anterior motion mediated mitral regurgitation can be expected. The safety and efficacy of septal myectomy carried at hypertrophic cardiomyopathy centres by properly trained surgeons achieved the desired outcomes established by recent hypertrophic cardiomyopathy guidelines.
Metrics
Details
- Title
- The first 200 septal myectomies: Ensuring gold standard outcomes
- Creators
- Eduard Quintana (Corresponding Author) - Univ Barcelona, Hosp Clin Barcelona, Cardiovasc Surg Dept, C Villarroel 170 Escala 1 Planta 5, Barcelona 08034, SpainPietro Bajona - Drexel University
- Publication Details
- Asian cardiovascular & thoracic annals, v 30(1), pp 28-34
- Publisher
- Sage
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000715957200001
- Scopus ID
- 2-s2.0-85118573638
- Other Identifier
- 991021860756504721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System