Midterm Outcome of Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy (HOCM): A Single-Center Observational Study

Authors

  • Mohammed Quamrul Islam Talukder, MD, FCPS, FCVS Department of Cardiac Surgery, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh
  • Saikat DasGupta, MS 2Junior Consultant, Department of Cardiac Surgery, Square hospital LTD, Dhaka, Bangladesh
  • Mauin Uddin, MS, MRCSEd Registrar Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, UK
  • Mohammed Ishtiaque Sayeed Al-Manzo, FCPS Department of Cardiac Surgery, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh
  • Mohammed Ziaur Rahman, MS Department of Cardiac Surgery, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh
  • A.T.M. Khalilur Rahman Department of Cardiac Anesthesia, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh
  • Farooque Ahmed, MS Department of Cardiac Surgery, National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh

DOI:

https://doi.org/10.1532/hsf.3287

Keywords:

Hypertrophic Obstructive Cardiomyopathy (HOCM), Septal Myectomy, Systolic Anterior Motion, Left Ventricular Outflow Tract Obstruction (LVOTO), Alcohol Septal Ablation (ASA)

Abstract

Background: For years, septal myectomy has been considered the best available treatment for hypertrophic cardiomyopathy. In Bangladesh, however, this technique is only nascent. We present a case series of septal myectomy with outcomes after 1 to 6 years at the National Heart Foundation Hospital & Research Institute.

Methods: For this study, 21 patients who underwent septal myectomy from 2014 to 2019 were monitored retrospectively. Evidence was collected from the hospital database and followed up via telephone conversations using a structured questionnaire. Patients’ preoperative, postoperative, and follow-up clinical data were collected and analyzed.

Results: The results reveal that after septal myectomy, there were significant improvements in terms of left ventricular outflow gradient (P ≤ .01), septal thickness
(P ≤ .01), left ventricular ejection fraction (P = .001), pulmonary arterial systolic pressure (P ≤ .01), mitral regurgitation (P ≤ .01), systolic anterior motion (P ≤ .01), and New York Heart Association class (P ≤ .01).

Conclusion: This study suggests that septal myectomy be offered to symptomatic hypertrophic obstructive cardiomyopathy patients, as its survival benefits and symptoms relief are excellent. This study suggests that septal myectomy that dynamic obstruction at the left ventricular outflow tract is the major hemodynamic problem. We hope that with appropriate measures, new myectomy programs in our country can provide extended longevity and restore the quality of life.

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Published

2020-11-24

How to Cite

Islam Talukder, M. Q. ., DasGupta, S. ., Uddin, M., Syed Al Manzoo, I. ., Ziaur Rahman, M. ., Rahman, A. T. M. K. ., & Ahmed, F. . (2020). Midterm Outcome of Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy (HOCM): A Single-Center Observational Study. The Heart Surgery Forum, 23(6), E873-E879. https://doi.org/10.1532/hsf.3287

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