Surgery for hypertrophic cardiomyopathy |
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| Authors: | James J Wu Michael Seco Caroline Medi Chris Semsarian David R Richmond Joseph A Dearani Hartzell V Schaff Michael J Byrom Paul G Bannon |
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| Institution: | 1.Sydney Medical School, The University of Sydney, Sydney, Australia ;2.The Baird Institute of Applied Heart & Lung Surgical Research, Sydney, Australia ;3.Cardiothoracic Surgery Unit, Royal Prince Alfred Hospital, Sydney, Australia ;4.Molecular Cardiology Group, Centenary Institute, Sydney, NSW Australia ;5.Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW Australia ;6.Cardiac Surgery Unit, Mayo Clinic, Rochester, MN USA |
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| Abstract: | Hypertrophic cardiomyopathy (HCM) is a genetically determined cardiac disease characterised by otherwise unexplained myocardial hypertrophy of the left ventricle, and may result in left ventricular outflow tract obstruction. It is the most common cause of sudden cardiac death in young adults due to arrhythmias. Septal myectomy is a surgical treatment for HCM with moderate to severe outflow tract obstruction, and is indicated for patients with severe symptoms refractory to medical therapy. The surgical approach involves obtaining access to the interventricular septum via transaortic, transapical or transmitral approaches, and excising a portion of the hypertrophied myocardium to relieve the outflow tract obstruction. Large, contemporary series from centres experienced in septal myectomy patients have demonstrated a low early mortality of <2 %, excellent long-term survival that matches the general population, and durable relief of symptoms. |
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| Keywords: | Hypertrophic cardiomyopathy Septal myectomy Alcohol septal ablation Left ventricular outflow tract obstruction |
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