Long‐term outcomes for different surgical strategies to treat left ventricular outflow tract obstruction in hypertrophic cardiomyopathy

Abstract

Septal myectomy is a safe procedure resulting in symptomatic improvement in the majority of patients. The annual incidence of non-fatal disease-related complications after surgical treatment of LVOTO is relatively high. Patients who underwent MV replacements had poorer outcomes with less symptomatic benefit in spite of a similar reduction in LVOT gradients.

We need more high‐volume myectomy centres in Europe

“…With regard to perioperative mortality and long‐term survival, the results of this study would not appear to differ substantially from those reported by high‐volume centres for surgical septal myectomy. However, rather than being encouraging, this conclusion raises some important questions.…”

“…The results of this study suggest a possible answer to this question. The authors report that, at 1‐year follow‐up, about 30% of patients did not improve in NYHA functional class and about 30% described exertional chest pain, pre‐syncope, syncope, or palpitations .…”

“…In this issue of the Journal, Collis et al . report on the results of surgical treatment of obstructive HCM at four main HCM referral institutions in London over a period of almost 30 years, from 1988 to 2015 . A total of 347 HCM patients underwent surgical treatment for LV outflow obstruction, representing an average of about 13 patients per year.…”

“…At 1‐year follow‐up, about 70% of patients reported symptomatic improvement with a decrease in NYHA functional class and about 90% of patients had no significant postoperative LV outflow gradient (≥30 mmHg) at rest. Over a median follow‐up period of 5.2 years, 20 of the patients who survived surgery died, including five of cardiovascular causes, seven of non‐cardiac and eight of unknown causes; nine patients were lost to follow‐up …”

“…1,3,4 In this issue of the Journal, Collis et al report on the results of surgical treatment of obstructive HCM at four main HCM referral institutions in London over a period of almost 30 years, from 1988 to 2015. 6…”