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

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.

Endocardial Radiofrequency Ablation vs. Septal Myectomy in Patients With Hypertrophic Obstructive Cardiomyopathy: A Systematic Review and Meta-Analysis

“…Eighteen studies were for SM and seven studies were for ERASH. For SM cohorts, five studies (28%) were from European centers (544 patients) ( 18 , 21 , 24 , 27 , 28 ), five studies (28%) from North American centers (1,187 patients) ( 12 , 15 , 16 , 20 , 25 ), five studies (28%) from China (650 patients) ( 13 , 14 , 17 , 26 , 29 ), and the remaining three studies from Argentina (28 patients) ( 37 ), Turkey (41 patients) ( 22 ), and Bangladesh (21 patients) ( 23 ). For ERASH cohorts, three studies (43%) were from European centers (56 patients) ( 30 , 31 , 36 ), two studies (29%) from North American centers (16 patients) ( 32 , 34 ), and the remaining two studies from China (30 patients) ( 35 ) and India (7 patients) ( 33 ).…”