Post-operative management of hypertrophic obstructive cardiomyopathy

Mitra, Saikat; Ramanathan, Kollengode; MacLaren, Graeme

doi:10.1177/02184923211069189

Cited by 2 publications

(3 citation statements)

References 47 publications

(122 reference statements)

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“…HOCM patients are at raised risk of sudden cardiac arrest owing to dynamic LVOTO, arrhythmias and myocardial ischaemia, and septal myectomy is considered as a gold standard therapy for HOCM patients [15]. In our study, all patients underwent modi ed enlarged septal myotomy.…”

Section: Discussionmentioning

confidence: 92%

Mitral annular calcification in patients with hypertrophic obstructive cardiomyopathy: risk factors and prognosis

Guo,

Song,

et al. 2024

Preprint

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Objective This research aimed to ascertain the risk factors for the development of mitral annular calcification (MAC) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and the impact of MAC on prognosis. Methods HOCM patients underwent interventricular diaphragmatic myectomy were collected and examined by echocardiography and CT to test whether MAC occurred or not. General data and risk factors affecting MAC development in HOCM patients were observed. Differences in cardiac function indicators and perioperative clinical data were compared between patients with MAC and those without MAC. After surgery, patients were followed up until December 2022, with the primary endpoint being postoperative all-cause mortality and the secondary endpoint being major adverse cardiovascular and cerebrovascular events (MACCE). Prognosis and MACCE occurrence were analyzed, and differences in brain natriuretic peptide (BNP), Apelin, and Galectin-3 levels were assessed between patients with MAC and patients without MAC, and the correlation between factor levels and cardiac function indicators were explored. Results There were 24 patients with MAC (7.74%) and 286 patients without MAC (92.26%). Female and older patients were more common in the MAC group. The MAC group had a higher incidence of SAM sign, aortic annular calcification, aortic calcification, coronary artery calcification, mitral leaflet thickening, and moderate and severe tricuspid regurgitation. Gender, age, aortic calcification, aortic annular calcification, SAM sign, and mitral leaflet thickening were independent risk factors for MAC development. The MAC group had higher LVEDD, lower LVEF and heavier LVMM than the no-MAC group. Patients in the no-MAC group had a better prognosis and better MACCE incidence than patients in the MAC group. Conclusion Independent risk factors affecting MAC development in HOCM patients are gender, age, aortic calcification, aortic annular calcification, SAM sign, and mitral leaflet thickening. MAC development may lead to a poor prognosis in HOCM patients.

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Section: Discussionmentioning

confidence: 92%

Mitral annular calcification in patients with hypertrophic obstructive cardiomyopathy: risk factors and prognosis

Guo,

Song,

et al. 2024

Preprint

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“…Patients are at risk of various perioperative complications from anesthesia and surgery due to the underlying complexity of their disease, but septal myectomy remains the gold standard therapy for patients with hypertrophic obstructive cardiomyopathy (HOCM) refractory to other therapy (5) .…”

Section: Discussionmentioning

confidence: 99%

“…Patients with MOCM are at increased risk of sudden cardiac arrest due to dynamic left ventricular outflow tract obstruction, myocardial ischemia and arrhythmias. Septal myectomy remains the gold standard therapy for patients with HOCM refractory to other treatment options (5) .…”

Section: Introductionmentioning

confidence: 99%

Hypertrophic Obstructive Cardiomyopathy Repair with Coronary Artery Bypass Surgery: A Case Report

Khalil¹,

Elsokkary²,

Sayed³

2022

SJMS

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Background: Hypertrophic obstructive cardiomyopathy (HOCM) is a cardiac condition of an abnormal interventricular septum (IVS) thickening. It is due to an autosomal dominant mutation in sarcomeric protein genes. It had many phenotypes with different distribution of myocardial hypertrophy. Septal myectomy remains the treatment of choice for hypertrophic obstructive cardiomyopathy resistant to medical therapy. However, controversy exist regarding standard treatment option(s). Description of the Case: Here we described a case of 47-year-old patient admitted with diagnosis of acute coronary syndrome, with typical chest pain of angina class II, shortness of breath class-II (NYHA), smoker on regular renal hemodialysis. Echocardiography showed HOCM, IVS thickening, normal Left ventricle global systolic function and mild to moderate eccentric regurge. Coronary angiography revealed normal left main with total (LAD) proximal occlusion, proximal and mid (LCX) (50%) occlusion, first (OM) mid (90%) lesion, (RCA) dominant with non-flow limiting lesions. He was submitted to open heart surgery with four grafts, sub-valvular myomectomy, and successful myomectomy. Distal anastomosis was done first then myomectomy then proximal anastomosis. Patient extubated after (9) hours with stable hemodynamics and complete neurological condition, with accepted drains output. He gradually weaned from inotropic support and chest drains removed on 3rd postoperative day. All lines and pacemakers were removed, the wound was dry with stable sternum and improvement of all symptoms. Then discharged home after 9 days of hospital stay on medical treatment. Postoperative echocardiography showed significant improvement. Conclusion: Surgical treatment is the standard option in treatment of HOCM to improve symptoms.

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Post-operative management of hypertrophic obstructive cardiomyopathy

Cited by 2 publications

References 47 publications

Mitral annular calcification in patients with hypertrophic obstructive cardiomyopathy: risk factors and prognosis

Mitral annular calcification in patients with hypertrophic obstructive cardiomyopathy: risk factors and prognosis

Hypertrophic Obstructive Cardiomyopathy Repair with Coronary Artery Bypass Surgery: A Case Report

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