Surgical management of hypertrophic obstructive cardiomyopathy

Dönmez, Arzu Antal; Boyacıoğlu, Kamil; Akbulut, Mustafa; Mete, Hızır

doi:10.1007/s11748-020-01306-5

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…They incur <1% of complications such as early deaths, cerebrovascular accidents, ventricular arrhythmias, valve injury, and VSDs ( 43 ). Early mortality after SM procedure was higher for the patients in small centers (1–3%) than the patients in specialized centers (<1%) ( 14 , 18 , 21 , 22 , 24 ). There was no perioperative death observed in five out of seven ERASH studies ( 30 , 32 – 35 ), which illustrated the safety of ERASH.…”

Section: Discussionmentioning

confidence: 89%

“…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 ).…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2022

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BackgroundSeptal myectomy (SM) has been the gold standard therapy for most patients with hypertrophic obstructive cardiomyopathy (HOCM). Endocardial radiofrequency ablation of septal hypertrophy (ERASH) is a novel treatment for septal reduction. We aimed to assess the efficacy and safety between two treatment strategies.MethodsWe searched PubMed, Web of Science, Cochrane Library, and Embase databases to identify relevant studies published up to March 2021. Random-effect models were used to calculate standardized mean difference (SMD) and 95% confidence intervals (CIs) for resting left ventricular outflow tract gradient (LVOTG) and septal thickness.ResultsTwenty-five studies are included in this review, eighteen studies for SM and seven studies for ERASH. During follow-up, there were significant reductions of the mean resting LVOTG in adults (SM groups: SMD = −3.03, 95% CI [−3.62 to −2.44]; ERASH groups: SMD = −1.95, 95% CI [−2.45 to −1.45]) and children (SM groups: SMD = −2.67, 95% CI [−3.21 to −2.12]; ERASH groups: SMD= −2.37, 95% CI [−3.02 to −1.73]) after the septal reduction therapies. For adults, SM groups contributed to more obvious reduction than ERASH groups in interventricular septal thickness (SM groups: SMD = −1.82, 95% CI [−2.29 to −1.34]; ERASH groups: SMD = −0.43, 95% CI [−1.00 to 0.13]). The improvement of the New York Heart Association class was similar in the two groups (SM groups: 46.4%; ERASH groups: 46.7%). The periprocedural mortality in SM and ERASH were 1.1 and 1.8%, respectively.ConclusionsThis systematic review suggests that SM is superior to ERASH in the treatment of HOCM. But for the patients who are at risk for open cardiac surgeries or prefer a less invasive approach, ERASH might be an optional approach.

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Section: Discussionmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

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

et al. 2022

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“…69.5 min, which were relatively higher in the MVR + Myectomy groups although not statistically significant (p values = 0.15 and 0.16). The median ventilation time and ICU stay were 9(6)(7)(8)(9)(10)(11)(12)(13)(14) and 39 h (11-71), indicating no statistically significant difference among the three groups (p values = 0.59 and 0.80).Inotropes were used in 50% of the patients, and 5 (4.9%) required intra-aortic balloon pump support. Concomitant surgeries were conducted in 42 (41%) patients, with the most common surgery being CABG (20 patients), followed by Aortic valve repair(7 patients) or replacement (9 patients) and Tricuspid valve repair (4 patients) or replacement (2 patients).…”

mentioning

confidence: 95%

“…10 Moreover, due to mitral valve (MV) abnormalities in HCM patients and further relief of LVOT obstruction, mitral valve replacement (MVR) or repair (MVr) is necessary for some of these patients. [11][12][13] Therefore, surgeons may perform septal myectomy and MVR simultaneously to improve symptoms for HCM patients. 14 However, there is a lack of clinical evidence comparing these treatments directly.…”

Section: Introductionmentioning

confidence: 99%

Comparing long‐term outcomes of septal myectomy and mitral valve replacement in hypertrophic cardiomyopathy patients: A retrospective cohort study in Iran

Ayati,

Khoshfetrat,

Davoodi

et al. 2024

Health Science Reports

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BackgroundHypertrophic cardiomyopathy (HCM) affects millions of individuals worldwide. In severe cases, it can cause life‐threatening conditions such as left ventricular outflow tract (LVOT) obstruction, mitral regurgitation (MR), and sudden cardiac death, making surgical treatment necessary. This study aimed to report the long‐term outcomes of HCM patients undergoing septal myectomy or mitral valve replacement (MVR) and compare the results between different types of surgeries.MethodsThis was a retrospective cohort study on HCM patients who underwent surgical treatment in an Iranian referral center between 2005 and 2021. Patients were divided into three groups according to the type of surgery received: septal myectomy, MVR, or a combination of both surgeries. Patient characteristics, surgical and echocardiographic features, and in‐hospital and long‐term outcomes were reported and compared between the three groups.ResultsA total of 102 patients with an average age of 53.3 ± 16.9 were included. Twenty‐six patients had septal myectomy, 23 had MVR, and 53 had combined septal myectomy and MVR surgery. All surgeries were associated with a significant reduction in interventricular septum thickness and LVOT gradients. After a median of 6.8‐year follow‐up time, patients with an isolated septal myectomy had significantly lower mortality and major adverse cardiac and cerebrovascular events rates than the other groups.ConclusionIsolated septal myectomy showed better long‐term survival rates and can correct HCM‐related MR, while MVR should be preserved only for intrinsic valve defects. More extensive studies are needed to confirm these findings and achieve a comprehensive guideline on surgical treatment of HCM.

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Mavacamten, a first-in-class cardiac myosin inhibitor for the treatment of hypertrophic cardiomyopathy

Chen,

Long,

Wang

et al. 2025

Drug Discovery Stories

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Surgical management of hypertrophic obstructive cardiomyopathy

Cited by 4 publications

References 22 publications

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

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

Comparing long‐term outcomes of septal myectomy and mitral valve replacement in hypertrophic cardiomyopathy patients: A retrospective cohort study in Iran

Mavacamten, a first-in-class cardiac myosin inhibitor for the treatment of hypertrophic cardiomyopathy

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