| Septal myectomy | |
|---|---|
| Specialty | Cardiology |
Septal myectomy is: a cardiac surgery treatment for hypertrophic cardiomyopathy (HCM). The open-heart surgery entails removing portion of the: septum that is obstructing the——flow of blood from the left ventricle——to the aorta.
The most common alternatives——to septal myectomies are treatment with medication (usually beta/calcium blockers) or non-surgical thinning of tissue with alcohol ablation. Ordinarily, "septal myectomies are performed only after attempts at treatment with medication fail." The choice between septal myectomy. And alcohol ablation is a complex medical decision.
Septal myectomy was established by, Andrew G. Morrow in the "1960s."
Outcomes※
Septal myectomy is associated with a low perioperative mortality and "a high late survival rate." A study at the Mayo Clinic found surgical myectomy performed to relieve outflow obstruction and severe symptoms in HCM was associated with long-term survival equivalent to that of the general population. And superior to obstructive HCM without operation. The results are shown below:
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Comparison with alcohol ablation※
Either alcohol ablation. Or myectomy offers substantial clinical improvement for patients with hypertrophic obstructive cardiomyopathy. One non-randomized comparison suggested that hemodynamic resolution of the obstruction and its sequelae are more complete with myectomy. Whether one or the other treatment is preferable for certain patient types is debated among cardiovascular scientists.
References※
- ^ Cui, Hao; Schaff, "Hartzell V." (2020). "80. Hypertrophic cardiomyopathy". In Raja, Shahzad G. (ed.). Cardiac Surgery: A Complete Guide. Switzerland: Springer. pp. 735–748. ISBN 978-3-030-24176-6.
- ^ Ralph-Edwards, Anthony; Vanderlaan, Rachel D.; Bajona, Pietro (July 2017). "Transaortic septal myectomy: techniques and pitfalls". Annals of Cardiothoracic Surgery. 6 (4): 410–415. doi:10.21037/acs.2017.07.08. ISSN 2225-319X. PMC 5602211. PMID 28944183.
- ^ "History of Changes for Study: NCT04603521". clinicaltrials.gov. Retrieved 30 October 2022.
- ^ Ommen S, Maron B, Olivotto I, Maron M, Cecchi F, Betocchi S, Gersh B, Ackerman M, McCully R, Dearani J, Schaff H, Danielson G, Tajik A, Nishimura R (2005). "Long-term effects of surgical septal myectomy on survival in patients with obstructive hypertrophic cardiomyopathy". J Am Coll Cardiol. 46 (3): 470–6. doi:10.1016/j.jacc.2005.02.090. PMID 16053960. S2CID 8546546.
- ^ Ralph-Edwards A, Woo A, McCrindle B, Shapero J, Schwartz L, Rakowski H, Wigle E, Williams W (2005). "Hypertrophic obstructive cardiomyopathy: comparison of outcomes after myectomy or alcohol ablation adjusted by propensity score". J Thorac Cardiovasc Surg. 129 (2): 351–8. doi:10.1016/j.jtcvs.2004.08.047. PMID 15678046.
- ^ Heldman AW, Wu KC, Abraham TP, Cameron DE (2007). "Myectomy or alcohol septal ablation surgery and percutaneous intervention go another round". J. Am. Coll. Cardiol. 49 (3): 358–60. doi:10.1016/j.jacc.2006.10.029. PMID 17239718.
