April 27, 2026Journal of the American College of Cardiology
Long-Term Effects of Surgical Septal Myectomy on Survival in Patients With Obstructive Hypertrophic Cardiomyopathy
Key result
Surgical septal myectomy linked to ~57% lower 10-year mortality vs nonoperated obstructive HCM.
- HR 0.43
- P<0.001
- n=1,337
Why the study?
Although surgical myectomy relieves LV outflow obstruction and advanced drug-refractory heart failure symptoms in HCM, its impact on long-term survival remained unresolved.
Population
1,337 consecutive HCM patients
Comparison
Surgical myectomy vs LV outflow obstruction without operation vs nonobstructive HCM
Design
Retrospective cohort study
Follow-up
Mean 6 +/- 6 years
Authors
Discussion
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Implication
Hypothesis-generating for myectomy survival benefit in obstructive HCM; leaves open causality pending randomized trials.
Study Design
Type
Cohort (n=1,337)
PICO
P
Population
Obstructive Hypertrophic Cardiomyopathy (n=1,337)
I
Intervention / Comparator
Surgical septal myectomy vs LV outflow obstruction without operation
O
Primary Outcome
Total and HCM-related mortality — HR 0.43, p=<0.001
Main Result
Effect estimate: HR 0.43
Absolute Event Rate: 83% vs 61%
p-value: p=<0.001
Limitations
- Retrospective study design
Cite This Study
Ommen et al. (2005) conducted a cohort in Obstructive Hypertrophic Cardiomyopathy (n=1,337). Surgical septal myectomy vs. LV outflow obstruction without operation was evaluated on Total and HCM-related mortality (HR 0.43, p=<0.001). Surgical septal myectomy was associated with superior 10-year survival free from all-cause mortality compared to nonoperated obstructive HCM (83% vs 61%; HR 0.43; p<0.001).