What is the clinical evidence from this study?

Study design: Case Report. Population: Apical hypertrophic cardiomyopathy (n=1). Intervention: Transapical myectomy. Primary outcome: Echocardiographic and functional parameters (LVEDV, SV, CO, 6MWT).

January 1, 2024Clinical and Experimental Surgery Petrovsky journalOpen Access

Transapical myectomy as an alternative to heart transplantation in patient with apical hypertrophic cardiomyopathy

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Key result

Transapical myectomy boosts cardiac output ~119% and improves walk distance in an apical HCM case.

Why the study?

Does transapical myectomy improve cardiac function and symptoms in a patient with apical hypertrophic cardiomyopathy?

Population

1 41-year-old woman with NYHA class III heart failure and apical HCM on the transplant waiting list

Comparison

Transapical myectomy

Design

Case report

Authors

AAAlexander AfanasyevMeshalkin National Medical Research Center ABA. V. Bogachev-ProkofievMeshalkin National Medical Research Center VKV. S. KirilovaMeshalkin National Medical Research Center

Discussion

Member takes

Implication

Transapical myectomy improved hemodynamics and exercise tolerance in one apical HCM case; hypothesis-generating and should not yet change practice.

Key Points

Evaluate the clinical feasibility and hemodynamic benefits of transapical myectomy as an alternative to heart transplantation in advanced apical hypertrophic cardiomyopathy.
Evaluated a 41-year-old female with NYHA class III heart failure and apical hypertrophic cardiomyopathy listed for heart transplantation for 6 months.
Performed transapical myectomy to relieve severe cavity reduction, apical aneurysm with transmural fibrosis, and refractory symptoms.
Left ventricular end-diastolic volume expanded from 46 mL to 88 mL, stroke volume rose from 28 mL to 63 mL, and maximal wall thickness decreased from 19 mm to 15 mm.
Cardiac output increased from 2.1 L/min to 4.6 L/min, and 6-minute walk distance improved from less than 50 m to 200 m.

Study Design

Type

Case Report (n=1)

Structured PICO

Does transapical myectomy improve cardiac function and symptoms in a patient with apical hypertrophic cardiomyopathy?

Population

1 41-year-old woman with NYHA class III heart failure, apical hypertrophic cardiomyopathy, severe diastolic dysfunction, small LV cavity, and apical aneurysm with transmural fibrosis, on the heart transplant waiting list for 6 months.

Intervention

Transapical myectomy

Outcome

Postoperative echocardiographic parameters (LV volumes, stroke volume, cardiac output) and functional capacity (6-minute walk test)surrogate

Transapical myectomy may serve as an effective alternative to heart transplantation in severely symptomatic patients with apical hypertrophic cardiomyopathy and small LV cavity.

Cite This Study

Afanasyev et al. (2024) conducted a case report in Apical hypertrophic cardiomyopathy (n=1). Transapical myectomy was evaluated on Echocardiographic and functional parameters (LVEDV, SV, CO, 6MWT). Transapical myectomy in a patient with apical hypertrophic cardiomyopathy increased cardiac output from 2.1 to 4.6 L/min and 6-minute walk distance from <50 to 200 m.

synapsesocial.com/papers/6a0e4e85bc348c84f2fd9b0f https://doi.org/10.33029/2308-1198-2024-12-1-127-134

Topics

Heart transplantation Hypertrophic cardiomyopathy Heart failure HFrEF treatment

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Implication

Transapical myectomy improved hemodynamics and exercise tolerance in one apical HCM case; hypothesis-generating and should not yet change practice.

Transapical myectomy as an alternative to heart transplantation in patient with apical hypertrophic cardiomyopathy

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Transapical myectomy as an alternative to heart transplantation in patient with apical hypertrophic cardiomyopathy

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

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