Key result
Septal myectomy is linked to marked improvements in hemodynamics and NYHA class in HOCM.
Why the study?
Septal myectomy is considered the best treatment for hypertrophic cardiomyopathy, but this technique is only nascent in Bangladesh.
Does septal myectomy improve hemodynamic parameters and symptoms in patients with hypertrophic obstructive cardiomyopathy?
Observational (n=21)
No
Does septal myectomy improve hemodynamic parameters and symptoms in patients with hypertrophic obstructive cardiomyopathy?
p-value: p=≤.01
Septal myectomy provides significant hemodynamic and symptomatic improvements in patients with hypertrophic obstructive cardiomyopathy at 1 to 6 years follow-up.
May support septal myectomy in HOCM; hypothesis-generating and should not yet change practice.
BACKGROUND: For years, septal myectomy has been considered the best available treatment for hypertrophic cardiomyopathy. In Bangladesh, however, this technique is only nascent. We present a case series of septal myectomy with outcomes after 1 to 6 years at the National Heart Foundation Hospital & Research Institute. METHODS: For this study, 21 patients who underwent septal myectomy from 2014 to 2019 were monitored retrospectively. Evidence was collected from the hospital database and followed up via telephone conversations using a structured questionnaire. Patients' preoperative, postoperative, and follow-up clinical data were collected and analyzed. RESULTS: The results reveal that after septal myectomy, there were significant improvements in terms of left ventricular outflow gradient (P ≤ .01), septal thickness (P ≤ .01), left ventricular ejection fraction (P = .001), pulmonary arterial systolic pressure (P ≤ .01), mitral regurgitation (P ≤ .01), systolic anterior motion (P ≤ .01), and New York Heart Association class (P ≤ .01). CONCLUSION: This study suggests that septal myectomy be offered to symptomatic hypertrophic obstructive cardiomyopathy patients, as its survival benefits and symptoms relief are excellent. This study suggests that septal myectomy that dynamic obstruction at the left ventricular outflow tract is the major hemodynamic problem. We hope that with appropriate measures, new myectomy programs in our country can provide extended longevity and restore the quality of life.
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Talukder et al. (2020) conducted an observational in Hypertrophic obstructive cardiomyopathy (n=21). Septal myectomy was evaluated on Left ventricular outflow gradient, septal thickness, left ventricular ejection fraction, pulmonary arterial systolic pressure, mitral regurgitation, systolic anterior motion, and New York Heart Association class (p=≤.01). Septal myectomy significantly improved left ventricular outflow gradient, septal thickness, pulmonary arterial systolic pressure, and NYHA class (all P≤0.01) in patients with HOCM.
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