Does a modified surgical technique with extended myectomy and papillary muscle excision improve survival and functional status in severely symptomatic HOCM patients?
Extended myectomy combined with papillary muscle mobilization and partial excision is a feasible and effective surgical strategy for severely symptomatic, medically refractory HOCM, yielding low mortality and excellent functional improvement.
A modified surgical technique for correction of hypertrophic obstructive cardiomyopathy (HOCM) with extended myectomy together with mobilisation and partial excision of papillary muscles was performed between 1/79 and 12/92 in 58 severely symptomatic patients refractory to medical treatment. Low hospital mortality rate (1.7%) and perioperative complication rate, an equally low linear mortality 1.4% per patient year and excellent functional status (77% class I or II NYHA) of the patients at follow-up demonstrate the necessity of a comprehensive approach for correction of severely symptomatic patients with HOCM and the feasibility of our operative strategy.
Schoendube et al. (Sat,) studied this question.