Septal myectomy
Encyclopedia
Septal myectomy is a cardiac surgery
treatment for hypertrophic cardiomyopathy
(HCM). The surgery entails removing a portion of the septum
that is obstructing the flow of blood from the left ventrical to the aorta. Septal myectomies have been successfully performed for more than 25 years. The alternatives to septal myectomies are treatment with medication (usually beta or calcium blockers) or non-surgical removal 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.
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:
* Includes 0.8% operative mortality.
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.
Cardiac surgery
Cardiovascular surgery is surgery on the heart or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease , correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart...
treatment for hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy is a disease of the myocardium in which a portion of the myocardium is hypertrophied without any obvious cause...
(HCM). The surgery entails removing a portion of the septum
Septum
In anatomy, a septum is a wall, dividing a cavity or structure into smaller ones.-In human anatomy:...
that is obstructing the flow of blood from the left ventrical to the aorta. Septal myectomies have been successfully performed for more than 25 years. The alternatives to septal myectomies are treatment with medication (usually beta or calcium blockers) or non-surgical removal 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.
Outcomes
Septal myectomy is associated with a low perioperative mortality and a high late survival rate. A study at the Mayo ClinicMayo Clinic
Mayo Clinic is a not-for-profit medical practice and medical research group specializing in treating difficult patients . Patients are referred to Mayo Clinic from across the U.S. and the world, and it is known for innovative and effective treatments. Mayo Clinic is known for being at the top of...
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:
Comparison with alcohol ablation
Either alcohol septal ablationAlcohol septal ablation
Alcohol septal ablation is a percutaneous, minimally-invasive treatment performed by an interventional cardiologist to relieve symptoms and improve functional status in severely symptomatic patients with hypertrophic cardiomyopathy who meet strict clinical, anatomic and physiologic selection...
or myectomy offers substantial clinical improvement for patients with hypertrophic obstructive cardiomyopathy
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy is a disease of the myocardium in which a portion of the myocardium is hypertrophied without any obvious cause...
. 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.