Beukers, S.H.Q (2022) Septal myectomy for hypertrophic obstructive cardiomyopathy: amelioration of symptoms and echocardiographic parameters on long-term follow-up. thesis, Medicine.
Full text available on request.Abstract
INTRODUCTION In hypertrophic obstructive cardiomyopathy (HOCM), an asymmetrical hypertrophy of the intraventricular septum (IVS) develops, which impedes the flow through the left ventricular outflow tract (LVOT). For patients with a peak LVOT pressure gradient (PG) of >50 mm Hg and New York Heart Association (NYHA) functional class III-IV despite optimal medical therapy, septal reduction therapy is recommended. RESEARCH OBJECTIVE Evaluation of short- and long-term clinical, functional and echocardiographic outcomes of the Morrow septal myectomy for therapy-resistant symptomatic HOCM. METHOD Retrospectively, 157 patients who underwent a septal myectomy with or without concomitant surgery for symptomatic and therapy-resistant HOCM in the period of 2011 to 2020 in the St Antonius Hospital in Nieuwegein were included. Of 118 living patients, the NYHA functional class was determined through telephonic follow-up. RESULTS Both early and late postoperative echocardiograms demonstrated significant amelioration of the LVOT PG and IVS diameter. On the long-term, the maximum LVOT PG decreased with 73 mmHg and the IVS diameter decreased with 5.6 mm. At a median of 6 years after surgery, 79% of patients were in NYHA functional class I-II, with 52.5% of patients showing a significant functional improvement. The 1-, 5- and 10-year survival rates were 89.6%, 82.5% and 76.4%. CONCLUSION Septal myectomy, even when combined with other interventions or performed in nonelective setting, has excellent survival and leads to significant amelioration of heart failure symptoms. This translates into profound improvement of echocardiographic HOCM-related measurements at both short term and long-term follow-up, when compared to preoperative values.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Verstraeten, S.E. and Hegeman, R.M.J.J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 17 May 2023 13:10 |
| Last Modified: | 17 May 2023 13:10 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3523 |
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