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Tanıl Özer1, Ali Elveran2, Cem Doğan2, Mehmet Aksüt1, Rezzan Deniz Acar2, Zübeyde Bayram2, Öge Altaş Yerlikhan1, Nihal Özdemir2, Kaan Kırali1
1Department of Cardiovascular Surgery, Health Science University, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Turkey
2Department of Cardiology, Health Science University, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Turkey
Keywords: Hypertrophic cardiomyopathy, myectomy, obstruction, septal alcohol ablation
Objectives: This study aims to compare the efficacy of septal myectomy (SM) and septal alcohol ablation (SAA) for the relief of the left ventricular outflow tract (LVOT) gradient in patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM).
Patients and methods: Between January 2005 and January 2010, a total of 45 patients (32 males, 13 females; mean age 51.5 years; range, 17 to 87 years) with symptomatic drug-refractory obstructive HOCM were consecutively enrolled. The patients were divided into two groups as SM (n=17) and SAA (n=28). All patients underwent clinical and echocardiographic examinations before, during the procedure, and at the end of one-year follow-up.
Results: There was no significant difference in clinical and demographic characteristics of the patients who underwent SM and SAA. The mean LVOT gradients early after the procedures significantly decreased (p<0.001). At the end of one year, the mean maximal gradients in LVOT after exercise were similar (54±39 mmHg for SM and 73±53 mmHg for SAA; p=0.220).
Conclusion: Although SM is considered the preferred treatment in patients with HOCM, SAA may be an alternative approach to SM in
the LVOT gradient reduction in experienced centers for high-risk surgical patients.
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