The long‐term outcomes of transcoronary ablation of septal hypertrophy compared to surgical myectomy in patients with symptomatic hypertrophic obstructive cardiomyopathy. Issue 2 (31st August 2013)

• Record Type: Journal Article
• Authors: Samardhi, Himabindu; Walters, Darren L; Raffel, Christopher; Rateesh, Shruti; Harley, Catherine; Burstow, Darryl; Pohlner, Peter; Aroney, Con
• Is Part Of: Catheterization and cardiovascular interventions. Volume 83:Issue 2(2014:Feb. 01)
• Page Start: 270
• Page End: 277
• Publication Date: 2013-08-31
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25134
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25134-sec-0001" sec-type="section"> <title>Objectives</title> <p>The aim of this study was to compare the long‐term outcomes of transcoronary ablation of septal hypertrophy (TASH) with open surgical myomectomy (SM) in patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM).</p> </sec> <sec id="ccd25134-sec-0002" sec-type="section"> <title>Methods</title> <p>We reviewed patients who underwent either procedure at our institution. The demographics, clinical outcomes, echocardiographic parameters, and complications were compared.</p> </sec> <sec id="ccd25134-sec-0003" sec-type="section"> <title>Results</title> <p>Seventy patients with HOCM were treated with either TASH (<italic>n</italic> = 47, 26 male) or SM (<italic>n</italic> = 23, 10 male). Compared to those treated with SM, patients undergoing TASH were older (57+/− 14.7 years versus 47 +/− 20.6 years, <italic>P</italic> = 0.021) and more symptomatic. A higher proportion of patients had syncope as a presenting feature in the TASH group compared to the SM group (57.5% vs. 17.4%, <italic>P</italic> = 0.002) respectively. They were also more likely to be in New York Heart Association (NYHA) class III/IV compared to the patients who underwent SM (85.1% vs. 39.1%; <italic>P</italic> < 0.001). Patients were followed for a mean period of 43 months (TASH) and 46 months (SM). Repeat procedures were more common in the TASH group (17% vs. 0%, <italic>P</italic> = 0.04) but mitral valve replacement was more common in the SM group (0% vs. 8.7%, <italic>P</italic> = 0.105). Symptom improvement, the rate of complications and all cause mortality rates were similar in both groups.</p> </sec> <sec id="ccd25134-sec-0004" sec-type="section"> <title>Conclusions</title> <p>TASH compares favorably with surgical myectomy with regard to symptom resolution, rate of complications and mortality in a tertiary referral centre and should be seen as an attractive alternative to surgical myectomy in the appropriate patient population. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>