Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy: A Retrospective Analysis in Regional Australia

Abstract

Hypertrophic obstructive cardiomyopathy (HOCM) is as a relatively common contemporary and treatable disease that is compatible with normal or extended life expectancy. The presence of a peak left ventricular outflow tract (LVOT) gradient of ≥30 mmHg is indicative of obstruction, with resting or provoked gradients ≥50 mmHg considered to be the threshold for septal reduction therapy. Left ventricular outflow tract obstruction is associated with impaired stroke volume, increased risk of heart failure, and poor survival. Surgical-related mortality has reduced from 6–8% to <0.5% at high-volume centres but remains around 3% at general centres. There is currently no centralised referral centre for surgical myectomy in Australia and no published data at a regional cardiothoracic centre.