Comparison of surgical septal myectomy to medical therapy alone in patients with hypertrophic cardiomyopathy and syncope

Nicholas M. Orme, Paul Sorajja, Joseph A. Dearani, Hartzell V. Schaff, Bernard J. Gersh, Steve R. Ommen

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

The presence of syncope despite medical therapy in patients with hypertrophic cardiomyopathy (HC) is considered an indication for surgical myectomy; however, no study has examined the long-term effects on recurrent syncope and survival after surgery in these patients. We examined 239 patients with HC and a history of syncope who had undergone surgical myectomy (mean age 48 ± 17 years; 56% men). The patients were age- and gender-matched to patients with HC and syncope who were treated medically without myectomy (mean age 51 ± 16 years; 59% men). The median follow-up period was 4.7 years (0.8, 11.3). The recurrence rate of syncope was 11% in the myectomy patients and 40% in the medical group (p <0.0001). Multiple episodes of syncope, left ventricular outflow tract obstruction, and recent syncope were identified as baseline predictors of recurrent syncope. Survival free of all-cause mortality was greater for patients who had undergone surgical myectomy than for the medically treated patients (10-year estimate 82 ± 4% vs 69 ± 4%; p = 0.01). In conclusion, surgical myectomy in patients with HC and a history of syncope was associated with a reduction in recurrent syncope and increased survival.

Original languageEnglish (US)
Pages (from-to)388-392
Number of pages5
JournalAmerican Journal of Cardiology
Volume111
Issue number3
DOIs
StatePublished - Feb 1 2013

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Comparison of surgical septal myectomy to medical therapy alone in patients with hypertrophic cardiomyopathy and syncope'. Together they form a unique fingerprint.

  • Cite this