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

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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

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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