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Exercise Echocardiography following Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy

Novén, Johan ; Stagmo, Martin LU ; Wierup, Per LU ; Nozohoor, Shahab LU ; Bjursten, Henrik LU ; Sjögren, Johan LU ; Zindovic, Igor LU and Ragnarsson, Sigurdur LU (2022) In The Thoracic and Cardiovascular Surgeon 70(1). p.18-25
Abstract

Objectives To investigate outcome after septal myectomy and to evaluate long-term hemodynamics with exercise echocardiography. Methods This study included 40 consecutive patients operated with septal myectomy for hypertrophic obstructive cardiomyopathy from January 1998 to August 2017 at Skane University Hospital, Lund, Sweden. Perioperative clinical data and echocardiography measurements were reviewed retrospectively. Patients (n = 36) who were alive and living in Sweden were invited for exercise echocardiography to evaluate exercise capacity and hemodynamics, of whom 19 patients performed exercise echocardiography. Results Overall survival was 100% at 1 year and 96% at 5 years following surgery. Preoperative median resting peak LVOT... (More)

Objectives To investigate outcome after septal myectomy and to evaluate long-term hemodynamics with exercise echocardiography. Methods This study included 40 consecutive patients operated with septal myectomy for hypertrophic obstructive cardiomyopathy from January 1998 to August 2017 at Skane University Hospital, Lund, Sweden. Perioperative clinical data and echocardiography measurements were reviewed retrospectively. Patients (n = 36) who were alive and living in Sweden were invited for exercise echocardiography to evaluate exercise capacity and hemodynamics, of whom 19 patients performed exercise echocardiography. Results Overall survival was 100% at 1 year and 96% at 5 years following surgery. Preoperative median resting peak LVOT (left ventricular outflow tract) gradient was 80 mm Hg. Septum thickness was reduced from 22 ± 4 mm preoperatively to 16 ± 3 mm postoperatively (p < 0.001). During exercise echocardiography, the peak LVOT gradient was 8 mm Hg at rest, and increased to 13 mm Hg during exercise echocardiography (p = 0.002). None of the patients had dynamic LVOT obstruction during exercise echocardiography, and there was no clinically significant systolic anterior motion or severe mitral insufficiency during exercise. Conclusions Long-term survival following septal myectomy is very good. At long-term follow-up, LVOT gradients were low and exercise echocardiography demonstrated good hemodynamics.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
exercise echocardiography, hypertrophic obstructive cardiomyopathy, septal myectomy
in
The Thoracic and Cardiovascular Surgeon
volume
70
issue
1
pages
18 - 25
publisher
Georg Thieme Verlag
external identifiers
  • scopus:85096793639
  • pmid:33225436
ISSN
0171-6425
DOI
10.1055/s-0040-1716896
language
English
LU publication?
yes
id
6b7a1dcc-1e74-4263-a1c7-e3576c59fb28
date added to LUP
2020-12-06 17:02:54
date last changed
2024-04-17 20:02:18
@article{6b7a1dcc-1e74-4263-a1c7-e3576c59fb28,
  abstract     = {{<p>Objectives To investigate outcome after septal myectomy and to evaluate long-term hemodynamics with exercise echocardiography. Methods This study included 40 consecutive patients operated with septal myectomy for hypertrophic obstructive cardiomyopathy from January 1998 to August 2017 at Skane University Hospital, Lund, Sweden. Perioperative clinical data and echocardiography measurements were reviewed retrospectively. Patients (n = 36) who were alive and living in Sweden were invited for exercise echocardiography to evaluate exercise capacity and hemodynamics, of whom 19 patients performed exercise echocardiography. Results Overall survival was 100% at 1 year and 96% at 5 years following surgery. Preoperative median resting peak LVOT (left ventricular outflow tract) gradient was 80 mm Hg. Septum thickness was reduced from 22 ± 4 mm preoperatively to 16 ± 3 mm postoperatively (p &lt; 0.001). During exercise echocardiography, the peak LVOT gradient was 8 mm Hg at rest, and increased to 13 mm Hg during exercise echocardiography (p = 0.002). None of the patients had dynamic LVOT obstruction during exercise echocardiography, and there was no clinically significant systolic anterior motion or severe mitral insufficiency during exercise. Conclusions Long-term survival following septal myectomy is very good. At long-term follow-up, LVOT gradients were low and exercise echocardiography demonstrated good hemodynamics.</p>}},
  author       = {{Novén, Johan and Stagmo, Martin and Wierup, Per and Nozohoor, Shahab and Bjursten, Henrik and Sjögren, Johan and Zindovic, Igor and Ragnarsson, Sigurdur}},
  issn         = {{0171-6425}},
  keywords     = {{exercise echocardiography; hypertrophic obstructive cardiomyopathy; septal myectomy}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{18--25}},
  publisher    = {{Georg Thieme Verlag}},
  series       = {{The Thoracic and Cardiovascular Surgeon}},
  title        = {{Exercise Echocardiography following Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy}},
  url          = {{http://dx.doi.org/10.1055/s-0040-1716896}},
  doi          = {{10.1055/s-0040-1716896}},
  volume       = {{70}},
  year         = {{2022}},
}