title: Surgical septal myectomy for hypertrophic cardiomyopathy in Greece: a single-center initial experience.
abstract: BACKGROUND
  Surgical septal myectomy is thought to be the gold standard of treatment for obstructive hypertrophic cardiomyopathy (HCM) with obstruction symptoms refractory to optimal medical therapy. In Europe, during the last 2 decades, myectomy has been set aside, while alcohol septal ablation has been widely promoted. In this paper, we analyze our first experience of surgical septal myectomy in a small cohort of patients with HCM coming from a single tertiary center.
  
  
  METHODS
  Thirty-two patients (16 male, 50%) with a mean age of 58.1 ± 14.4 (range 12-79 years) underwent myectomy for HCM symptoms refractory to negative inotropic agents. The technique used for the myectomy was the one introduced by Andrew Morrow. Mean follow-up time after procedure was 16.8 ± 13.3 months with a median of 13 months (range 4-58 months).
  
  
  RESULTS
  Post-myectomy, there was a significant improvement in patients' NYHA class (from 3.3 ± 0.46 to 1.38 ± 0.49, p<0.0005), while interventricular septum thickness was reduced from 2.3 ± 0.4 cm to 1.6 ± 0.4 cm (p<0.0005), and peak gradient at the site of obstruction from 94.9 ± 29 to 16.7 ± 7.9 mmHg (p<0.0005). During the follow-up period, only 1 out of 32 patients died, from non-cardiovascular causes, with the overall survival post-myectomy being 97.2% (95%CI: 94.5-99.9%) at 1-year follow up.
  
  
  CONCLUSIONS
  Surgical septal myectomy in patients with HCM and drug-refractory symptoms is a safe procedure that greatly improves symptoms and quality of life. Further follow-up of our patients is mandatory in order to determine whether the good survival rate achieved at 1 year will persist.
authors.affiliation: Cardiomyopathies Center, First Cardiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Georgios K
authors.initials: GK
authors.lastname: Efthimiadis
authors.forename: Antonis
authors.initials: A
authors.lastname: Pitsis
authors.forename: Efstathios D
authors.initials: ED
authors.lastname: Pagourelias
authors.forename: Vasileios
authors.initials: V
authors.lastname: Kamperidis
authors.forename: Timotheos
authors.initials: T
authors.lastname: Kelpis
authors.forename: Soultana
authors.initials: S
authors.lastname: Meditskou
authors.forename: Stavros
authors.initials: S
authors.lastname: Hadjimiltiades
authors.forename: Vlassios
authors.initials: V
authors.lastname: Ninios
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Mezilis
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Maron
authors.forename: Ioannis H
authors.initials: IH
authors.lastname: Styliadis
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality / Q000523:psychology; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D002317:Cardiovascular Agents / Q000627:therapeutic use; D004351:Drug Resistance; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006115:Greece; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000209:etiology / Q000503:physiopathology / Q000601:surgery
chemical_list: D002317:Cardiovascular Agents