Gordon Fox • July 4, 2022
Training and Experience Count: Myectomy is Safest at High-Volume Centers
Myectomies at hospitals averaging more than 10 procedures per year led to fewer deaths and complications than at other hospitals.

Large study of US myectomies

Myectomy is safest at high-volume centers. A study accepted in The Annals of Thoracic Surgery provides new evidence of this.

Kimberly A. Holst and her collaborators (2022) examined nearly 6,000 US myectomies reported from 2012 to 2019. Their data came from a database compiled by the Society of Thoracic Surgeons.

Mortality and post-operative risks lowest in high-volume centers

The researchers found that the chance of death was lowest in hospitals that performed more of the surgeries. But they also found that the risk of serious complications was much lower in these hospitals. The complications they studied included perforation of the interventricular septum and complete heart block.

Furthermore, those high-volume hospitals replaced mitral valves less often as part of the procedure.

Myectomy is safest in high-volume centers

These results strengthen the conclusions suggested by Kim et al. (2016) , that septal myectomy is safest at high-volume centers.

Literature cited

Holst, K. A., H. V. Schaff, N. G. Smedira, E. B. Habermann, C. N. Day, V. Badhwar, H. Takayama, P. M. McCarthy, and J. A. Dearani. 2022. Impact of Hospital Volume on Outcomes of Septal Myectomy for Hypertrophic Cardiomyopathy. The Annals of Thoracic Surgery , in press.

Kim, L. K., R. V. Swaminathan, P. Looser, R. M. Minutello, S. C. Wong, G. Bergman, S. S. Naidu, C. L. F. Gade, K. Charitakis, H. S. Singh, and D. N. Feldman. 2016. Hospital volume outcomes after septal myectomy and alcohol septal ablation for treatment of obstructive hypertrophic cardiomyopathy: US nationwide inpatient database, 2003-2011. J AMA Cardiology 1:324–332.

HCMA Blog

April 30, 2025
Medical Management means using medicines and other non-invasive therapies to relieve symptoms. It's exciting that new treatments for HCM are being studied and that the FDA approved Camzyos in 2022! HCM can cause various symptoms depending on how stiff the heart is, how much scarring (fibrosis) there is, and whether there is obstruction. Some people have no noticeable symptoms. Common symptoms are chest pain/pressure, shortness of breath, lightheadedness, fatigue, palpitations, and brain fog. Syncope (fainting) is dramatic but not as common as the other symptoms. Medications are the first-line treatment for symptoms of HCM. If patients can't take one class of medication, they can try a medication from a different class. Here are some medications used to treat HCM and what they're for: Beta Blockers - make your heart beat slower and relax better. They allow the heart to fill more completely between beats. They can lower blood pressure and relieve symptoms. Calcium Channel Blockers - used to lower blood pressure and slow the heart rate. May reduce symptoms from obstruction in HCM. Myosin Inhibitors - cause the heart to beat with less force. They may reduce obstruction and septal thickness in some patients. Camzyos (mavacamten) is the first of this class of medication. For more information, click HERE . Antiarrhythmics - help to restore normal rhythm in the heart. Blood Thinners - anticoagulants and anti-platelets make it harder for blood to clot. They are prescribed to reduce the risk of stroke. This risk is higher in patients with afib, aflutter, and artificial heart valves. Diuretics , or "water pills," help the kidneys get rid of extra water and salt, reducing swelling in the body. Sodium Channel Blockers - may reduce gradient in obstructive HCM and can treat chest pain. Some also act as antiarrhythmics. Antibiotics - treat or prevent bacterial infections. In HCM, they may be given before dental work to prevent infective endocarditis. To learn more and see the side effects of these medications, click HERE .
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