Hypertrophic Cardiomyopathy Surgery

Overview and Facts about Hypertrophic Cardiomyopathy Surgery

Hypertrophic cardiomyopathy is a disease of the heart that occurs when a portion of the heart muscle becomes abnormally thick. Thickened heart muscle can lead to impaired pumping of the heart, chest pain, irregular heart rhythms (arrhythmias) and sudden cardiac death (SCD).

Treatment of the disease aims to decrease its symptoms and prevent SCD. Hypertrophic cardiomyopathy may be treatable with medication, though some cases require surgical intervention. These interventions include septal myectomy, septal ablation and placement of an implantable cardioverter-defibrillator (ICD) in the chest.

Septal myectomy is an open heart procedure in which part of the thickened wall (septum) between the left and right chambers of the heart is removed. In septal ablation, part of the septum is destroyed by pure alcohol delivered through a catheter.

The ICD implantation procedure does not remove or destroy any part of the thickened heart wall or septum, but, instead, places a device that detects abnormal heart rhythms and delivers electric shocks to restore normal rhythm.

What to Expect with Hypertrophic Cardiomyopathy Surgery

The surgical procedures used to treat hypertrophic cardiomyopathy range from minimally invasive to open heart. All procedures are performed in the hospital by a physician who specializes in cardiac surgery.

Septal myectomy is performed under general anesthesia, leaving you comfortably sedated for the procedure, which lasts between three and six hours. Your heart will be exposed through an incision in your chest and stopped and you will be placed on a heart-lung pump to continue the flow of oxygenated blood throughout your body. Part of the septal wall is surgically removed, widening the blood pathway between the left ventricle and the aorta.

You can expect to remain in the hospital for five to seven days following the procedure. In septal ablation, a catheter is inserted into an artery in your groin and threaded to your heart. Alcohol is then released into an artery in the septum, chemically destroying a part of the muscle and achieving the same result as the septal myectomy.

You will not be sedated during septal ablation, but you will be administered medication to relax you and a local anesthetic to numb the area of catheter insertion. The procedure takes between one and two hours. Most patients remain hospitalized for about three days.

What are the Side Effects of Hypertrophic Cardiomyopathy Surgery?

Certain temporary side effects are common and predictable following any procedure performed on the heart.

Depending on the type of hypertrophic cardiomyopathy surgery you undergo, you may or may not experience:

• Appetite loss
• Constipation
• Discomfort or pain at the incision site
• Pain in your chest, shoulders or back
• Trouble sleeping

What are the Risks of Hypertrophic Cardiomyopathy Surgery?

The likelihood of developing complications after hypertrophic cardiomyopathy surgery depends on the type of surgery performed and your overall health and risk factors. Possible complications include:

• Bleeding
• Blood clots
• Breathing problems
• Heart attack
• Heart or lung damage
• Infection
• Irregular heartbeat
• Stroke