دورية أكاديمية
Impact of concomitant surgical interventions on outcomes of septal myectomy in obstructive hypertrophic cardiomyopathy.
| العنوان: | Impact of concomitant surgical interventions on outcomes of septal myectomy in obstructive hypertrophic cardiomyopathy. |
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| المؤلفون: | Altibi AM; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, United States of America., Sapru A; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, United States of America., Ghanem F; Internal Medicine Department, East Tennessee State University, Johnson City, TN, United States of America., Zhao Y; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, United States of America., Alani A; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, United States of America., Cigarroa J; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, United States of America., Nazer B; Division of Cardiovascular Medicine, University of Washington Medical Center, Seattle, WA, United States of America., Song HK; Division of Cardiothoracic Surgery, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, United States of America., Masri A; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, United States of America. Electronic address: Masria@ohsu.edu. |
| المصدر: | International journal of cardiology [Int J Cardiol] 2024 Apr 01; Vol. 400, pp. 131790. Date of Electronic Publication: 2024 Jan 17. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8200291 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1874-1754 (Electronic) Linking ISSN: 01675273 NLM ISO Abbreviation: Int J Cardiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Amsterdam : Elsevier Original Publication: Amsterdam : Elsevier/North-Holland Biomedical Press, c1981- |
| مواضيع طبية MeSH: | Cardiomyopathy, Hypertrophic*/diagnostic imaging , Cardiomyopathy, Hypertrophic*/surgery , Cardiomyopathy, Hypertrophic*/complications , Heart Valve Prosthesis Implantation*, Humans ; United States ; Aged ; Hospital Mortality ; Treatment Outcome ; Coronary Artery Bypass |
| مستخلص: | Background: Septal myectomy (SM) is offered to symptomatic patients with obstructive hypertrophic cardiomyopathy (oHCM) despite medical therapy. Frequently, patients undergo concomitant planned or ad-hoc mitral valve replacement (MVR), aortic valve replacement (SAVR), or coronary artery bypass grafting (CABG). Objectives: We sought to assess characteristics and outcomes of patients with oHCM undergoing concomitant surgical interventions at the time of SM. Methods: The National Readmission Databases were used to identify all SM admissions in the United States (2010-2019). Patients undergoing SM were stratified into: isolated SM (±MV repair), SM + CABG only, SM + MVR, SM + SAVR, and SM + MVR + SAVR. Primary outcomes were in-hospital mortality, in-hospital adverse events, and 30-day readmission. Results: 12,063 encounters of patients who underwent SM were included (56.1% isolated SM, 9.0% SM + CABG only, 17.5% SM + MVR, 13.1% SM + SAVR, and 4.3% SM + MVR + SAVR). Patients who underwent isolated SM were younger (54.3 vs. 67.1 years-old, p < 0.01) and had lower overall comorbidity burden. In-hospital mortality was lowest in isolated SM, followed by CABG only, SM + SAVR, SM + MVR, and SM + SAVR+MVR groups (2.3% vs. 3.7% vs. 5.3% vs. 6.7% vs. 13.7%, p < 0.01), respectively. SM with combined surgical interventions was associated with higher adverse in-hospital events (24.3% vs. 11.1%, p < 0.01) and 30-day readmissions (16.9% vs. 10.4%, p < 0.01). MV repair performed concomitantly with SM was not associated with increased in-hospital mortality (3.9% vs. 3.4%, p = 0.72; aOR 0.99; 95% CI: 0.54-1.80, p = 0.97]) or adverse clinical events. Conclusions: In SM for oHCM, patients undergoing concomitant surgical interventions were characteristically distinct. Aside from MV repair, concomitant interventions were associated with worse in-hospital death, adverse in-hospital events, and 30-day readmission. (Copyright © 2024. Published by Elsevier B.V.) |
| فهرسة مساهمة: | Keywords: Coronary artery bypass graft (CABG); Hypertrophic cardiomyopathy (HCM); Mitral valve replacement (MVR); Septal myectomy (SM); Surgical aortic valve replacement (SAVR) |
| تواريخ الأحداث: | Date Created: 20240119 Date Completed: 20240220 Latest Revision: 20240220 |
| رمز التحديث: | 20240220 |
| DOI: | 10.1016/j.ijcard.2024.131790 |
| PMID: | 38242508 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1874-1754 |
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| DOI: | 10.1016/j.ijcard.2024.131790 |