Make Appointment
Make Appointment

Surgery For HOCM (Hypertrophic Obstructive Cardiomyopathy)

  • Home
  • Surgery For HOCM (Hypertrophic Obstructive Cardiomyopathy)

Overview

Hypertrophic obstructive cardiomyopathy (HOCM), historically referred to as idiopathic hypertrophic subaortic stenosis, is a relatively common disorder. HOCM is a significant cause of sudden cardiac death in young people, including well-trained athletes, and affects men and women equally across all races.
In most patients, it results from asymmetric septal hypertrophy causing outflow obstruction of the left ventricle. It is difficult to diagnose and presents a challenge to medical health professionals in evaluating at-risk athletes. This activity reviews the evaluation and management of hypertrophic obstructive cardiomyopathy and highlights the role of interprofessional team members in collaborating to provide well-coordinated care and enhance outcomes for affected patients.

Hypertrophic obstructive cardiomyopathy (HOCM) is a relatively common disorder. Historically, it has been referred to as idiopathic hypertrophic subaortic stenosis. HOCM is a significant cause of sudden cardiac death in young people, including well-trained athletes, affecting men and women equally across all races. In most patients, it results from asymmetric septal hypertrophy causing outflow obstruction of the left ventricle. It is difficult to diagnose and presents a challenge to medical health professionals in evaluating at-risk athletes. Unfortunately, hypertrophic obstructive cardiomyopathy is often not diagnosed until a significant cardiac event has occurred.

Hypertrophic obstructive cardiomyopathy (HOCM), also known as hypertrophic cardiomyopathy (HCM), is a genetic heart condition characterized by the thickening of the heart muscle (myocardium), particularly in the left ventricle. This thickening can obstruct the flow of blood out of the heart, leading to various symptoms and complications. Surgery may be considered in some cases of HOCM to alleviate symptoms and improve the flow of blood through the heart.

There are several surgical approaches for treating HOCM:

Septal Myectomy:Septal myectomy is the most common surgical procedure for treating HOCM. It involves the removal of a portion of the thickened septal muscle (the wall that separates the left and right ventricles) to relieve the obstruction of blood flow. This surgery is typically performed through a sternotomy (an incision in the chest), and it requires the use of a heart-lung machine to support circulation during the procedure. Septal myectomy can significantly improve symptoms, such as shortness of breath, chest pain, and fatigue, by reducing the obstruction to blood flow.

Mitral Valve Surgery: In some cases of HOCM, there may also be abnormalities in the mitral valve, which can worsen the obstruction of blood flow. In such cases, mitral valve surgery may be performed in conjunction with septal myectomy to address both issues.

Alcohol Septal Ablation (ASA): Alcohol septal ablation is a less invasive alternative to septal myectomy. It is performed by injecting a small amount of alcohol into a specific artery that supplies blood to the thickened septal muscle. The alcohol causes controlled damage to the targeted muscle, leading to a reduction in muscle thickness and relief from obstruction. ASA is typically considered for individuals who are not good candidates for open-heart surgery or prefer a less invasive approach.

The choice of surgical procedure for HOCM depends on several factors, including the severity of symptoms, the anatomy of the heart, the patient's overall health, and the surgeon's expertise. It's important for individuals with HOCM to work closely with a specialized cardiac team to determine the most appropriate treatment plan.

After surgery, patients typically require a period of recovery and may need ongoing medical management to optimize their heart function and prevent complications. Long-term follow-up care, including medication and regular check-ups, is essential for individuals with HOCM to manage their condition effectively and maintain a good quality of life.