This weekend I was able to attend a International Symposium on HCM in Boston, MA where Dr. Joseph Dearani, Chief of Cardiac Surgery at Mayo Clinic, gave a presentation on myectomy. What follows are the notes I took from his presentation. I hope that you will find them useful.
-When obstruction has been removed, patients live normal life spans and have less discharges of their ICD.
-Mayo now does between 200 – 250 myectomies/year. (My note – This number was 50 – 100 lower 10 years ago).
-there are 3 surgeons at Mayo who perform the surgery: Dearani, Schaff and Said.
-myectomy does not leave a scar but alcohol ablation does leave a scar which shows up on MRI.
-He spent some time talking about mid-ventricular obstruction and the need to extend further into the ventricle from the aortic valve and then possibly an apical approach as well.
-a second myectomy is usually only needed if the initial myectomy was incomplete.
-Dearani does not feel that myectomy lends itself to be performed either minimally invasively or robotically at this time. The potential for incomplete myectomy and the inability to deal with complications is too great.
-EXPERIENCE OF THE SURGEON MATTERS! Choose wisely. (My note: I know I am glad that I did! I was lucky enough to have Dr. Dearani myself!)