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Re: Hypertrophic Cardiomyopathy
Posted By CCF CARDIO MD-APS on October 18, 1998 at 14:50:06:

In Reply to: Hypertrophic Cardiomyopathy posted by Helen on October 15, 1998 at 18:14:08:

My 56-year-old father was just diagnosed with Hypertrophic Cardiomyopia. He
has an enlarged septum, and this is causing problems in the left ventricle.
His cardiologist has suggested surgury to remove part of the septum and
perhaps repair the valve if needs be.  That is what my father told me.  I was
just wondering if you could provide me with more information about this
disease and also about the surgery to correct it.  How serious is the surgery?
What are the chances for successful surgery and how long does it take to
recover?  Any pertinent information would be wonderful!
Thank you very much,

Dear Helen,
Abbreviated HOCM for hypertrophic obstructive cardiomyopathy, this is a condition where the outflow of blood can be obstructed by a 'bulge' of the muscle sitting just below the aortic valve (which is the outlet valve for the left ventricle that pumps newly oxygenated blood to the body.)   Once the patient becomes symptomatic or once the gradient across the bulge (pressure difference before and after the obstruction) is severe and thereby mimics aortic valve stenosis, it is time for intervention.  The conventional treatment for this is to surgically remove the bulge (open heart surgery), however there is an as yet unproven medical treatment called alcohol ablation.  It appears that surgery has been appropriately recommended since the medical treatment called alcohol ablation is still in it's investigative stages; thus this seems to be very good advice.
As for the risks of open heart surgery, they vary from hospital to hospital and from surgeon to surgeon on occasion.  This type of surgery for HOCM correction is not as common of course as bypass surgery or straight valve surgery which means that you really want the surgeon to have done a number of this type of surgery as well as a significant number of valves if this is also a possibility, i.e. valve repair and or replacement.  All open heart surgeries carry some risk of the following: Heart attack, death, and stroke.   The national average risk for death following open heart surgery is close to 4%.  Other considerations in determining this number is how sick is the patient (for instance if there are any concomitant diseases like diabetes, prior heart attack, etc. then the risk goes up for that patient.)  The Cleveland Clinic averages >4,000 open hearts per year and our
Mortality (death rate) is closer to 1%.  Good Luck.  While you did not ask this question I might tell you that HOCM in some forms is hereditary, hence it is sometimes suggested that all family members be screened; you might want to discuss this with your father's cardiologist.
I hope you find this information useful. Information provided in the heart forum is for general medical informational purposes
only. Only your physician can provide specific diagnosis and therapies.
Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire
online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your problem.

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