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yperthrophic Obstructed Cardiomyopathy) and Myectomy

Hyperthrophic Obstructed Cardiomyopathy) and Myectomy

Hypertrophic Obstructive CardioMyopathy (HOCM) is a relatively uncommon disease, whereby a muscle bar blocks the outflow of the heart, just beneath the aortic valve. Most patients don’t notice any symptoms, which include shortness of breath, abnormal cardiac rhythm or chest pain. Treatment is based on drugs to slow down the heart rate and/or use of pacemaker. Some cases may require a catheter base procedure or open heart surgery.

The Surgery

Conventionally, the heart is accessed via a vertical incision over the breastbone (called ‘sternum’).
Cardiopulmonary bypass (CPB) and cardiac preservation are then established (please see ‘Cardiopulmonary Bypass and the Heart-Lung Machine’ and ‘Cardiac Preservation’).

The aorta is opened, the muscle obstructing the outflow of the heart is resected through the aortic valve. Extreme care is taken not to injury the aortic valve and clean all debris. The aorta is closed and air is evacuated from the heart.

The blood supply to the heart is resumed and it starts to beat again. Sometimes, a small electric shock is used to re-establish normal rhythm. Finally, the heart takes over the circulation again and the heart-lung machine is disconnected.
Afterwards, the surgeon controls potential sites of bleeding and inserts chest drains. A temporary pacemaker wire is also inserted. Drains and wires are removed in ICU or ward when no longer required.
The breastbone is closed with stainless steel wires. They will remain in your bone and should not activate metal detectors.

Commonly Associated Procedures with Myectomy

Associated Risks

Cardiac surgery is routinely performed all over the world. Australia ranks very well internationally, reflecting a high standard of care from both the operative setup and the hospital systems. As with any medical procedure, in a small number of cases, complications (adverse events) may occur.

The 5 major risks are bleeding and blood transfusion, mediastinitis (infection deeper to the chest bone), heart attack, stroke and even death. Other risks include need for pacemaker and organ failure (e.g. heart, lungs, kidneys).

The risk of infections, heart and lung problems and thrombosis increases with diabetes, obesity and smoking.

Please speak to your surgeon regarding your individual circumstances and any questions or doubts you may have.

For information about associated risks of cardiac surgery, please click here.


For an appointment or seeking a second opinion with Dr Provenzano, please contact:

Gold Coast Private Specialist Suites 14 Hill Street, Southport

P: (07) 5699 8258   F: (07) 5676 6784

Dr Sylvio Provenzano

MD, MSc, FRACS


Dr Sylvio Provenzano is an exam-qualified Cardiothoracic Surgeon by the Royal Australasian College of Surgeons (RACS). He specialises in cardiac, thoracic and congenital cardiac surgery.

Opening Hours

Gold Coast Private Specialist Suites


14 Hill Street, Southport 4215
9:00 – 16:00
 
Phone: (07) 5699 8258
Fax: (07) 5676 6784
 
Correspondence:
PO Box 809, Southport BC, Qld 4215