Hypertrophic Obstructive Cardiomyopathy - Cleveland Clinic

Hypertrophic Obstructive Cardiomyopathy

Patient Volume

2011

Total HOCM Outpatient Visits New Patients with HOCM

1,561 358

Hypertrophic obstructive cardiomyopathy (HOCM) is thickening of the lower chambers of the heart. The septal muscle, which divides the right and left chambers, is especially affected. The condition can impede blood flow from the heart to the aorta. Cleveland Clinic physicians use a comprehensive approach to diagnose and treat patients with HOCM. This approach includes a physical exam, EKGs, chest X-ray and MRI. Cleveland Clinic has a special interest in HOCM. We are actively screening patients and their family members for genetic abnormalities associated with the disease.

Surgical Volume and Outcomes

2011

Surgeries for HOCM

183

Hospital Mortality

0%

Cleveland Clinic is a national leader for HOCM surgery. In 2011, our surgeons performed 183 procedures to treat patients with HOCM. The overall mortality rate was 0 percent.

HOCM Surgeries

2007 ? 2011 Volume 250

200

150

100

50

0 2007

2008

2009

2010

2011

During a septal myectomy, the surgeon removes septal muscle to widen the path for blood to leave the heart.

44

Outcomes 2011

Surgical Procedure Distribution (N = 183)

2011

Septal myectomy is used to treat patients with HOCM. Patients who require this procedure often require additional procedures.

100%

39% Isolated Septal Myectomy (N = 72) 38% Septal Myectomy + Valve +/- Other (N = 70)

Septal Myectomy Mortality

2011 Cleveland Clinic has excellent outcomes for patients who have a septal myectomy. In 2011, the expected mortality rate was 2 percent; however, our surgeons achieved a 0 percent mortality rate for this procedure. Percent

6

4

9% Septal Myectomy + Coronary Artery Bypass +/- Other (N = 17)

9% Septal Myectomy + Other (N = 16) 4% Septal Myectomy + Valve Surgery + Coronary Artery Bypass +/- Other (N = 7) 1% Valve +/- Other (N = 1)

Papillary Muscle Reorientation/Realignment

2007 ? 2011

Volume 25

Maximal Intraventricular Septal Thickness 18 mm Maximal Intraventricular Septal Thickness > 18 mm Mortality (%)

20

15

10

5

0

2007

2008

2009

2010

2011

2

0% 0

Observed

Expected

Source: University HealthSystem Consortium (UHC) Comparative Database, 2011 discharges

Patients with HOCM who have outflow tract obstruction with minimal or mild hypertrophy may also have abnormal papillary muscle function. Cleveland Clinic surgeons use various techniques to repair the mitral valve and correct the condition. One technique, developed at Cleveland Clinic, involves reorienting papillary muscles that are abnormally positioned or excessively mobile.

Sydell and Arnold Miller Family Heart & Vascular Institute

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