Abstract 4495: No Per-Procedural Mortality during Percutaneous Transluminal Septal Myocardial Ablation (ptsma) in Patients with Hypertrophic Obstructive Cardiomyopathy (hocm) and No Excess Mortality at Long Term Follow Up
BACKGROUND Long term outcome following PTSMA in patients with hypertrophic obstructive cardiomyopathy (HOCM) has been awaited for comparison to the solid results of myectomy. We assessed the short and long term (9 years) outcome of PTSMA using comparable groups and the euroSCORE as a preoperative evaluation of expected mortality in relation to myectomy.
METHOD/RESULTS From our hypertrophic cardiomyopathy (HCM) cohort 71 consecutive PTSMA patients (51% female) were identified. Patients suffered from none to multiple co-morbidities (hypertension 42%, COPD 12%, IHD 30%, previous cerebrovascular events 8%). Baseline data was evaluated by the euroSCORE for operative mortality, and showed an expected mortality if the patients had undergone myectomy of 3.6 %. There was no per-procedural PTSMA mortality. Long term survival for all PTSMA patients (13 deaths - 6 cardiac) were compared to an age and sex matched background population. In addition, comparison was performed with a HCM group (outflow tract gradient (LVOTG) < 30 mmHg) and a HOCM group (LVOTG ≥ 30 mmHg) with no outflow tract intervention (Figure⇓ and table⇓).
CONCLUSSION Per-procedural mortality in PTSMA was below the expected mortality in myectomy, and the long term mortality following PTSMA is low and comparable to the background population. Consequently, PTSMA seems at least as safe as myectomy.