Training and Experience Count: Myectomy is Safest at High-Volume Centers

Myectomies at hospitals averaging more than 10 procedures per year led to fewer deaths and complications than at other hospitals.

Large study of US myectomies

Myectomy is safest at high-volume centers. A study accepted in The Annals of Thoracic Surgery provides new evidence of this.

Kimberly A. Holst and her collaborators (2022) examined nearly 6,000 US myectomies reported from 2012 to 2019. Their data came from a database compiled by the Society of Thoracic Surgeons.

Mortality and post-operative risks lowest in high-volume centers

The researchers found that the chance of death was lowest in hospitals that performed more of the surgeries. But they also found that the risk of serious complications was much lower in these hospitals. The complications they studied included perforation of the interventricular septum and complete heart block.

Furthermore, those high-volume hospitals replaced mitral valves less often as part of the procedure.

Myectomy is safest in high-volume centers

These results strengthen the conclusions suggested by Kim et al. (2016), that septal myectomy is safest at high-volume centers.

Literature cited

Holst, K. A., H. V. Schaff, N. G. Smedira, E. B. Habermann, C. N. Day, V. Badhwar, H. Takayama, P. M. McCarthy, and J. A. Dearani. 2022. Impact of Hospital Volume on Outcomes of Septal Myectomy for Hypertrophic Cardiomyopathy. The Annals of Thoracic Surgery, in press.

Kim, L. K., R. V. Swaminathan, P. Looser, R. M. Minutello, S. C. Wong, G. Bergman, S. S. Naidu, C. L. F. Gade, K. Charitakis, H. S. Singh, and D. N. Feldman. 2016. Hospital volume outcomes after septal myectomy and alcohol septal ablation for treatment of obstructive hypertrophic cardiomyopathy: US nationwide inpatient database, 2003-2011. JAMA Cardiology 1:324–332.