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Another Myectomy Question


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  • Another Myectomy Question

    Hi everyone

    I have a question which may or may not make sense - but here goes. My history over the past 5-7 years shows my gradient increasing yearly or every 2 years from 28 to 36 to 64 to 100 (mmHG). So in 1998 it was 28. Last september it was 100 +

    My Question is as follows:

    If say in 2000 when it was 36, or even in 2002 when it was 64mmHG if I were to have had a myectomy back then, and lets say after the surgery it was "0" (A perfect myectomy.. ). After this then would/should it have continued to increase the additional 36 mmHG as it did without the surgrey to a new gradient reading of 36mmHG or would/should the surgrey have somehow stopped it.

    This is deffinatly a question i will ask the folks at cleveland, just curious if anyone here ever had any thoughts or opinions on this

    thanks again


  • #2

    There really isn’t a ‘perfect’ answer to you question.
    A good percentage of post-Myectomy patients do get a Gradient of zero and it stays that way for years to come, if not the rest of their lives.
    But remember, a Myectomy is a procedure to relieve symptoms. It is not a cure for HCM. You still have a stiff heart, and your septum is still thick, but it is no longer obstructed.
    There is a likelihood that some gradient will return, but usually it will not be enough to cause difficult symptoms. In rare cases the obstruction can grow back.
    The main question is “what are your symptoms, and are they making your life unbearable?” If yes, then get thee to an HCM center (NEMC in Boston, Cleveland Clinic, or the Mayo).
    Before considering a Myectomy, you should be seen at one of these centers and then totally exhaust the various drug therapies.
    If your symptoms are currently tolerable, then why don’t you sign up for the annual meeting in June? A wealth of information can be had there.
    BTW, I am 14 months post-Myectomy. For the first 6 months my gradient was zero. My last echo showed a gradient of 10 at rest, 50 at stress. My current cardiologist believes this is being caused by my mitral valve. I am waiting to hear back from NEMC to see what they think.


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