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Myectomy vs Bypass

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  • Myectomy vs Bypass

    Hi everyone,

    I was wondering which open heart surgery is easier to perform and easier to recover from -- a myectomy or bypass.

    Or are they about the same?

    Any thoughts?


    Hugs to All

    Eve
    49 yrs. old
    Diagnosed at 31.
    Cardiac Arrest 2003, RF Ablation in AZ, no positive result -
    First ICD 2003 - In 2006 lead went bad, abandoned lead, threaded new one & new generator
    Myectomy 5-5-05 at The Cleveland Clinic - Dr. Lever & Dr. Smedira -heart surgeon.
    Currently have Grade 2 Diastolic Dysfunction with pulmonary hypertension & pulmonary edema.
    My brother passed away suddenly at 34 yrs old from HCM.
    2 teenage children, ages 17 and 15.

  • #2
    Hi Eve,

    I hope you are feeling well. I'm not certain about the answer to your question, but I would imagine that a bypass would be easier to recover from. Both are open heart surgeries, but the bypass opertion does not actually involve cutting the heart open and removing muscle, as in the myectomy.

    When I was in hospital for my myectomy,there was an 80 year old woman who had abypass the same day as my surgery. After surgery she was up and scooting around the ward like a 30 year old days before I was even out of bed! Even though I am only 35, I felt that even the really old bypass patients where recovering faster than I was. Having said all that, my surgery ended up being very complicated!

    Take care. Keep us updated on what's happening with your surgery.

    Paul
    Age 38, dad of two young children, dx 1996, myectomy March 2005, a-fib issues, due for ICD soon.

    Comment


    • #3
      hi

      Hello,

      I did not think that during myectomy that they cut your heart open - I thought that they made an incision on the Aorta above the heart and worked down throught this incision..

      Saing this i am sure there is a greater recovery from a myectomy and Bypass surgrey since it does involve cutting out the muscle

      Vinnie

      Comment


      • #4
        Vinnie,

        You are correct. The heart is not cut open , an aoratomy is performed. A small incision is made in the top, anterior portion of the aorta and the aortic valve is stretched. The surgeon goes through this little space to remove some of the septum; a tiny wedge.

        Open heart for bypass patients means the added burden of recovering from leg incisions that can be the full length of both their legs and even their arms if the surgeons can not harvest enough vessel in the legs. I have seen some very difficult recoveries with bad leg infections on these individuals. As well their bodies must now develope collateral circulation to allow blood to reach the areas that have had vascular harvesting. I am not sure if we myectomy people have it any tougher or worse then them. That said , open heart is a very challenging procedure for all.

        Best to you all.

        Pam
        Dx @ 47 with HOCM & HF:11/00
        Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
        Lead failure,replaced 12/06.
        SF lead recall:07,extracted leads and new device 2012
        [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
        Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
        Genetic mutation 4/09, mother(d), brother, son, gene+
        Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin

        Comment


        • #5
          Yes,

          You guys are right. They don't actually cut open your heart, but rather go in through the aorta (hence why its called an aortotomy). My point is that this is, coupled with the fact that they cut part of your heart away, is a considerable blow for the whole cardiac system. That said, bypass isn't exactly a walk in the park either!

          Paul
          Age 38, dad of two young children, dx 1996, myectomy March 2005, a-fib issues, due for ICD soon.

          Comment


          • #6
            Honestly I do not think you can "compare" the two.

            Lisa
            Knowledge is power ... Stay informed!
            YOU can make a difference - all you have to do is try!

            Dx age 12 current age 46 and counting!
            lost: 5 family members to HCM (SCD, Stroke, CHF)
            Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
            Therapy - ICD (implanted 97, 01, 04 and 11, medication
            Currently not obstructed
            Complications - unnecessary pacemaker and stroke (unrelated to each other)

            Comment


            • #7
              Eve-
              Both have approximately the same recovery time. I had my ByPass 8 months after my Myectomy & "bounced back" a little more quickly from the ByPass. I spent more time in the CCU, after ByPass (3 days) vs Myectomy. I think the Big Diff was my familiarity with what to expect. I was more relaxed & better able to tolerate the pain. My ByPass was done, as an emergency directly following a Heart Cath-they moved me from the Cath Lab to the OR. My Surgeon, was truly an Artist-he cracked me exactly in the same spot as the myectomy, the scar goes a little higher from the ByPass. Yes, the incisions on my leg were also bothersome.
              I am proud to say, that April 16 is my 1 year anniversary of my ByPass.
              Some of my Girlfriends have asked me why I don't "cover" my incision totally & don't I feel uncomfortable when it shows! Their heads are in a different place from mine-I'm so Happy to be Alive & Walking aound!

              Eve- it's true that G-d does not give you anything to handle, that you can't handle. You will get thru this & come out stronger for it. It certainly helps you prioritize.
              BE WELL
              RONNIE

              Comment


              • #8
                Wow Ronnie,

                I couldn't imagine doing the two so close together. How on earth did you recover? I am having a hard enough time recovering from my myectomy. There is no way I would be able to do a bypass in 7 or 8 months. What was the impact of the two surgeries on mood? Were you down in the dumps?

                Cheers,

                Paul
                Age 38, dad of two young children, dx 1996, myectomy March 2005, a-fib issues, due for ICD soon.

                Comment


                • #9
                  I would think that By-Pass would be mainly because they also take an artery from your leg most of the time, my dad said the chest was nothing compared to the leg healing and the fact he still after 17 years has pain in that leg because of cellulitis which is not curable but can be managed, in fact i was working on his feet tonight and the leg was very swollen tonight, it seems that when he retains fluid it hits that leg first, but just my opinion

                  Shirley
                  Diagnosed 2003
                  Myectomy 2-23-2004
                  Husband: Ken
                  Son: John diagnosed 2004
                  Daughter: Janet (free of HCM)

                  Grandchildren: Drew 15,Aaron 13,Karen 9,Connor 9

                  Comment


                  • #10
                    Hi Guys,
                    You didn’t think you were going to get away with this discussion without me throwing in my two cents did you?

                    First of all, there is such a wide range of approaches within each of these procedures themselves, lumping all the variations of one procedure together is all but impossible. Then to compare this lump with yet another lump of other procedures is just about imposable.

                    The first choice bypass procedure in men, if it is possible to do it, is to connect the mammary arteries to the heart side of the blocked artery or arteries, thereby retuning flow to the inflicted area of the heart. (Arterial grafts do best when the transplantation is closest to the original artery site.) In this case there is only half the arterial joining to deal with, and the artery is already part of the chest area. Zip, Zip, done quick.

                    Now compare that with a bypass where arterial material has to be harvested from both legs and both arms, then joined together, then connected around both sides of the blockage. You now have a bunch of little pieces joined together where each connection can create problems, and the patient’s arms and legs are invaded and their normal blood flow is also screwed up.

                    Now you take these two extremes and call them both bypass operations, which you then try to compare to the various myectomy procedures and try to discern which procedure is easiest to deal with. I’m afraid it works out to be sometimes this and sometimes that – all depending on the actual problem, the condition of the patient, the extent of the repair required, and the skill of the surgeon and his/her staff.

                    The best approach in my opinion is to pick the best doctor you can, in the best facility, with the best staff, and get yourself into the best shape you can be in prior to the procedure. Then you get all your friends and family to intercede with The Man Upstairs to whatever extent they can.

                    (I left out a whole raft of other considerations which also play a part, but I hope I at least gave an inkling of just what’s involved in all this. Which procedure is best to go through – the one you need the most.)
                    Burt

                    Comment

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