HOCM and Septal Myectomy Surgery For Heart

Hypertrophic obstructive cardiomyopathy (HOCM) is a type of heart disease that is associated with thickening of the heart muscle especially at the septum (the muscular wall separating left and right of the heart) found just below the aortic valve. Due to this asymmetrical growth and increase of muscle cells (thickness varying from few millimeters to centimeters), the passageway to the aorta becomes very narrow which further blocks the blood supply from the left ventricle to the aorta. ‘This condition of the heart is referred to as outflow tract obstruction which makes the pumping of the blood harder’, shares best heart surgeon in Delhi, Dr. Sujay Shad, at Sir Ganga Ram Hospital, New Delhi. 

This diseases is also considered the most common genetically transmitted disorder (i.e. autosomal dominant type of inheritance). 

Signs and symptoms of hypertrophic obstructive cardiomyopathy:

  • Chest pain while exercising 
  • Fainting during or just after exercise
  • Murmuring of heart
  • A sensation of rapid, fluttering, or pounding heartbeats or palpitations
  • Shortness of breath, especially during exercise
Septal Myectomy for HOCM

What causes HOCM?

Hypertrophic obstructive cardiomyopathy is believed to be caused as a result of the inheritance of abnormal genes or gene mutations, which causes the heart muscle to develop abnormally thick. It may also be because of the unusual arrangement of heart muscle cells or myofibril disarray which can trigger arrhythmias in some individuals. 

Other possible causes of HOCM may include:

  • Intensified sympathetic stimulation due to secretion of excess catecholamine or its decreased uptake.
  • Abnormally thickened coronary arteries which may lead to myocardial ischemia.
  • Abnormal microcirculation prevents the normal contractile function of the myofibrils. 

Septal myectomy surgery for the heart:

Septal myectomy or HOCM Surgery in India surgical procedure is performed at Sir Ganga Ram Hospital, New Delhi to relieve hypertrophic obstructive cardiomyopathy (an inherited disease that occurs when the muscle of the heart’s left ventricle becomes thicker than normal, obstructing blood flow to the rest of the body). It is performed by an expert heart surgeon Dr. Sujay Shad and his team, when obstruction caused by septal thickening limits the blood ejection from the heart. After undergoing septal myectomy, heart patients experience rapid relief of symptoms of HOCM and also have an improved quality of life. 

Septal Myectomy Surgical Procedure:

The septal myectomy process involves the following steps:

  • Firstly, general anesthesia is given to the patient about 30-45 minutes before the treatment by a cardiothoracic anesthesiologist. The anesthesiology team at Sir Ganga Ram Hospital, New Delhi uses state-of-the-art equipment and monitors to ensure that patient is safely anesthetized during the procedure.
  • Next, an incision is made down the center of the chest, dividing the sternum (breastbone) into two halves to provide the surgeon with direct access to the heart. Through the aortic valve, the surgeon approaches the thickened muscular septum to prevent the making of direct incisions into the heart muscle.  
  • Then, the cardiopulmonary bypass (also called a heart-lung machine) is connected to the patient heart which takes over the normal functioning of the heart so the surgeon can perform the procedure on a “still” heart. This bypass machine is used to re-route the flow of blood through it and also allow the exchange of oxygen and carbon dioxide gases in the blood which is eventually pumped back into the body. It also helps protect the other organs while the heart is stopped. 
  • During the surgery, the surgeon eliminates the small portion of the thickened septal wall to help widen the outflow tract from the left ventricle to the aorta and clear the obstruction caused by it.
  • Once the procedure is completed, the heart-lung machine is turned off. The beating of the heart and the flow of blood comes back to normal. Sometimes, temporary pacing wires attached to a pacemaker are used to normalize the pumping of the heart or regulate the heart rhythms until there is improvement in the heart condition.
  • Next, drainage tubes are placed into the chest to take out surgical fluids before the sternum is closed with sternal wires. 
  • Lastly, the skin and subcutaneous tissue are closed with internal and absorbable sutures. 

Septal myectomy surgery nearly takes about 6 to 8 weeks for a full recovery. Dr. Sujay Shad, best heart surgeon in Delhi provides specific guidelines to the patient for early  recovery and informs about the right time to return to normal daily life as well as when to have the first follow-up appointment.  

Aftercare:

Regular follow-up appointments are important to evaluate the heart function after the surgery. These appointments also include a medical exam as well as diagnostic tests such as an echocardiogram to be repeated at regular intervals. During these follow-up sessions, the patient’s medications may be adjusted to relieve symptoms and optimize heart function. The frequency of the follow-up visits is based on the patient’s current health. 

To know more about Septal Myectomy in Delhi, schedule an appointment with the top heart surgeon and specialist in India Dr. Sujay Shad or call at 91 – 9911177891. 

Published by drsujayshad

Dr Sujay Shad is Professor and Senior Consultant of Cardiac Surgery and Director of Cardiac Transplants. He is also the Co-Chairman of his department. He performs life-saving operations on some of the most high-risk patients in his field. He is also the first cardiac surgeon to successfully perform Heart Transplants in a private hospital in North India.

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