Evidence map›Paper›PMID 40878834›Full record

ArticleEuropean heart journal2026

Surgical myectomy for hypertrophic cardiomyopathy: procedural volume and outcomes.

Tijn J P Heeringa, Romy M J J Hegeman, Yvonne Koop, Sulayman El Mathari, Marieke Hoogewerf, Maaike M Roefs, Karin C Smits, Dorien Laenens, Giulia De Zan, Maarten J Cramer and 6 more

Abstract readMulticenter Study
In one paragraph

Article in European heart journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Tijn J P HeeringaDepartment of Cardiothoracic Surgery, University Medical Centre Utrecht, 3584 CX, Heidelberglaan 100, Utrecht, The Netherlands.ORCID 0009-0006-2567-9429
Romy M J J HegemanDepartment of Cardiothoracic Surgery, Sint Antonius Hospital Nieuwegein, Niewegein, The Netherlands.ORCID 0000-0002-1173-3192
Yvonne KoopJulius Centre for Health Sciences and Primary Care, Cardiovascular Epidemiology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.ORCID 0000-0001-6150-0859
Sulayman El MathariDepartment of Cardiothoracic Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands.ORCID 0000-0003-2519-991X
Marieke HoogewerfDepartment of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands.ORCID 0000-0002-8415-5282
Maaike M RoefsDepartment of Research, Netherlands Heart Registration, Utrecht, The Netherlands.
Karin C SmitsDepartment of Cardiothoracic Surgery, Thorax Centrum Twente, Medisch Spectrum Twente, The Netherlands.ORCID 0000-0001-6352-5769
Dorien LaenensDepartment of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.ORCID 0000-0001-8906-2395
Giulia De ZanDepartment of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands.ORCID 0009-0008-9486-9618
Maarten J CramerDepartment of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands.ORCID 0000-0002-6041-6759
Marco GuglielmoDepartment of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands.ORCID 0000-0003-1718-9949
Pim van der HarstDepartment of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands.ORCID 0000-0002-2713-686X
Ilonca VaartjesJulius Centre for Health Sciences and Primary Care, Cardiovascular Epidemiology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.ORCID 0000-0002-9951-5164
Mostafa M MokhlesDepartment of Cardiothoracic Surgery, University Medical Centre Utrecht, 3584 CX, Heidelberglaan 100, Utrecht, The Netherlands.ORCID 0009-0007-4518-4332
Patrick KleinDepartment of Cardiothoracic Surgery, Sint Antonius Hospital Nieuwegein, Niewegein, The Netherlands.ORCID 0000-0002-5514-4816
Niels P van der KaaijDepartment of Cardiothoracic Surgery, University Medical Centre Utrecht, 3584 CX, Heidelberglaan 100, Utrecht, The Netherlands.ORCID 0000-0002-3669-5209

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsOutcomes after surgical myectomy in hypertrophic obstructive cardiomyopathy (HOCM) patients have not been investigated in a multicentre registry with detailed clinical data. Hence, the objectives of this multicentre Dutch study are to describe the 30-day clinical outcomes after surgical myectomy, and to assess factors associated with increased 30-day complication rates.

methodsAll HOCM patients (n = 335) who underwent surgery between 2012 and 2020 across 12 Dutch hospitals were analysed using data from the Netherlands Heart Registration. Multiple logistic regression analyses assessed factors associated with a higher 30-day complication rate.

resultsIsolated surgical myectomy was performed in 22%, surgical myectomy with one concomitant procedure in 54%, and surgical myectomy with two or more concomitant procedures in 24%. Thirty-day complication rates concerned mortality (5%), ventricular septal defect (2%), stroke (3%), and surgical reoperation (2%). Mean resting left ventricular outflow tract (LVOT) gradient improved from 61 ± 30 mmHg to 13 ± 12 mmHg postoperatively, systolic anterior motion from 80% to 8%, and mitral regurgitation grade 3 or 4 from 31% to 6%. Low-volume hospital (<10 surgical myectomy procedures/year), female sex, and ≥2 concomitant procedures were significantly associated with increased 30-day complication rates. The adjusted 30-day complication rate was increased in low-volume hospitals (odds ratio 3.23 (95% confidence interval: 1.43-8.09); P = .007).

conclusionsSurgical myectomy with or without concomitant procedures effectively relieved LVOT obstruction in 93% of patients in this multicentre cohort. Female sex, ≥ 2 concomitant procedures, and low-volume hospitals were associated with higher 30-day complication rates. Although an inverse volume-complication relation was observed, this finding should be interpreted cautiously, and further investigation in larger sample size studies is warranted.

Indexed as

Cardiac Surgical ProceduresCardiomyopathy, HypertrophicAgedFemaleHospitals, High-VolumeHospitals, Low-VolumeHumansMaleMiddle AgedNetherlandsPostoperative ComplicationsRegistriesReoperationTreatment OutcomeEchocardiographyHeart septumHypertrophic obstructive cardiomyopathyLeft ventricular outflow obstructionMorrowSurgical volume

Identifiers

PMID40878834
PMCPMC13191829

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.