Major adverse cardiovascular events after modified morrow surgery in hypertrophic obstructive cardiomyopathy: A 12-year cohort study

This study investigates the incidence and risk factors for major adverse cardiovascular events (MACE) in patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing modified Morrow surgery. It also aims to develop a predictive model for MACE to improve clinical risk assessment. This retrospective cohort study included 292 HOCM patients who underwent modified Morrow surgery. The primary endpoint was the incidence of MACE. Univariate and multivariate logistic regression were used to identify independent risk factors for MACE, and a predictive model was developed. MACE occurred in 39.04 % of patients (114/292), with 4.7 % mortality (14/292), 3.1 % cardiac arrest, 2.7 % requiring intra-aortic balloon pump (IABP) support, and 1.0 % requiring extracorporeal membrane oxygenation (ECMO). Low cardiac output syndrome occurred in 19.2 %, atrial fibrillation in 18.2 %, and third-degree atrioventricular block (AVB) in 3.1 %. Key risk factors included age (OR = 1.044), eGFR (OR = 1.025), preoperative pulmonary hypertension >30 mmHg (OR = 2.274), interventricular septal thickness (OR = 1.084), MRI delayed enhancement (OR = 2.021), and postoperative leukocytosis (OR = 1.061). The predictive model demonstrated strong performance (AUC = 0.815, P