Evaluating the prevalence of cardiac surgery-associated acute kidney injury after septal myectomy combined with concomitant procedures in obstructive hypertrophic cardiomyopathy

Objectives Hypertrophic obstructive cardiomyopathy (HOCM) may be treated by septal myectomy. Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common complication, but little is known about its incidence after septal myectomy. The objectives were to (i) evaluate the prevalence of CSA-AKI after septal myectomy and (ii) identify potential perioperative and phenotype-related factors contributing to CSA-AKI. Design Retrospective database analysis with new data analysis. Setting Single expertise university academic centre for septal myectomy HOCM patients. Participant Data from 238 HOCM patients operated with septal myectomy between 2005-2022. Interventions CSA-AKI was stratified by the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines by measurement of creatinine and urine production. Important HOCM phenotype-related and perioperative factors were analysed for their possible association with CSA-AKI. Measurements and Main Results CSA-AKI occurred in 45% of patients, of these, 55% were classified as KDIGO stage I, and the remaining 45% as stage II, with no chronic kidney damage being observed. Moreover, there were no phenotypical or perioperative characteristics that were more prevalent in the CSA-AKI cohort. However, the use of beta-blockers and coronary artery disease were more prevalent in the CSA-AKI cohort. Conclusions CSA-AKI is a common complication after septal myectomy, but was transient and kidney function recovered in all patients.