Background and Goal of Study: Recently, the influence of non-cardiac surgery on patients with hypertrophic cardiomyopathy (HCM) has attracted attention. Although several studies have demonstrated that non-cardiac surgery in HCM patients is safe, long-term outcomes remains unclear. The study aimed to evaluate short- and long-term outcomes in patients with hypertrophic cardiomyopathy who received non-cardiac surgery.
Materials and Methods: The study participants were consecutive patients who underwent non-cardiovascular surgery for HCM from January 2007 through September 2015. Patient background and preoperative and postoperative HCM-related events were collected from medical records, and intraoperative data were collected from anesthesia records. Primary outcome was the incidence of HCM-related events defined as sudden death, delivery of implantable cardioverter-defibrillator shock, heart failure, and thrombosis caused by arrhythmia. We divided the patients into two groups, depending on the experience of HCM-related events: patients in group E experienced intra- and postoperative these events, but those in group NE did not experience such events. For event-free rate analysis, we divided the patients into two groups, depending on presence of left ventricular outflow obstruction, namely, group hypertrophic obstructive cardiomyopathy (HOCM) and non-HOCM. 
Results and Discussion: Seventy-two patients were included in this study. Duration of the median postoperative follow-up was 1382 days. Intraoperative HCM-related events occurred in 1 patient and 1 patient died during hospital stay. Postoperative events occurred in 11 patients (15%). Thus, group E and NE comprised 12 and 60 patients, respectively. The mean patient age in group E was significantly less than that in group NE (61 ± 15 vs. 69 ± 10 years, p = 0.04). The 2-year event-free rate in the HOCM group was significantly lower than that in the non-HOCM group (log-rank test p = 0.03). Thus, we thought that non-cardiac surgery in HCM patients might be safe because in-hospital mortality and morbidity rate were 2.8%. However, surgical procedures might be one of the risk factors causing instability of the disease condition in HOCM patients.
Conclusion: Our retrospective study suggests that non-cardiovascular surgery in HCM patients is safe in terms of short-term outcome. However, the 2-year event-free rate in the HOCM group was significantly lower than that in the non-HOCM group.

Short- and long-term outcomes of patients with hypertrophic cardiomyopathy who received non-cardiac surgery