Hypertrophic obstructive cardiomyopathy: what, when, why, for whom?. (9th February 2018)

• Record Type: Journal Article
• Authors: Mestres, Carlos A; Bartel, Thomas; Sorgente, Antonio; Müller, Silvana; Gruner, Christiane; Dearani, Joseph; Quintana, Eduard
• Is Part Of: European journal of cardio-thoracic surgery. Volume 53:Number 4(2018)
• Page Start: 700
• Page End: 707
• Publication Date: 2018-02-09
• Subjects: Obstructive hypertrophic cardiomyopathy -- Septal myectomy -- Septal reduction therapy -- Alcohol septal ablation; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; 617.54
• DOI: 10.1093/ejcts/ezy020
• Languages: English
• ISSNs: 1010-7940

Abstract

Abstract: Hypertrophic cardiomyopathy is the most common genetic cardiovascular disorder and is associated with symptoms of heart failure and increased risk of sudden cardiac death. The most common condition is obstruction of the left ventricular outflow tract. Surgical septal myectomy and alcohol septal ablation are the 2 accepted modes of septal reduction therapy and are indicated when there are advanced symptoms and a peak left ventricular outflow gradient ≥50 mmHg. Advantages of alcohol septal ablation are limited groin approach, reduction of obstruction of the left ventricular outflow tract and functional improvement, but there are higher chances for intracardiac device implantation and residual obstruction. Septal myectomy offers very low mortality, absolute and immediate resolution of obstruction of the left ventricular outflow tract and survival comparative to a matched general population with almost negligible residual obstruction. It is recommended that patients with obstructive hypertrophic cardiomyopathy should be treated at experienced centres.