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Septal Ablation Versus Surgical Myomectomy for Hypertrophic Obstructive Cardiomyopathy

F Pelliccia1, H Seggewiss2, F Cecchi3

  • 1Department of Cardiovascular Sciences, University Sapienza, Via del Policlinico 155, 00161, Rome, Italy. f.pelliccia@mclink.it.

Current Cardiology Reports
|October 2, 2021
PubMed

Insights

Choosing between surgical myectomy and alcohol septal ablation for hypertrophic cardiomyopathy (HCM) with left ventricular outflow tract obstruction (LVOTO) remains challenging. A multidisciplinary HCM heart team approach is emerging to optimize patient care and treatment selection.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Hypertrophic cardiomyopathy (HCM) with left ventricular outflow tract obstruction (LVOTO) causes significant symptoms and functional decline.
  • Surgical myectomy and alcohol septal ablation (ASA) are invasive options for relieving LVOTO.
  • Optimal treatment selection for individual HCM patients with LVOTO remains a clinical challenge.

Purpose of the Study:

  • To review current invasive strategies for managing LVOTO in HCM.
  • To discuss the challenges and emerging concepts in treatment selection for HCM patients.
  • To highlight the importance of a multidisciplinary approach in HCM management.

Main Methods:

  • Review of recent guidelines and retrospective studies on HCM treatment.
  • Analysis of expert opinions regarding invasive interventions for LVOTO.
  • Discussion of the evolving role of the "HCM heart team".

Main Results:

  • Invasive strategies for LVOTO in HCM are now included in international guidelines.
  • Management decisions are influenced by local expertise and patient preference.
  • A collaborative "HCM heart team" approach is gaining traction.

Conclusions:

  • Effective management of HCM with LVOTO requires a multidisciplinary team.
  • The "HCM heart team" concept is crucial for navigating treatment complexities.
  • Standardizing the choice of intervention based on individual patient profiles is an ongoing area of focus.
Abstract

Keywords:
Alcohol septal ablationGradientHypertrophic cardiomyopathyLeft ventricular outflow tractMyectomyObstruction

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