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Cirugía para la miocardiopatía hipertrófica obstructiva: la perspectiva europea

Eduard Quintana¹, Polina Danchenko², Kostiantyn Rudenko²

¹Department of Cardiovascular Surgery, Departament de Cirurgia I EspecialitatsMedicoquirúrgiques, Facultat de Medicina I Ciències de La Salut, Hospital Clínic de Barcelona, University of Barcelona, Villarroel 170, 08034 Barcelona, CP Spain.

Indian journal of thoracic and cardiovascular surgery

|January 30, 2026

Resumen

La mectomy septal quirúrgica para la miocardiopatía hipertrófica (MCH) está infrautilizada en Europa debido a alternativas como la ablación septal con alcohol (ASA) y los inhibidores de la miosina cardíaca (IMC). Se necesita una mayor formación y estandarización para restaurar este tratamiento definitivo.

Área de la Ciencia:

Cardiología
Cirugía Cardíaca
Historia de la Medicina

Sus antecedentes:

La miocardiopatía hipertrófica (MCH) es una afección cardíaca significativa con un panorama de tratamiento complejo en Europa.
La mectomy septal quirúrgica, históricamente una intervención clave, enfrenta desafíos en su adopción generalizada en el continente.
El auge de la ablación septal con alcohol (ASA) y los nuevos inhibidores de la miosina cardíaca (IMC) han impactado la experiencia y la disponibilidad quirúrgicas.

Objetivo del estudio:

Revisar la evolución histórica del tratamiento quirúrgico de la MCH obstructiva en Europa.
Evaluar el estado actual y las disparidades en los programas de mectomy septal en los centros europeos.
Evaluar las implicaciones clínicas y económicas del tratamiento quirúrgico frente al farmacológico de la MCH.

Principales métodos:

Análisis de datos históricos y tendencias en intervenciones quirúrgicas de MCH en Europa.
Correspondencia directa con cirujanos cardíacos europeos activos para recopilar información sobre programas de mectomy.
Recopilación y revisión de datos institucionales sobre volúmenes de mectomy septal y acceso.

Principales resultados:

La adopción de la mectomy septal es desigual en Europa, con solo tres centros que realizan más de 25 procedimientos al año.
Existen disparidades significativas en el acceso, el volumen de procedimientos y la coordinación nacional para la cirugía de la MCH.
Los tratamientos farmacológicos contemporáneos y la ASA han contribuido a una disminución de la experiencia quirúrgica.

Conclusiones:

Existe una necesidad urgente de programas de formación estructurados y estandarización de procedimientos para la mectomy septal en Europa.
Es crucial un mayor reconocimiento de la mectomy septal como un tratamiento definitivo y rentable para la MCH obstructiva.
Abordar las disparidades en el acceso y promover la experiencia quirúrgica puede mejorar los resultados de los pacientes con MCH.

Palabras clave:

Ablación septal con alcohol Inhibidores de la miosina cardíaca Ceptectomía cardíaca Miocardiopatía hipertrófica Miocardiopatía hipertrófica obstructiva Mectomy septal Terapia de reducción septal

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