Septal reduction therapies in hypertrophic cardiomyopathy: Comparison of surgical septal myectomy and alcohol septal ablation

Jeffrey B. Geske, Kyle W. Klarich, Steve R. Ommen, Hartzell V. Schaff, Rick A. Nishimura

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

Left ventricular outflow tract obstruction, either resting or labile, occurs in approximately 70% of patients with hypertrophic cardiomyopathy and is a major cause of symptoms. In patients with obstructive physiology and medically refractory symptoms, septal myectomy and alcohol septal ablation reduce the left ventricular outflow tract gradient and improve symptoms. Myectomy is more effective at gradient reduction compared with ablation, with lower need for subsequent pacemaker implantation. However, cohort studies and meta-analyses have shown short-term mortality and post-procedural functional classes are similar between procedures. In many centers alcohol septal ablation case volumes have surpassed myectomy. There remains significant controversy regarding choice of myectomy or ablation. This review describes the two septal reduction procedures, examines the available comparative data for clinical outcomes and discusses clinical considerations when selecting myectomy or ablation.

Original languageEnglish (US)
Pages (from-to)199-215
Number of pages17
JournalInterventional Cardiology (London)
Volume6
Issue number2
DOIs
StatePublished - Apr 2014

Keywords

  • alcohol septal ablation
  • hypertrophic cardiomyopathy
  • septal myectomy
  • septal reduction therapy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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