Surgical management of obstructive hypertrophic cardiomyopathy: The gold standard

Morgan L. Brown, Hartzell V. Schaff

Research output: Contribution to journalReview article

30 Scopus citations

Abstract

While medication is the first line of therapy in obstructive hypertrophic cardiomyopathy, patients who have symptoms refractory to medical treatment or asymptomatic patients with high resting gradients (≥30 mmHg) may require septal myectomy. Surgical septal myectomy can be performed safely, with excellent survival, relief from symptoms and low morbidity. Alcohol septal ablation is an alternative to surgical treatment, but late outcomes are uncertain. Although both methods of septal reduction relieve left ventricular outflow tract gradients and improve functional status, the need for permanent pacing appears higher with alcohol ablation compared with surgical myectomy. As our understanding of obstructive hypertrophic cardiomyopathy continues to grow, the indications for intervention will evolve. In our practice, septal myectomy remains the gold standard for treatment of obstructive hypertrophic cardiomyopathy.

Original languageEnglish (US)
Pages (from-to)715-722
Number of pages8
JournalExpert Review of Cardiovascular Therapy
Volume6
Issue number5
DOIs
StatePublished - Jun 1 2008

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Keywords

  • Alcohol septal ablation
  • Hypertrophic cardiomyopathy
  • Hypertrophic obstructive cardiomyopathy
  • Myectomy

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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