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 language | English (US) |
|---|---|
| Pages (from-to) | 715-722 |
| Number of pages | 8 |
| Journal | Expert Review of Cardiovascular Therapy |
| Volume | 6 |
| Issue number | 5 |
| DOIs | |
| State | Published - Jun 2008 |
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Keywords
- Alcohol septal ablation
- Hypertrophic cardiomyopathy
- Hypertrophic obstructive cardiomyopathy
- Myectomy
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Internal Medicine
Cite this
Surgical management of obstructive hypertrophic cardiomyopathy : The gold standard. / Brown, Morgan L.; Schaff, Hartzell V.
In: Expert Review of Cardiovascular Therapy, Vol. 6, No. 5, 06.2008, p. 715-722.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Surgical management of obstructive hypertrophic cardiomyopathy
T2 - The gold standard
AU - Brown, Morgan L.
AU - Schaff, Hartzell V
PY - 2008/6
Y1 - 2008/6
N2 - 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.
AB - 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.
KW - Alcohol septal ablation
KW - Hypertrophic cardiomyopathy
KW - Hypertrophic obstructive cardiomyopathy
KW - Myectomy
UR - http://www.scopus.com/inward/record.url?scp=47149107250&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=47149107250&partnerID=8YFLogxK
U2 - 10.1586/14779072.6.5.715
DO - 10.1586/14779072.6.5.715
M3 - Article
C2 - 18510487
AN - SCOPUS:47149107250
VL - 6
SP - 715
EP - 722
JO - Expert Review of Cardiovascular Therapy
JF - Expert Review of Cardiovascular Therapy
SN - 1477-9072
IS - 5
ER -