Current management and surgical advances in patients with obstructive hypertrophic cardiomyopathy.

Current management and surgical advances in patients with obstructive hypertrophic cardiomyopathy. Kardiol Pol. 2019 Sep 09;: Authors: Dorobantu L, Ticulescu R, Greavu M, Dermengiu A, Alexandrescu M, Trofin M Abstract Hypertrophic Cardiomyopathy (HCM) is the most frequent primary cardiomyopathy, a genetic disease affecting 1:500 of the general population. Integrated multimodality imaging - using transthoracic echocardiography, 2D/3D-transesophageal echocardiography, stress-echocardiography and cardiac magnetic resonance succeeds in providing answers to management questions, leading to standardized protocols. If the late 90s came with the news of a non-surgical method to treat the obstruction in HCM patients, nowadays, it is increasingly evident the septal ablation is not able to address all the mechanisms of the LVOT gradient, especially the mitral valve involvement. Both the American College/American Heart Association Guidelines and the European Society of Cardiology Guidelines have selected the surgical septal myectomy as the gold standard treatment. The "standard" deep surgical myectomy requiar specific operator and institutional experience; that's why myectomy is a procedure who should be discouraged in small community hospitals and be performed in only "HCM centers of excelence". Described in 2015, the Ferrazzi's technique, consisting in cutting of the fibrous secondary chordae of the mitral valve, avoid a deep myectomy by movin...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research