Abstract
New ESC guidelines on hypertrophic cardiomyopathy: new insights in invasive treatment?
Highlights
Hypertrophic cardiomyopathy (HCM) is a complex, yet relatively common genetic cardiac disease and has been the subject of intensive investigation since its first description in 1958
It is of interest to take notice of the paper by Maron et al [8], published in 2011(!) in the European Heart Journal (EHJ), where they encouraged the European cardiology and cardiothoracic-surgery community to reconsider surgical septal myectomy as a treatment option for severely symptomatic obstructive HCM patients within Europe. This was based on the fact that the less invasive alcohol septal ablation, introduced by Ulrich Sigwart (Geneva, London) in 1994, became more and more common practice in Europe resulting in the virtual obliteration of the surgical option for HCM patients in Europe [9]
What do the new ESC guidelines, published in the EHJ October 2014 issue [10], teach us about the value of invasive therapy in severely affected HCM patients? What is the current status of myectomy, septal alcohol ablation and dual chamber pacing? First of all, there are no data to support the use of invasive procedures to reduce left ventricular outflow tract (LVOT) gradients in asymptomatic patients, regardless of their severity
Summary
Hypertrophic cardiomyopathy (HCM) is a complex, yet relatively common genetic cardiac disease and has been the subject of intensive investigation since its first description in 1958. Surgical septal myectomy (Morrow procedure) has been advocated to reduce outflow obstruction and relieve symptoms. It is of interest to take notice of the paper by Maron et al [8], published in 2011(!) in the European Heart Journal (EHJ), where they encouraged the European cardiology and cardiothoracic-surgery community to reconsider surgical septal myectomy as a treatment option for severely symptomatic obstructive HCM patients within Europe.
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