Key result
Percutaneous transluminal septal myocardial ablation is a less invasive alternative to surgical myectomy for drug-refractory hypertrophic obstructive cardiomyopathy, though it carries a higher risk of complete atrioventricular block and repeat procedures.
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This review summarizes the emerging concepts, practical implications, and available evidence for septal reduction therapies (PTSMA and surgical myectomy) in drug-refractory hypertrophic obstructive cardiomyopathy.
Hypertrophic cardiomyopathy (HCM) is a complex and relatively common genetic cardiac disease that has been the subject of intense investigation for over 50 years. Most patients with HCM are asymptomatic, but some develop symptoms, often many years after the appearance of electrocardiographic or echocardiographic evidence of left ventricular hypertrophy. Symptoms due to the left ventricular outflow tract obstruction frequently worsen over time, requiring septal reduction therapy (SRT) despite optimal medical therapy. Percutaneous transluminal septal myocardial ablation (PTSMA) and surgical myectomy are collectively known as SRT. In this review, we will focus on the emerging concept and practical implication of SRT and the available evidence on either PTSMA or surgical myectomy in the literature.
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Maekawa et al. (2018) conducted a review in Drug-Refractory Hypertrophic Obstructive Cardiomyopathy. Septal Reduction Therapy (PTSMA and Surgical Myectomy) was evaluated. Percutaneous transluminal septal myocardial ablation is a less invasive alternative to surgical myectomy for drug-refractory hypertrophic obstructive cardiomyopathy, though it carries a higher risk of complete atrioventricular block and repeat procedures.
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