May 30, 2008Expert Review of Cardiovascular Therapy
Surgical management of obstructive hypertrophic cardiomyopathy: the gold standard
Key result
Surgical septal myectomy remains the gold standard for oHCM, requiring less permanent pacing than alcohol ablation.
Why the study?
Patients with obstructive hypertrophic cardiomyopathy who are refractory to medical treatment or have high resting gradients may require septal reduction, but the optimal intervention remains to be clarified.
Does surgical septal myectomy compared to alcohol septal ablation improve outcomes in patients with obstructive hypertrophic cardiomyopathy?
Population
Patients with obstructive hypertrophic cardiomyopathy with refractory symptoms or high resting gradients (≥30 mmHg)
Comparison
Surgical septal myectomy vs alcohol septal ablation
Design
Review
Authors
Discussion
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Member takes
Implication
Supports myectomy preference in obstructive HCM; leaves open need for randomized comparisons with ablation.
Structured PICO
Does surgical septal myectomy compared to alcohol septal ablation improve outcomes in patients with obstructive hypertrophic cardiomyopathy?
P
Population
Patients with obstructive hypertrophic cardiomyopathy who have symptoms refractory to medical treatment or asymptomatic patients with high resting gradients (≥30 mmHg)
I
Intervention
Surgical septal myectomy
C
Comparator
Alcohol septal ablation
Surgical septal myectomy remains the gold standard for treating obstructive hypertrophic cardiomyopathy, offering excellent symptom relief and lower pacing requirements compared to alcohol septal ablation.
Cite This Study
Brown et al. (2008) conducted a review in Obstructive hypertrophic cardiomyopathy. Surgical septal myectomy vs. Alcohol septal ablation was evaluated. Surgical septal myectomy remains the gold standard for obstructive hypertrophic cardiomyopathy, offering excellent survival and symptom relief with a lower need for permanent pacing than alcohol ablation.