Hypertrophic cardiomyopathy: septal myectomy and alcohol ablation should be personalized

• Dzemeshkevich S.L.
• Motreva A.P.
• Korzh D.A.
• Martyanova Yu.B.
• Sadekova M.A.
• Balashova M.S.
• Zaklyazminskaya E.V.

Abstract

The elimination of obstruction in the left ventricle outflow tract in hypertrophic cardiomyopathy patients today is achievable by two methods: septal myectomy under circulatory bypass, or alcohol septal ablation by endovascular occlusion of the first septal coronary branch. A continuing debate regarding advantages and disadvantages of these approaches has occupied a significant place in research publications over the past 30 years. Growing international experience suggests optimal decision-making should be based on genetic, anatomic, and clinical phenotype of the patient rather than on personal preferences. In this paper we illustrate this point by two clinical cases in which the surgical approach was chosen based on the patient’s objective data.

Keywords: hypertrophic cardiomyopathy; restrictive myectomy; alcohol ablation; anatomical phenotype of hypertrophic cardiomyopathy; genotype-negative patient

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