Imperial College London
Alternate

Professor SirMagdiYacoub

Faculty of Medicine, National Heart & Lung Institute

Emeritus Professor
 
 
 
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Contact

 

+44 (0)1895 828 893m.yacoub

 
 
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Location

 

Heart Science Centre, HarefieldHarefield HospitalHarefield Hospital

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Summary

 

Publications

Citation

BibTex format

@article{Maron:2011:eurheartj/ehr006,
author = {Maron, BJ and Yacoub, M and Dearani, JA},
doi = {eurheartj/ehr006},
journal = {Eur Heart J},
pages = {1055--1058},
title = {Controversies in cardiovascular medicine. Benefits of surgery in obstructive hypertrophic cardiomyopathy: bring septal myectomy back for European patients.},
url = {http://dx.doi.org/10.1093/eurheartj/ehr006},
volume = {32},
year = {2011}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Hypertrophic cardiomyopathy (HCM), a heterogeneous genetic heart disease with global distribution, is an important cause of heart failure disability at any age. For 50 years, surgical septal myectomy has been the preferred and primary treatment strategy for most HCM patients with progressive, drug refractory functional limitation due to left ventricular (LV) outflow tract obstruction. With very low surgical mortality at experienced centres, septal myectomy reliably abolishes impedance to LV outflow and heart failure-related symptoms, restores quality of life, and importantly is associated with long-term survival similar to that in the general population. Nevertheless, alternatives to surgical management are necessary for selected HCM patients. For example, after a brief flirtation with dual-chamber pacing 20 years ago, percutaneous alcohol septal ablation has garnered a large measure of enthusiasm and a dedicated following in the interventional cardiology community, achieving benefits for patients, paradoxically, by virtue of producing a transmural myocardial infarct. However, an unintended consequence has been the virtual obliteration of the surgical option for HCM patients in Europe, where several robust myectomy programmes once existed. Therefore, clear differences are now evident internationally regarding management strategies for symptomatic obstructive HCM. The surgical option is now unavailable to many patients based solely on geography, including some who would likely benefit more substantially from surgical myectomy than from catheter-based alcohol ablation. It is our aspiration that this discussion will generate reconsideration and resurgence of interest in surgical septal myectomy as a treatment option for severely symptomatic obstructive HCM patients within Europe.
AU  - Maron,BJ
AU  - Yacoub,M
AU  - Dearani,JA
DO  - eurheartj/ehr006
EP  - 1058
PY  - 2011///
SP  - 1055
TI  - Controversies in cardiovascular medicine. Benefits of surgery in obstructive hypertrophic cardiomyopathy: bring septal myectomy back for European patients.
T2  - Eur Heart J
UR  - http://dx.doi.org/10.1093/eurheartj/ehr006
UR  - https://www.ncbi.nlm.nih.gov/pubmed/21324934
VL  - 32
ER  -
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