Septal myotomy–myectomy and transcoronary septal alcohol ablation in hypertrophic obstructive cardiomyopathy. A comparison of clinical, haemodynamic and exercise outcomes

• Published in: European heart journal 2002-10, Vol.23 (20), p.1617-1624
• Main Authors: Firoozi, S., Elliott, P.M., Sharma, S., Murday, A., Brecker, S.J., Hamid, M.S., Sachdev, B., Thaman, R., McKenna, W.J.
• Format: Article
• Language: English
• Subjects: Adult; alcohol septal ablation; Biological and medical sciences; Cardiac Surgical Procedures; Cardiology. Vascular system; Cardiomyopathy, Hypertrophic - diagnosis; Cardiomyopathy, Hypertrophic - drug therapy; Cardiomyopathy, Hypertrophic - surgery; Echocardiography; Ethanol - therapeutic use; Exercise Test; Female; Follow-Up Studies; Heart; Heart Septum - drug effects; Heart Septum - surgery; Humans; Hypertrophic cardiomyopathy; Male; Medical sciences; Middle Aged; myectomy; Myocarditis. Cardiomyopathies; obstruction; peak oxygen consumption; Time Factors
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1053/euhj.2002.3285

Aims Surgical myectomy has been successfully used to treat patients with symptomatic obstructive hypertrophic cardiomyopathy (HCM). More recently, alcohol septal ablation has been advocated as a less invasive, but equally effective alternative therapy. The aim of this non-randomized cohort study was to compare subjective and objective outcomes in patients undergoing these therapies. Methods Forty-four patients (25 male; age 41±15 years) with symptomatic drug-refractory obstructive HCM were studied. Twenty-four patients underwent surgical myectomy and 20 alcohol septal ablation. All patients underwent clinical evaluation, echocardiography and upright maximal cardiopulmonary exercise testing using a cycle ergometer before and following their intervention. Results Peak gradient was reduced to a similar extent by both modalities (myectomy: 83±23 to 15±10mmHg (P