[Non-pharmacological treatment of hypertrophic obstructive cardiomyopathy guided by echocardiography].
As a relevant cause of symptoms and adverse clinical prognosis, left ventricular obstruction should be regarded as an important therapeutic target in patients with hypertrophic obstructive cardiomyopathy. The surgical approach (including septal myectomy or mitral valve surgery) and percutaneous transluminal septal myocardial ablation offer a non-pharmacological option for the treatment of symptomatic left ventricular obstruction and symptoms unresponsive to medical treatment. The surgical approach is established as an effective strategy for relieving symptoms from dynamic obstruction. Percutaneous septal ablation, on the other hand, has only recently been introduced into clinical practice and, despite its efficacy as an obstructive abolisher, little is known about the prognostic long-term impact of procedural-induced myocardial damage. Due to its accuracy and diagnostic versatility, including intraprocedural use, Doppler echocardiography provides essential information for the planning and monitoring of non-pharmacological therapy in patients with hypertrophic obstructive cardiomyopathy.
La Canna
Giovanni
G
Sezione di Ecocardiografia, Divisione di Cardiochirurgia, Istituto Universitario San Raffaele, Milano. lacanna.giovanni@hsr.it
Montorfano
Matteo
M
Ficarra
Eleonora
E
Michev
Iassen
I
Capritti
Elvia
E
Grimaldi
Antonio
A
De Cobelli
Francesco
F
Verzini
Alessandro
A
Colombo
Antonio
A
Alfieri
Ottavio
O
D015906:Angioplasty, Balloon, Coronary; D001281:Atrial Fibrillation / Q000150:complications; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation; D015150:Echocardiography, Doppler; D000431:Ethanol / Q000008:administration & dosage; D006346:Heart Septum / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery; D011379:Prognosis; D012307:Risk Factors; D013599:Systole
D000431:Ethanol