Article
Cardiac & Cardiovascular Systems
Amgad Mentias, Nicholas G. Smedira, Amar Krishnaswamy, Grant W. Reed, Susan Ospina, Maran Thamilarasan, Zoran B. Popovic, Bo Xu, Samir R. Kapadia, Milind Y. Desai
Summary: This study investigated the long-term outcomes of septal reduction therapies in elderly Medicare patients with oHCM, as well as the relationship between hospital volume and outcomes. The results showed that septal myectomy was associated with lower mortality and need for redo procedures compared to alcohol septal ablation. Additionally, higher-volume centers had better outcomes. However, most patients underwent treatment at low-volume centers.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Review
Medicine, General & Internal
Victor Arevalos, Juan Jose Rodriguez-Arias, Salvatore Brugaletta, Antonio Micari, Francesco Costa, Xavier Freixa, Monica Masotti, Manel Sabate, Ander Regueiro
Summary: Hypertrophic cardiomyopathy (HCM) can cause left ventricle outflow tract obstruction, requiring invasive treatments like septal myectomy (SM) and alcohol septal ablation (ASA). Both procedures have similar efficacy, but ASA is usually reserved for older patients or those unsuitable for surgery. Despite advancements, the most common complication remains complete atrio-ventricular block, necessitating a permanent pacemaker.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Cardiac & Cardiovascular Systems
Yujiro Yokoyama, Tomonari Shimoda, Yuichi J. Shimada, Junichi Shimamura, Keitaro Akita, Risako Yasuda, Hiroo Takayama, Toshiki Kuno
Summary: A meta-analysis compared alcohol septal ablation (ASA) and septal myectomy as septal reduction therapies for obstructive hypertrophic cardiomyopathy. The results showed similar all-cause mortality between the two treatments, but ASA was associated with less reduction of left ventricular outflow tract (LVOT) pressure gradient and a higher reoperation rate. Subgroup analysis with follow-up >= 5 years revealed higher long-term mortality with ASA.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2023)
Article
Pediatrics
Paola Dolader, Iosune Alegria, Patricia Martinez Oloron, Joaquin Fernandez-Doblas, Ferran Gran, Ferran Roses-Noguer
Summary: Hypertrophic cardiomyopathy is a common heart disease with sudden cardiac death as the leading cause of mortality. Implantable cardioverter defibrillator is the most reliable treatment option. The choice of devices and programming strategies may vary based on individual patient conditions.
FRONTIERS IN PEDIATRICS
(2022)
Article
Cardiac & Cardiovascular Systems
Hao Cui, Hartzell Schaff, Shuiyun Wang, Brian D. Lahr, Ethan J. Rowin, Hassan Rastegar, Shengshou Hu, Mackram F. Eleid, Joseph A. Dearani, Carey Kimmelstiel, Barry J. Maron, Rick A. Nishimura, Steve R. Ommen, Martin S. Maron
Summary: This study compared the long-term mortality of patients with obstructive HCM who underwent septal myectomy or ASA. The results showed that ASA was associated with higher all-cause mortality compared to septal myectomy.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2022)
Review
Cardiac & Cardiovascular Systems
Xifeng Zheng, Bin Yang, Haosheng Hui, Bing Lu, Yinhui Feng
Summary: This study evaluates the safety and effectiveness of alcohol septal ablation (ASA) and septal myectomy (SM) for treating hypertrophic obstructive cardiomyopathy. The results show that there is no significant difference in postoperative mortality between ASA and SM patients, but ASA is associated with slightly lower reduction in left ventricular outflow tract pressure gradient and postoperative improvement in cardiac function compared to SM. Additionally, ASA is associated with higher risk of pacemaker implantation and reoperation. The choice of surgical plan should be made through multidisciplinary discussions considering the patients' wishes and clinical situation.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Ahmed M. Altibi, Fares Ghanem, Yuanzi Zhao, Miriam Elman, Joaquin Cigarroa, Babak Nazer, Howard K. Song, Ahmad Masri
Summary: This study analyzed the outcomes of septal reduction therapy and the relationship between procedural volume and outcomes in patients with obstructive hypertrophic cardiomyopathy in the United States between 2010 and 2019. The study found that the in-hospital mortality rate for septal myectomy was 4%, and it had an inverse relationship with procedural volume. However, the mortality rate for alcohol septal ablation was not associated with procedural volume. Complications associated with septal reduction therapy were common across all procedural volume groups.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Article
Cardiac & Cardiovascular Systems
Josef Veselka, Lothar Faber, Max Liebregts, Robert Cooper, Jaroslav Januska, Maksim Kashtanov, Maciej Dabrowski, Peter Riis Hansen, Hubert Seggewiss, Jiri Bonaventura, Eva Polakova, Eva Hansvenclova, Henning Bundgaard, Jurrien ten Berg, Rodney Hilton Stables, Jiri Jarkovsky, Morten Kvistholm Jensen
Summary: The study evaluated short- and long-term outcomes related to dose of alcohol administered during alcohol septal ablation (ASA) in HOCM patients. Results showed that patients receiving low-dose or high-dose of alcohol had similar short- and long-term outcomes, with the low-dose group undergoing more subsequent septal reduction procedures.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2021)
Review
Cardiac & Cardiovascular Systems
Ragavendar Saravanabavanandan, Aniket Jaimalani, Muhammad Ahsan Naseer Khan, Sania Riaz, Gabriel de Moraes Mangas, Syed Muhammad Ahsan, Sarojini Posani, Tirath Patel, Moiz Fawad, Mohammed Al-Tawil
Summary: This study found that in patients undergoing alcohol septal ablation or septal myectomy, female patients tend to be older at the time of intervention and have a higher risk of mortality, a higher incidence of atrioventricular block, a higher likelihood of permanent pacemaker requirement, and a longer hospital stay.
AMERICAN JOURNAL OF CARDIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Pietro Francia, Iacopo Olivotto, Pier D. Lambiase, Camillo Autore
Summary: Choosing the right ICD for patients with HCM is crucial, as overly complex devices may increase the risk of complications. Young patients stand to gain the most from ICD therapy but also face higher risks, necessitating careful consideration in device selection.
Review
Cardiac & Cardiovascular Systems
Alexandru Achim, Adela Mihaela Serban, Stefan Dan Cezar Mot, Gregor Leibundgut, Madalin Marc, Ulrich Sigwart
Summary: Percutaneous and surgical therapies for septal reduction for hypertrophic cardiomyopathy have similar outcomes and mortality rates, but myectomy seems to have superiority in certain cases. However, the external validity of studies endorsing myectomy is not universal. This review aims to examine recent data on septal reduction therapy and phenotyping of patients for each treatment, and discusses the potential role of mavacampten as an alternative or complement to these therapies.
Article
Cardiac & Cardiovascular Systems
Xiangbin Meng, Wen-yao Wang, Jun Gao, Kuo Zhang, Jilin Zheng, Jing-jia Wang, YuPeng Liu, Chunli Shao, Yi-Da Tang
Summary: Patients with hypertrophic obstructive cardiomyopathy (HOCM) have a higher risk of ventricular arrhythmia and heart failure, especially in young people. Surgical myectomy is more effective than alcohol septal ablation and medical therapy in reducing left ventricular outflow tract gradients, particularly in younger patients. Patients in the medical treatment group are at the highest risk of all-cause mortality and heart transplantation.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Hao Cui, Hartzell Schaff, Joseph A. Dearani, Brian D. Lahr, Jason K. Viehman, Jeffrey B. Geske, Rick A. Nishimura, Steve R. Ommen
Summary: This study evaluated outcomes after septal myectomy in patients with obstructive hypertrophic cardiomyopathy, finding that preoperative atrial fibrillation was associated with higher all-cause mortality, but there was no significant impact on survival when considering surgical ablation.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Gabrielle Norrish, Henry Chubb, Ella Field, Karen McLeod, Maria Ilina, Georgia Spentzou, Jan Till, Piers E. F. Daubeney, Alan Graham Stuart, Jane Matthews, Dominic Hares, Elspeth Brown, Katie Linter, Vinay Bhole, Krishnakumar Pillai, Michael Bowes, Caroline B. Jones, Orhan Uzun, Amos Wong, Arthur Yue, Shankar Sadagopan, Tara Bharucha, Norah Yap, Eric Rosenthal, Sujeev Mathur, Satish Adwani, Zdenka Reinhardt, Jasveer Mangat, Juan Pablo Kaski
Summary: This study analyzed the outcomes of ICD insertion in a national pediatric HCM cohort, finding a high rate of appropriate therapies and some inappropriate therapies. Complications with the devices were also observed in a significant portion of patients, with no predictors for inappropriate therapies or lead complications identified.
Article
Cardiac & Cardiovascular Systems
Lior Jankelson, Leonid Garber, Mark Sherrid, Daniele Massera, Paul Jones, Chirag Barbhaiya, Douglas Holmes, Robert Knotts, Scott Bernstein, Michael Spinelli, David Park, Anthony Aizer, Larry Chinitz
Summary: This study aimed to assess the incidence of ICD therapy in patients with HCM implanted with TV-ICD vs S-ICD in real-world settings.
Article
Cardiac & Cardiovascular Systems
Sukhjinder Singh Nijjer
CARDIOLOGY CLINICS
(2024)
Article
Cardiac & Cardiovascular Systems
Doosup Shin, Seung Hun Lee, David Hong, Ki Hong Choi, Joo Myung Lee
Summary: Post-PCI physiologic assessment has significant prognostic value and plays a role in functionally optimized PCI. Investigating the reasons behind suboptimal post-PCI physiologic results using pressure-wire pullback tracings and/or intravascular imaging is important. Functionally optimized PCI should be considered at the beginning of the procedure, and careful PCI planning using pre-PCI physiologic evaluation can increase the probability of achieving it.
CARDIOLOGY CLINICS
(2024)
Article
Cardiac & Cardiovascular Systems
Sonal Pruthi, Emaad Siddiqui, Nathaniel R. Smilowitz
CARDIOLOGY CLINICS
(2024)
Review
Cardiac & Cardiovascular Systems
Robert D. Safian
CARDIOLOGY CLINICS
(2024)
Article
Cardiac & Cardiovascular Systems
Adam Bland, Eunice Chuah, William Meere, Thomas J. Ford
Summary: CMD remains a challenging condition to manage due to its heterogeneous pathophysiology, presentation, and response to therapy. Awareness of CMD is improving, but there is a lack of randomized trials for therapy. Invasive assessment of the coronary microcirculation can improve patient-centered outcomes. Beta-blockers are still the cornerstone of therapy for angina due to CMD, while non-pharmacological interventions play a central role in management.
CARDIOLOGY CLINICS
(2024)
Article
Cardiac & Cardiovascular Systems
Samer Fawaz, Christopher M. Cook
CARDIOLOGY CLINICS
(2024)
Article
Cardiac & Cardiovascular Systems
Nils P. Johnson
Summary: From the four recent RCTs on FFR published or presented in 2021, we have learned several important lessons: study design should focus on discordant decisions; composite endpoints for PCI should prioritize vessel-level outcomes over mortality; initial PCI must be considered when calculating the total amount of TVR; ultrahigh rates of FFR<0.8 do not influence treatment decisions based on angiography; and although PCI is a reasonable option, CABG yields better outcomes for patients with severe multivessel disease.
CARDIOLOGY CLINICS
(2024)
Article
Cardiac & Cardiovascular Systems
Tobin Joseph, Michael Foley, Rasha Al-Lamee
CARDIOLOGY CLINICS
(2024)
Article
Cardiac & Cardiovascular Systems
David M. Tehrani, Arnold H. Seto
Summary: Accurate interpretation of hemodynamic indices like FFR and NHPRs is crucial with their increasing use. The choice between FFR and NHPRs depends on specific clinical and procedural scenarios, and data on their use in special clinical situations is limited.
CARDIOLOGY CLINICS
(2024)
