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Non-surgical myocardial reduction for patients with hypertrophic obstructive cardiomyopathy

U. Sigwart1

Royal Brompton Hospital, London, U.K.

1 Correspondence: Ulrich Sigwart, MD, FACC, FESC, FRCP, Department of Invasive Cardiology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, U.K.

Abstract

Until 1994 surgical myotomy-myectomy was the most effective symptomatic treatment for patients with symptoms of hypertrophic cardiomyopathy and dynamic left ventricular outflow tract obstruction refractory to pacing and drug treatment. Similar functional results can now be achieved by the creation of an alcohol-induced septal infarction using a catheter technique. This therapeutic myocardial necrosis results in widening of the left ventricular outflow tract with consequent gradient reduction, followed by clinical and objective improvement, as well as further gradient reduction as a result of left ventricular remodelling.

Key Words: catheter intervention • hypertrophic obstructive cardiomyopathy • percutaneous myocardial ablation • ventricular remodelling


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