Septal myectomy for hypertrophic cardiomyopathy: important surgical knowledge and technical tips in the era of increasing alcohol septal ablation

  • Yuting P. Chiang
  • Yuichi J. Shimada
  • Jonathan Ginns
  • Shepard D. Weiner
  • Hiroo Takayama
Current Topics Review Article
  • 27 Downloads

Abstract

Hypertrophic cardiomyopathy (HCM) is the most commonly inherited cardiac disease—recent studies suggest a prevalence as high as 1 in 200. For symptomatic patients with obstructive HCM who are refractory to medical therapy, septal reduction is indicated. Septal myectomy (SM) is considered the gold standard septal reduction technique. However, due to a shortage of surgeons who are experienced in this technique, alcohol septal ablation (ASA) has overtaken SM as the most commonly performed procedure for obstructive HCM. In this review, we summarize the existing literature comparing SM with ASA and describe recent innovations in operative technique, including a detailed description of the approach used at our institution.

Keywords

Hypertrophic cardiomyopathy Septal myectomy Alcohol septal ablation 

Notes

Compliance with ethical standards

Conflict of interest

Dr. Chiang has no conflicts of interest to disclose. Dr. Shimada has no conflicts of interest to disclose. Dr Ginns has no conflicts of interest to disclose. Dr Weiner has no conflicts of interest to disclose. Dr Takayama has no conflicts of interest to disclose.

Supplementary material

Supplementary material 1 (M4V 107315 KB)

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Copyright information

© The Japanese Association for Thoracic Surgery 2018

Authors and Affiliations

  • Yuting P. Chiang
    • 1
  • Yuichi J. Shimada
    • 2
  • Jonathan Ginns
    • 2
  • Shepard D. Weiner
    • 2
  • Hiroo Takayama
    • 1
  1. 1.Division of Cardiothoracic and Vascular Surgery, Department of SurgeryColumbia University Medical CenterNew YorkUSA
  2. 2.Division of Cardiology, Department of MedicineColumbia University Medical CenterNew YorkUSA

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