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Surgery Litigation & Law Weekly

February 11, 2005

SECTION: EXPANDED REPORTING; Pg. 26

LENGTH: 503 words

HEADLINE: MINNEAPOLIS HEART INSTITUTE FOUNDATION; Surgery is most effective treatment in obstructive hypertrophic cardiomyopathy

BODY:

A recent report argued the case for surgery in obstructive hypertrophic cardiomyopathy.

According to scientists in the United States, "Relief of left ventricular (LV) outflow obstruction in patients with hypertrophic cardiomyopathy (HCM) and disabling symptoms refractory to maximum medical management has historically been a surgical problem. Surgical septal myectomy permanently abolishes systolic anterior motion of the mitral valve and mitral regurgitation, while normalizing LV pressures and wall stress. Also, these salutary goals are achieved without encumbering patients with post-procedural devices (e.g., pacemakers or defibrillators) or creating potentially arrhythmogenic substrates, as may occur with alcohol septal ablation."

B.J. Maron and colleagues of the Minneapolis Heart Institute Foundation continued, "Procedural morbidity and mortality risk with myectomy is similar to, and in some institutions less than, those for alcohol septal ablation. Over four decades, reports from numerous centers worldwide have consistently and unequivocally documented the benefits of surgery on hemodynamic and functional state, restoring normal and acceptable quality of life to patients of all ages by largely reversing the complications of heart failure."

"Long-term survival after myectomy is similar to that of the general population and superior to nonoperated patients with obstruction. The LV outflow tract morphology in HCM is heterogeneous and not uncommonly includes congenital anomalies of the mitral valve apparatus for which the surgeon has the flexibility to adapt the repair, often employing an extended myectomy," the authors observed

They concluded, "In the current atmosphere of increasing and perhaps excessive enthusiasm for newer catheter-based interventions, it is a critical time to promote and re-emphasize that surgery is the time-honored (and presently the most effective) treatment strategy for relieving heart failure-related disability resulting from dynamic LV outflow obstruction in HCM, and is the primary treatment option for this subgroup of severely symptomatic drug-refractory patients."

Maron and colleagues published their report in the Journal of the American College of Cardiology (The case for surgery in obstructive hypertrophic cardiomyopathy. J Am Coll Cardiol, 2004;44(10):2044-2053).

For additional information, contact B.J. Maron, Minneapolis Heart Institute Foundation, Hypertrophic Cardiomyopathy Center, 920, E 28th Street, Suite 60, Minneapolis, MN 55407, USA. [email protected]

The publisher's contact information for the Journal of the American College of Cardiology is: Elsevier Science Inc., 360 Park Avenue South, New York, NY 10010-1710, USA.

The information in this article comes under the major subject areas of Hypertrophy, Cardiac Surgery, Medical Devices, Septal Myectomy and Cardiology.

This article was prepared by Surgery Litigation & Law Weekly editors from staff and other reports. Copyright 2005, Surgery Litigation & Law Weekly via LawRx.com.

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