The evolving clinical practice of septal reduction therapy in hypertrophic obstructive cardiomyopathy

Le résumé fourni par la source

Hypertrophic obstructive cardiomyopathy remains a formidable clinical challenge, and septal reduction therapy (SRT) continues to be the cornerstone for managing drug-refractory left ventricular outflow tract obstruction. Over the past decade, SRT has undergone remarkable refinement and diversification. Traditional strategies - surgical septal myectomy and alcohol septal ablation - have been continually optimized, demonstrating durable relief of left ventricular outflow tract obstruction and sustained symptomatic improvement. Emerging techniques, including percutaneous intramyocardial septal radiofrequency ablation, transapical beating-heart myectomy, transcoronary radiofrequency ablation, and endoluminal electrosurgical myotomy, offer promising, less-invasive alternatives that achieve hemodynamic outcomes comparable to surgery. Nevertheless, long-term data on these novel procedures are scarce, and evidence-based algorithms for matching individual patients to the optimal technique remain elusive. This review synthesizes 65 years of technical evolution in SRT and proposes an evidence-driven framework for individualized procedure selection that integrates anatomical complexity, patient-specific risk profiles, and institutional expertise, thereby advancing the field toward truly personalized and effective care.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.