Adult and Pediatric Cardiac
Hypertrophic Cardiomyopathy
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Introduction
Hypertrophic cardiomyopathy (HCM) is a genetic disease of cardiac muscle that can manifest a wide range of structural and functional abnormalities and cause symptoms of dyspnea, angina, and syncope. Available therapies, both medical and surgical, have increased and improved considerably over the last half century, and HCM is now a treatable disease with favorable outcomes. Indeed, the gold standard for obstructive HCM refractory to optimal medical therapy is extended septal myectomy.[1],[2] In addition, newer techniques have expanded the role of surgery for both obstructive and nonobstructive HCM.
Early surgical approaches aimed at alleviating left ventricular outflow tract (LVOT) obstruction were hampered by lack of understanding of the anatomy and pathophysiology of obstructive HCM. With the advent of Doppler echocardiography and, more recently, cardiac MRI, surgeons can precisely assess location and degree of obstruction, left ventricular size and function, and morphology and function of the mitral valve.
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Introduction
Hypertrophic cardiomyopathy (HCM) is a genetic disease of cardiac muscle that can manifest a wide range of structural and functional abnormalities and cause symptoms of dyspnea, angina, and syncope. Available therapies, both medical and surgical, have increased and improved considerably over the last half century, and HCM is now a treatable disease with favorable outcomes. Indeed, the gold standard for obstructive HCM refractory to optimal medical therapy is extended septal myectomy.[1],[2] In addition, newer techniques have expanded the role of surgery for both obstructive and nonobstructive HCM.
Early surgical approaches aimed at alleviating left ventricular outflow tract (LVOT) obstruction were hampered by lack of understanding of the anatomy and pathophysiology of obstructive HCM. With the advent of Doppler echocardiography and, more recently, cardiac MRI, surgeons can precisely assess location and degree of obstruction, left ventricular size and function, and morphology and function of the mitral valve.
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