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Josef Veselka

Josef Veselka

2nd Medical School and Charles University Prague, Czech Republic

Title: Update of alcohol septal ablation for hypertrophic obstructive cardiomyopathy

Biography

Biography: Josef Veselka

Abstract

Hypertrophic cardiomyopathy (HCM) is characterized by the presence of increased thickness of the left ventricular wall that is not solely explained by abnormal loading conditions.Two-thirds of the patients with HCM have an obstruction in the left ventricle after provocation or even while at rest. Left ventricular outflow tract obstruction in HCM is associated with greater morbidity and mortality, and relief of obstruction is associated with improvement in symptoms and perhaps outcome. The first step in treating obstruction is the introduction of negatively inotropic medications. The two invasive therapeutic approaches for treating a left ventricular obstruction are alcohol septal ablation and surgical myectomy. The final decision concerning the optimal invasive therapy for patients with obstructive HCM should be individualized to each patient depending on his/her wishes and expectations, way of life, age, heart morphology, and hemodynamics, as well as the experience of the treating center. There is a clear learning and safety curve associated with volume of procedures in all forms of septal reduction, this suggests that these procedures should only be performed in expert centres (centres of excellence)