Surgical Ventricular Septal Myectomy in the Developing World

The American Journal of Cardiology
Barry J Maron, Paolo Spirito

Abstract

Surgical septal myectomy is the preferred treatment strategy in hypertrophic cardiomyopathy (HC) to reverse progressive heart failure symptoms due to left ventricular outflow obstruction. However, open-heart surgery and the ventricular septal myectomy option in particular have limited accessibility in many parts of the world, including developing countries such as India, where skilled surgeons familiar with the complex left ventricular outflow tract anatomy of obstructive HC are rare. Indeed, septal myectomy, which is currently performed in only a limited number of countries, can become available in other venues if experienced surgeons dedicate their skills to this highly specialized but rewarding operation. Relevant to this issue, we describe a recent myectomy initiative in India (New Delhi) that demonstrates the possibility of generating a surgical myectomy program outside of an elite academic center environment, otherwise regarded as unfavorable for such an initiative. Demonstration that safe and effective septal myectomy is possible under such difficult circumstances bodes well for the expansion of this operation to many countries in the best interests of the hypertrophic cardiomyopathy patient population.

References

Apr 24, 2012·European Heart Journal·Attilio IacovoniPaolo Ferrazzi
Jul 21, 2014·European Heart Journal·Barry J Maron, Ankur Kalra
Jan 17, 2015·The American Journal of Cardiology·Pieter A VriesendorpMichelle Michels
May 9, 2015·Journal of the American College of Cardiology·Barry J MaronMartin S Maron

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Citations

Mar 8, 2017·The Journal of Thoracic and Cardiovascular Surgery·Barry J MaronHartzell V Schaff
Nov 4, 2021·Asian Cardiovascular & Thoracic Annals·Eduard Quintana, Pietro Bajona

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