Prof Perry Elliott, Dr Costas O'Mahony and Mr Alex Shipolini are hosted by Cardiomyopathy UK Trustee Libby Jarman to discuss the management and treatment of obstruction in hypertrophic cardiomyopathy (HCM / HoCM). Find out more at www.cardiomyopathy.org
Chapters:
Part 1 - Understanding hypertrophic obstructive cardiomyopathy
00:01:03 - What do we mean by ‘obstruction’ in hypertrophic cardiomyopathy (HCM)?
00:03:35 - How are the symptoms of HCM managed?
00:04:45 - What are the next steps in HCM following medication?
00:07:50 - What happens when medication is no-longer effective?
00:11:30 - Who makes the decision about whether surgery is appropriate?
00:14:30 - Do we know the prognostic value for surgical intervention?
00:15:30 - What causes the obstruction in HCM?
00:16:35 - Does the muscle in the heart get thicker over time?
Part 2 - Septal myectomy in HCM
00:18:00 - What is a septal myectomy?
00:20:45 - Is septal myectomy only performed in ‘end-stage’ HCM?
00:23:10 - What are the eligibility criteria for septal myectomy?
00:24:25 - What are the risks of going on coronary bypass?
00:26:30 - What is ‘cell salvage’?
00:28:13 - Are there instant improvement in symptoms with myectomy?
00:29:00 - What does the follow-up to surgery involve?
00:29:45 - What are the practical considerations that should be made ahead of surgery?
00:34:30 - What are the longer-term outcomes of septal myectomy?
00:36:15 - Does the muscle grow back?
00:36:25 - Do people still need to be on medication following a septal myectomy?
Part 3 - Alcohol Septal Ablation
00:38:05 - What is alcohol septal ablation?
00:41:00 - What are the pros and cons of alcohol septal ablation
00:42:50 - What is a pacemaker?
00:44:05 - Are there any candidates that are not suitable for alcohol septal ablation?
00:45:03 - Does the muscle grow back?
00:45:20 - Do patients need to continue medication following alcohol septal ablation?
00:46:11 - What is meant by the ‘gradient’?
00:47:15 - How does septal myectomy compare to alcohol septal ablation?
00:49:00 - Is it still possible to have a septal myectomy following alcohol septal ablation?
00:51:30 - What are the most important things to consider when comparing alcohol septal ablation versus septal myectomy?
00:52:30 - What are the prognostic differences between septal myectomy and alcohol septal ablation?
00:55:10 - Conclusions
Part 4 - The Role of Mavacamten and Aficamten in HCM
00:55:30 - What is Mavacamten and how does it work?
01:00:05 - How will Mavacamten impact surgical intervention options in HCM?
01:02:10 - Will Mavacamten speed up the route to surgery in HCM?
01:04:15 - Will people who have had surgical interventions benefit from Mavacamten?
01:05:20 - How does Mavacamten impact the journey of HCM?
01:07:45 - Is Mavacamten only for people with obstruction, or could it work for people with non-obstructive HCM?
011:09:23 - Conclusions
For more information visit www.cardiomyopathy.org