JUAN A. CRESTANELLO: Welcome to the Cardiovascular Surgery Series, where I review the latest research from cardiovascular surgery. I will discuss early septal reduction therapy for patients with obstructive hypertrophic cardiomyopathy. Guidelines recommended the septal reduction therapy, either alcohol septal ablation or septal myectomy should be reserved for patients with symptoms are refractory to medical treatment.

With the current advances in septal myectomy and alcohol septal ablation, it is unclear whether waiting for treatment benefit patients or just delays the relief of the symptoms. Therefore, we designed this study to address the influence of early interventions on outcomes of patients with hypertrophic obstructive cardiomyopathy.

We review 1,300 patients with hypertrophic obstructive cardiomyopathy, who were treated either with early septal reduction therapy or with early medical treatment. Early treatment was defined as the septal reduction therapy, either septal myectomy or alcohol septal ablation, within six months of the index evaluation.

Of note, the majority of the patients in this study had septal myectomy. After a 10-year follow-up, early treatment was associated with substantial benefit in long-term survival. And that was particularly evident on female patients, patients who had NYHA Heart Association Functional Class III or IV at presentation, and in patients who were not diabetic.

Therefore, we conclude that in centers with experience in the management of patients with hypertrophic obstructive cardiomyopathy, early septal reduction therapy is associated with benefit in terms of long-term survival and that benefit is particularly evident in females and patients who present with advanced heart failure symptoms. Thank you for listening to the Cardiovascular Surgery series.