Gordon Fox • September 29, 2022
Septal Myectomy Today

What’s the status of septal myectomy today? A recent review paper by an Expert Panel for the American Journal of Cardiology ( Maron et al. 2022 ) concludes that “Surgical myectomy remains the time-honored primary treatment for hypertrophic cardiomyopathy patients with drug refractory limiting symptoms due to LV outflow obstruction.”

One of the safest of heart procedures

Septal myectomy – especially at high-volume centers – is one of the safest of heart procedures, and has a strong record of safely improving patient’s symptoms of heart failure. The authors review alternatives – useful especially in those who are poor surgical candidates – and drug treatments. Myectomy is used in those who are unresponsive to drug therapy.

What about myosin inhibitors?

Does the emergence of the new myosin-inhibiting drugs ( Camzyos , and others being tested) change this? No, the authors conclude. There will continue to be patients who will not respond to these drugs, or who cannot handle their considerable financial burden. Nor is it yet known whether myosin inhibitors will succeed as lifelong treatments; they may turn out to often be most useful in helping patients delay myectomy.

Conclusion

The authors emphasize that “As new medical initiatives emerge, it is particularly important to underscore the effectiveness of septal myectomy in the State-of-the-Art management of severely symptomatic obstructive HCM patients, careful to avoid delay or under-utilization of operative intervention.”

Literature cited

Maron, B. J., Dearani, J. A., Smedira, N. G., Schaff, H. V., Wang, S., Rastegar, H., Ralph-Edwards, A., Ferrazzi, P., Swistel, D., Shemin, R. J., Quintana, E., Bannon, P. G., Shekar, P. S., Desai, M., Roberts, W. C., Lever, H. M., Adler, A., Rakowski, H., Spirito, P., Nishimura, R. A., Ommen, S. R., Sherrid, M. V., Rowin, E. J., and Maron, M. S. 2022. Ventricular Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy (Analysis Spanning 60 Years Of Practice): AJC Expert Panel. The American Journal of Cardiology 180: 124–139. https://doi.org/10.1016/j.amjcard.2022.06.007

HCMA Blog

By Lisa Salberg July 3, 2025
Summer, greetings to all our big-hearted friends As July approaches, our focus is already on the fall and preparing for some major events, including our annual meeting coming up in October. July will also find us on the west coast in Seattle conducting a regional patient education meeting as part of our big-hearted warrior tour. We have been following the generic drug quality issue in the United States very closely and encourage you to watch the series starting with our Hill briefing in April and following with the additional webinars with our partners at Medshadow and the People's Pharmacy, and of course the ProPublica series of articles. See them all here . We are happy to have a new team member on board - we welcome Pam as our coordinator of both our All Hearts Collaborative and Hearts and Minds project. Over the next few months, you're going to be learning more about these two amazing initiatives and how we are working to provide better services for big hearts regardless of where you live, so we are meeting all of our big-hearted friends where they are. Please stay tuned for updates from these projects coming soon. We are also creating new volunteer opportunities and engagements that we hope will make it easier for you to participate in spreading the message of the importance of diagnosis, the importance of community readiness related to CPR and AED use and, of course, helping patients get to their ultimate diagnosis and getting them on the proper treatment pathways. This July I would like to recognize all of the special birthdays in my family, including HCMA Center of Excellence coordinator, Stacey Titus-brown and my daughter Rebecca Salberg. It's a milestone birthday for Becca - it’s hard to believe I have a 30-year-old child. Wishing you all a happy and healthy summer. Go build some memories!
An official seal in black  & red with white letters that say HCMS Recognized Centers of Excellence
By Sabrina Cuddy July 3, 2025
Getting HCM care at a HCMA Recognized Center of Excellence has a positive impact on patient's outcomes. Find out why in the post by Health Educator Sabrina Cuddy
By Erica Friedman June 26, 2025
Investigative journalists Debbie Cenziper, Megan Rose, Brandon Roberts and Irena Hwang from Pro Publica and NPR have concluded a 14-month long investigation into the quality of generic drugs coming into the United States from overseas. Among the many voices that spoke up for American patients was HCMA Founder and CEO, Lisa Salberg who has felt the effects of low-quality drugs personally. Salberg believes that fixing this problem is something we can do, even in this time, when even health care is highly politicized. Read the key takeaways from ProPublica’s 14-month investigation into the FDA’s oversight of foreign drugmakers in Threat in Your Medicine Cabinet: The FDA’s Gamble on America’s Drugs .
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