Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: Hypertrophic Cardiomyopathy
Forum: The Heart Forum
Topic Area: Cardiomyopathy
Posted by CCF CARDIO MD - MTR on August 05, 1998 at 23:00:33:
In Reply to: Hypertrophic Cardiomyopathy posted by Pat on August 03, 1998 at 19:51:07:



I was wondering at what particular septal thickness would surgery be indicated. I would also like to know about the effectiveness of septal ablation using a pure alcohol solution to "thin out" the septal wall. Is this procedure still considered experimental for insurance purposes. Thank you. Pat



_

Dear Pat, thank you for your question. Hypertrophic cardiomyopathy (HOCM) is a
diverse condition with different manifestations in every patient. There is
no absolute septal thickness for which septal myomectomy surgery is indicated,
although the septum generally is at least 2 cm thick when this surgery is done.
Patient symptoms are the most important factor in determining when to do surgery.
Also, the pressure gradients measured within the heart with an echocardiogram
give important information towards making a decision about surgery. Finally,
the response to medications is another important factor to consider. Alcohol
septal ablation is still an experimental procedure at this point and is not
proven and accepted yet. Thus, patients who are treated with this procedure
are enrolled in research protocols. We have performed a number of these
procedures at Cleveland Clinic and we've had mixed results. Some patients
get much better, some improve slightly, and some don't improve at all. We and
other centers are trying to determine which patients would stand to benefit the
most from this procedure. If you would like more information about alcohol
septal ablation for HOCM, call 1-800-CCF-CARE and ask for Dr. Harry Lever's office.
I hope you find this information useful.

Information provided in the heart forum is for general purposes only. Specific
diagnoses and therapies can only be provided by your physician.

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