(III-2B ) 61-year-old male with hypertrophic cardiomyopathy Joanna Łuszczak MD, Agnieszka Żygadło MD, Lidia Tomkiewicz-Pająk MD, PhD, Prof. Maria Olszowska MD, PhD, Prof. Piotr Podolec MD, PhD

BRIEF COMMENTS

EXPERT: Prof. Roland Hetzer, MD, PhD
Affiliation: German Heart Instiute, Berlin, Germany
COMMENT
Hemodynamic parameters in the check-up TTE do not differ much from the previous findings. What is more important – the LVOT pressure gradient remains high. I recommend full possible spectrum of pharmacotherapy (for example addition of disopiramide) and cardiosurgical consultation. Currently in this patient cardiosurgical risk is low and I would consider hybrid surgical treatment – septal myectomy with MV annuloplasty (in order to reduce SAM effect which appears to be the dominant hemodynamic issue at present). Septal myectomy is preferable to percutaneous ablation because in the latter case myocardial necrosis will make future cardiosurgical intervention very difficult.

CONCLUSIONS

1. Optimal pharmacotherapy (e.g addition of calcium channel blocker or disopiramide)
2. In case of ineffective medication treatment – cardiosurgical consultation.

• EXPERTISE 1

“Development of the European Network in Orphan Cardiovascular Diseases”
„Rozszerzenie Europejskiej Sieci Współpracy ds. Sierocych Chorób Kardiologicznych”