The article emphasizes that proper patient selection for either procedure is key. Further, it emphasizes the necessity of having both procedures done at at high volume center in order to increase the odds of a successful procedure.
And, despite the overwhelming evidence that septal reduction procedures performed at high volume centers have superior outcomes, 70% of septal reduction procedures are still being performed at low volume centers.
We need to spread the word that the success of septal reduction procedures is highly dependent on the experience and volume of the center!
Beginning with the introduction of the procedure at the National Institute of Health in the early 1960s, this paper surveys the history of the procedure until the present day. The conclusion of the paper is that myectomy remains the best treatment for patients with obstructive hypertrophic cardiomyopathy.
Good stories usually have a protagonist who is confronted with a challenge or conflict. The story then follows the protagonist’s journey to overcome that challenge. Often, there are one or more attempts at conflict resolution which prove unsuccessful, or that even make things worse before the path to success is revealed. In the end, the best stories are those where that successful path was right in front of the protagonist the entire time.
The Challenge for HCM Patients: Local Cardiologist vs. Center of Excellence
For a good story related to the world of hypertrophic cardiomyopathy, you need look no further than Jill Celeste’s HCMBeat blog post entitled “Myectomy: A Twice in a Lifetime Experience.” The protagonist in this story is obviously Jill. The conflict is the impact of her HCM symptoms on her quality of life. Her journey included unsuccessful forays into different therapies before finally, Jill arrived at the resolution of her conflict by seeking care at a medical center with dedicated expertise in the treatment of HCM.
In the sake of full disclosure, that center happens to be Mayo Clinic where I work. Jill’s great storytelling reminded me how some really clever books and movies tell the same story from a different point of view. In this blog post, I would like to give you my point of view as a physician who directs a HCM specialty center of the best way that you can navigate your own HCM. I will share how care by a “center of excellence” can fit into the bigger picture of your HCM care and give you some suggestions for ways to balance so you can work well with both your local care team as well as a specialty center that may be a long way from your home. Continue reading “Guest Blogger – The View from a HCM Center – by Dr. Steve Ommen of Mayo Clinic’s HCM Center”→
This editorial written by Drs. Steve Ommen and Rick Nishimura of Mayo Clinic’s HCM Center, citing the research of Kim, makes a very strong case that septal reduction procedures should be done ONLY in high volume centers.