Innovative surgical therapies for all patients

The treatment of HCM. The specialists speak

di Francesca Conti

The first edition of the event was held on June 18th at the Meyer Health Campus in Florence Course on the treatment of Obstructive Hypertrophic Cardiomyopathy: focus on cardiac surgery and medical therapy, organized by Prof. Franco Cecchi, Iacopo Olivotto, Pierluigi Stefàno, Paolo Ferrazzi, and sponsored by AICARM. The course, which was well attended, saw the presence of the main Italian experts in cardiomyopathies.

We spoke with some of the experts present such as Pierluigi Stefàno, Director of Cardiac Surgery at Careggi, Iacopo Olivotto, head of the Intercompany Center for the research and treatment of Cardiomyopathies AOU Careggi and Meyer, and Paolo Ferrazzi, Director of the Center for Hypertrophic Cardiomyopathy and Valvular heart disease at the Monza Polyclinic. Everyone underlined the fundamental role of AICARM for its action of dissemination and support for patients with cardiomyopathies and for its ability to bring together all the experts in the sector, reiterating the centrality of people, patients and their families.

Paolo Ferrazzi reiterated the importance of cardiac surgery. Also recalling the first transplants carried out - Ferrazzi performed the third transplant in Italy and over 10.000 cardiac surgical operations, of which over 500 in patients with obstructive Hypertrophic Cardiomyopathy (CMI) - he underlined how the surgical intervention of myectomy and mitral plastic surgery allows to improve the symptoms significantly. It is an important result, especially for young patients, who can live a practically "normal" life, even if they still have to undergo periodic checks. 'All this' stated Ferrazzi 'has been possible thanks to continuous research and study, to the improvement of the surgical technique, which must always be adapted to the anomalies identified in the individual patient. We must continue in this direction 'he continued' and be influenced as little as possible by economic logic, which we must necessarily take into account, but continuing to work in the patient's interest'.

Pierluigi Stefàno also focused on the surgical treatment of HCM, on how, in recent years, interventions have made significant progress towards minimally invasive techniques. These methodologies do not limit themselves to reducing the size of surgical incisions, but also aim to reduce the overall impact of surgical trauma, so as to allow for a quicker recovery after surgery, with clear benefits for both young and elderly people. . If for younger patients timely recovery is crucial for the return to work and physical activities, for the elderly the reduction of surgical trauma offers an enormous advantage, allowing them to recover more quickly and return to their daily lives.

For Stefano: 'The main objective is to guarantee the best possible treatment, resolve the intraventricular obstruction and ensure an excellent post-operative quality of life. The reduction of surgical trauma is essential for a fast and less painful recovery, reducing the fear linked to traditional interventions with the opening of the sternum. It is essential' he continued 'to adequately inform patients, alleviate their concerns about traditional surgery and promote awareness of the benefits of minimally invasive techniques. Clear and precise information can in fact encourage acceptance of the operation when necessary, and ensure patients not only a reduction in trauma, but also the possibility of a normal life after the operation.'

Finally, Iacopo Olivotto focused on the importance of centers specialized in the diagnosis and treatment of cardiomyopathies.

'During the day,' he stated, 'the need emerged to identify the specialized centers capable of offering the best support to patients suffering from HCM and other cardiomyopathies. These centers must be able to provide a complete range of therapeutic options, constituting real "Heart teams", i.e. multidisciplinary groups with specific experience. They can evaluate on a case-by-case basis and determine the most appropriate solution for each patient, without being limited by the availability of just one therapeutic option. In Italy there are already such centers of excellence, characterized by experts of the highest level and real spearheads in the field of cardiology. The presence of these specialists is distributed throughout the national territory and guarantees good coverage.

'Precisely from this perspective,' he concluded, 'it was decided to establish a register of innovative therapies for HCM, coordinated by the undersigned at the University of Florence. This registry represents a fundamental tool for collecting data, further improving therapeutic strategies, contributing to optimizing the care and quality of life of patients suffering from this pathology.