
Septal reduction therapy (SRT) in patients with obstructive hypertrophic cardiomyopathy (HCM) shows favorable long-term outcomes, with 83% event-free survival at 10 years. Data from 13 high-volume HCM centers in the SHARE registry were analyzed, involving 1832 patients who underwent SRT (25% alcohol septal ablation, 75% septal myectomy). Periprocedural mortality was low at 0.4%, and 92% of patients had significant relief from left ventricular outflow tract obstruction at 1 year. Over a median follow-up of 6.8 years, heart failure (HF) events occurred in 13% of patients, and ventricular arrhythmias were rare (5%). Predictors of HF included older age at SRT and female sex. Despite high initial success, pediatric patients showed a 16% incidence of HF composite outcomes, highlighting SRT’s effectiveness. There is also a need for long-term monitoring, especially in older and female patients.
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