258 ment and are indicated for more aggressive therapies, such as myotomy-myectomy-septal resection, dual-chamber pacemaker implantation, alcohol injection in the septal artery, defibrillator implantation (used in cases at high risk for sudden death), and even heart transplantation 3,4. Mitral stenosis is usually of rheumatic origin, occurring mainly among women (approximately 66% of the cases)...

Surgical relief of left ventricular outflow tract obstruction (LVOTO) in hypertrophic cardiomyopathy (HCM) requires more than septal myectomy. The procedure is currently the gold standard for all symptomatic HCM patients except those with comorbidities. The operation requires an individualized approach to restore the sophisticated functions of the left ventricular outflow tract (LVOT) without i...

The article published in Revista Española de Cardiologı́a describing the 10-year follow-up after alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) is a welcome addition to the literature. Although the series reflects an earlier experience with a technique that continues to evolve over time, the encouraging long-term outcomes bode well for the next gene...

I thank Alpat and Yilmaz [1] for their interest in my article published in the journal. It is my pleasure to respond. In our hypertrophic obstructive cardiomyopathy (HOCM) group with severe hypertrophy and obstruction of the right ventricular outflow tract (RVOT), we had no cases with severe mitral incompetence [2]. A systolic anterior movement of the mitral valve (SAM) after surgery was noted ...

A diagnosis of Hirschsprung's disease should be considered in children with constipation. An accurate neonatal history of bowel function and testing of anorectal pressure responses will aid the diagnosis. In the period 1971-75 inclusive, 140 children, aged 6 months to 14 years, were investigated by anorectal manometry. 26 showed a failed inhibition response to rectal dilatation, suggesting Hirs...

long-standing problem facing clinicians caring for atients with hypertrophic cardiomyopathy (HCM) is he scarcity of robust clinical evidence on which to base herapeutic decisions. For most interventions, there are o randomized controlled trial data. Rather, much of the iterature consists of retrospective observational studies ith historical controls. Individual referral centers with pecialist i...