Hypertrophic cardiomyopathy: current understanding and treatment objectives.

The understanding of hypertrophic cardiomyopathy (HCM) has changed dramatically over the last few decades, and it is now understood to be caused by a mutation in one of several cardiac sarcomeric genes. Due to complications such as outflow tract obstruction, diastolic dysfunction, arrhythmias, stroke, infective endocarditis and sudden cardiac death, appropriate and early identification of these patients is imperative. This review attempts to summarise the current state of knowledge on HCM, and provide insight of the appropriate investigations needed in patients with HCM. It also outlines treatment strategies for these patients. Much remains unknown about this complex and intriguing disease, and continued research in identifying the genetic basis of HCM, along with the assessment of therapeutic strategies, will help to optimise patient care.

Aortic stent grafts.

Abdominal aortic aneurysms (AAAs) occur when weakened areas of the abdominal aortic wall result in a ballooning of the blood vessel. Attributed risk factors include smoking, atherosclerosis and hypertension. Traditionally, AAAs were treated with open surgery, involving a large abdominal incision and the placement of a synthetic graft. The introduction of endovascular aneurysm repair (EVAR) however, proved to have many advantages over open repair, chief among which is a lower perioperative morbidity and mortality rate. EVAR is likely to continue to evolve and the complications associated with this procedure will likely continue to decrease. In the meantime, the benefit of the continued, detailed analyses of explanted devices is twofold: (1) for future development of new devices; and (2) cognisance of complications that arise with any new device. This review is a guide to the many FDA approved stents which are commercially available, and those likely to become available following clinical trials.