Hypertrophic obstructive cardiomyopathy is a hereditary condition that affects myocardial contraction. In case of failure of pharmacological treatment, alternative approaches might be used that include surgical myectomy, percutaneous transluminal septal myocardial ablation, and radiofrequency ablation. In respect of long-term advantages, surgical septal myectomy remains the therapy of choice for symptomatic hypertrophic obstructive cardiomyopathy. Alcohol septal ablation has been considered an alternative to surgical myectomy, which confers the benefits of a shorter hospital stay, less discomfort, and fewer complications. However, only expert operators should perform it on carefully chosen patients. Further, radiofrequency septal ablation reduces the left ventricular outflow tract gradient and improves the NYHA functional class of patients with hypertrophic obstructive cardiomyopathy, despite complications like cardiac tamponade and atrioventricular block. Further research with a larger sample size is required to compare the radiofrequency approach with established invasive treatment methods for hypertrophic obstructive cardiomyopathy. Septal myectomy has low morbidity and mortality rates, making it the preferred procedure; however, the efficacy and morbidity remain debatable. Advances in invasive techniques, including percutaneous septal radiofrequency ablation and transcatheter myotomy, have provided alternative approaches for reducing left ventricular outflow tract (LVOT) obstruction in patients who are not candidates for traditional surgical septal myectomy. Candidates for alcohol and radiofrequency septal ablation include patients with symptomatic hypertrophic obstructive cardiomyopathy, older adults, and those with multiple comorbidities.
Introdução: A telemedicina é uma união entre a medicina e a tecnologia, visando o oferecimento de amplo espectro de serviços à comunidade. Durante a pandemia, a telemedicina se tornou essencial, mas levantou o questionamento se a tecnologia de fato poderia ser utilizada para o treinamento médico de acadêmicos. Métodos: Trata-se de uma revisão integrativa da literatura nas bases de dados Pubmed, Cochrane e LILACS com os descritores “telemedicine” e “medical education”. Resultados: De 1675 artigos, 17 estudos fizeram parte da amostra final. A telemedicina, embora apresente pontos negativos, demonstrou-se extremamente custo-efetiva e, por vezes, subestimada. Conclusão: Os artigos demonstraram consonância dos ao inferir que a telemedicina se torna efetiva no ambiente acadêmico, ao proporcionar maior interatividade, integração dos conteúdos, acesso a oportunidades de aprendizado e maior nível de confiança em teleconsultas. Desta forma, se torna necessário a realização de mais estudos para que a telemedicina possa ser aplicada amplamente, reduzindo as suas limitações.
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