Combined anterior mitral valve leaflet retention plasty and septal myectomy in patients with hypertrophic obstructive cardiomyopathy

Nasseri, Boris A.; Stamm, Christof; Siniawski, Henryk; Kukucka, Marian; Komoda, Takeshi; Walter, Eva Maria Delmo; Hetzer, Roland

doi:10.1016/j.ejcts.2011.03.040

Cited by 21 publications

(29 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Resting LVOT gradient by transthoracic echocardiogram significantly reduced at discharge to 13 (22) mm Hg (P = 0.025, compared with preoperative values by Student paired t test). Median hospital stay length was 7 days.…”

Section: Resultsmentioning

confidence: 86%

Minimally Invasive Septal Myectomy for the Treatment of Hypertrophic Obstructive Cardiomyopathy and Intrinsic Mitral Valve Disease

Gilmanov

Bevilacqua

Solinas

et al. 2015

Innovations�(Phila)

View full text Add to dashboard Cite

Objective Transaortic left ventricular septal myectomy described by Morrow is a classical procedure for the treatment of systolic anterior motion of the mitral apparatus associated with hypertrophic obstructive cardiomyopathy (HOCM). We aimed to review our results of transmitral septal myectomy and mitral valve repair/replacement in patients with intrinsic mitral valve disease associated with HOCM, operated on through a minimally invasive approach. Methods Between 2005 and 2014, 19 patients [7 men (37%); mean (SD) age, 69.4 (14.5) years] were treated with minimally invasive approach for degenerative mitral regurgitation and HOCM. Preoperative peak left ventricular outflow tract (LVOT) gradient was 66 (24) mm Hg. Severe mitral regurgitation was diagnosed in 16 cases (84%). New York Heart Association functional class III to IV heart failure was present in 13 patients (68%). Results Fifteen patients (79%) underwent mitral valve replacement, and four patients (21%) underwent mitral valve repair. Left ventricular outflow tract obstruction was corrected directly in all patients via the mitral valve with septal myectomy/myotomy, avoiding aortotomy in majority of the patients. No significant prolongation of extracorporeal circulation/aortic cross-clamping times was observed ( P = 0.41 and P = 0.67, respectively) when compared with a similar population without HOCM. No iatrogenic ventricular septal defect developed in treated patients. No hospital mortality occurred. Resting LVOT gradient reduced at discharge to 13 (22) mm Hg ( P = 0.025). Conclusions Transmitral left ventricular septal myectomy in patients with degenerative mitral valve disease is quite a simple, feasible, and effective technique and does not require aortotomy in most cases. It can be performed with low early mortality and satisfactory resolution of LVOT obstruction in a minimally invasive setting.

show abstract

Section: Resultsmentioning

confidence: 86%

Minimally Invasive Septal Myectomy for the Treatment of Hypertrophic Obstructive Cardiomyopathy and Intrinsic Mitral Valve Disease

Gilmanov

Bevilacqua

Solinas

et al. 2015

Innovations�(Phila)

View full text Add to dashboard Cite

show abstract

“…Разными авторами были предложены различные методики клапаносохраняющих операций у пациентов с ГКМП, включая увеличение передней створки МК [12][13][14], ретенционные пластики [15,16], пликационные техники [17][18][19] и подклапанные вмешательства [4,7,19]. Выбор техники чаще всего хирург-зависимый, нежели универсальный, особенно в случае необходимости выполнения повторной окклюзии аорты.…”

Section: Discussionunclassified

Septal Myectomy With Subvalvular Apparatus Intervention in Patients With Hypertrophic Obstructive Cardiomyopathy: Immediate Results

Афанасьев¹,

Богачев-Прокофьев²,

Железнев³

et al. 2018

Sibirskij medicinskij žurnal

View full text Add to dashboard Cite

Aim. Surgical septal myectomy is a standard treatment option for patients with hypertrophic obstructive cardiomyopathy. Subvalvular abnormalities of the mitral valve may play an important role in residual left ventricular outflow tract obstruction. This study aimed to evaluate the surgical outcomes of septal myectomy with subvalvular interventions.Material and Methods. Between July, 2015 and December, 2016, 40 eligible patients underwent septal myectomy with subvalvular intervention. The peak gradient was 92.3±16.9 mm Hg. The mean septum thickness was 26.8±4.5 mm. Moderate or severe systolic anterior motion syndrome-mediated mitral regurgitation was observed in all patients.Results. There was no residual mitral regurgitation. Residual systolic anterior motion syndrome was observed in 5%. The postoperative gradient was 8.7±4.5 mm Hg. At 12-month follow-up, all patients were alive. According to the New York Heart Association (NYHA) classification, 87.5 and 12.5% of patients had NYHA functional classes I and II, respectively. The prevalence rate of residual mitral regurgitation was 10%.Conclusions. Concomitant subvalvular intervention during septal myectomy effectively eliminated left ventricular outflow tract obstruction and provided high freedom from residual mitral regurgitation one year after surgery.

show abstract

“…To address HOCM and concomitant mitral valve disease, a variety of techniques have been described . First, a standard trans‐aortic septal myectomy and a trans‐atrial mitral valve repair or replacement can be performed with adequate results . However, this traditional approach involves bicaval cannulation, atriotomy, mitral valve exposure, as well as an aortotomy.…”

Section: Discussionmentioning

confidence: 99%

“…8 First, a standard trans-aortic septal myectomy and a trans-atrial mitral valve repair or replacement can be performed with adequate results. 4,9 However, this traditional approach involves bicaval cannulation, atriotomy, mitral valve exposure, as well as an aortotomy. To avoid this and potentially simplify the procedure, a variety of alternative techniques have been proposed.…”

Section: Discussionmentioning

confidence: 99%

Trans-aortic Alfieri stitch at the time of septal myectomy for hypertrophic obstructive cardiomyopathy

2016

View full text Add to dashboard Cite

show abstract

Combined anterior mitral valve leaflet retention plasty and septal myectomy in patients with hypertrophic obstructive cardiomyopathy

Abstract: Combined subaortic septal myectomy and ALRP is a safe and effective therapy in HOCM patients with significant SAM. ALRP can help prevent residual or recurrent LVOT obstruction and improves mitral regurgitation.

Cited by 21 publications

References 19 publications

Minimally Invasive Septal Myectomy for the Treatment of Hypertrophic Obstructive Cardiomyopathy and Intrinsic Mitral Valve Disease

Minimally Invasive Septal Myectomy for the Treatment of Hypertrophic Obstructive Cardiomyopathy and Intrinsic Mitral Valve Disease

Septal Myectomy With Subvalvular Apparatus Intervention in Patients With Hypertrophic Obstructive Cardiomyopathy: Immediate Results

Trans-aortic Alfieri stitch at the time of septal myectomy for hypertrophic obstructive cardiomyopathy

Contact Info

Product

Resources

About