Minimally Invasive Surgery for Hypertrophic Obstructive Cardiomyopathy With Mitral Regurgitation

Jiang, Zhaolei; Tang, Min; Líu, Hao; Ma, Nan; Ding, Fang; Bao, Chunde; Mei, Ju

doi:10.1016/j.athoracsur.2020.06.028

Cited by 4 publications

(7 citation statements)

References 33 publications

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“…However, a reduction in EF was also observed, which was still in the range for a normal EF. Previous reports on echocardiographic outcomes of HCM surgeries have reported similar results 34,41,42 …”

Section: Discussionsupporting

confidence: 59%

“…Previous reports on echocardiographic outcomes of HCM surgeries have reported similar results. 34,41,42 The most common postoperative complication was heart block, which was reported in 5.9% of the patients requiring CIED. Although lower rates of this complication have been reported by several studies, 30,[43][44][45] the 2016 nationwide reports from US hospitals reported a 9%-14% requirement for ICD implantation in these patients.…”

Section: Discussionmentioning

confidence: 99%

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Comparing long‐term outcomes of septal myectomy and mitral valve replacement in hypertrophic cardiomyopathy patients: A retrospective cohort study in Iran

Ayati,

Khoshfetrat,

Davoodi

et al. 2024

Health Science Reports

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BackgroundHypertrophic cardiomyopathy (HCM) affects millions of individuals worldwide. In severe cases, it can cause life‐threatening conditions such as left ventricular outflow tract (LVOT) obstruction, mitral regurgitation (MR), and sudden cardiac death, making surgical treatment necessary. This study aimed to report the long‐term outcomes of HCM patients undergoing septal myectomy or mitral valve replacement (MVR) and compare the results between different types of surgeries.MethodsThis was a retrospective cohort study on HCM patients who underwent surgical treatment in an Iranian referral center between 2005 and 2021. Patients were divided into three groups according to the type of surgery received: septal myectomy, MVR, or a combination of both surgeries. Patient characteristics, surgical and echocardiographic features, and in‐hospital and long‐term outcomes were reported and compared between the three groups.ResultsA total of 102 patients with an average age of 53.3 ± 16.9 were included. Twenty‐six patients had septal myectomy, 23 had MVR, and 53 had combined septal myectomy and MVR surgery. All surgeries were associated with a significant reduction in interventricular septum thickness and LVOT gradients. After a median of 6.8‐year follow‐up time, patients with an isolated septal myectomy had significantly lower mortality and major adverse cardiac and cerebrovascular events rates than the other groups.ConclusionIsolated septal myectomy showed better long‐term survival rates and can correct HCM‐related MR, while MVR should be preserved only for intrinsic valve defects. More extensive studies are needed to confirm these findings and achieve a comprehensive guideline on surgical treatment of HCM.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Comparing long‐term outcomes of septal myectomy and mitral valve replacement in hypertrophic cardiomyopathy patients: A retrospective cohort study in Iran

Ayati,

Khoshfetrat,

Davoodi

et al. 2024

Health Science Reports

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“…Unlike SM, PIMSRA does not have the ability to carry out MV repair during surgery, [29][30][31] even though it is just as effective as SM in reducing the LVOT gradient. [32][33][34] to being swept into the septum. 35 The comparison between SAM patients and normal subjects who have HCM reveals that SAM patients have a smaller distance between the MV leaflet coaptationseptal (C-sept).…”

Section: Discussionmentioning

confidence: 99%

“…We noticed a considerable decline in SAM following the PIMSRA procedure. Unlike SM, PIMSRA does not have the ability to carry out MV repair during surgery, 29–31 even though it is just as effective as SM in reducing the LVOT gradient 32–34 . PIMSRA reduces SAM based on similar principles to Mavacamten.…”

Section: Discussionmentioning

confidence: 99%

Short time effects of two radiofrequency ablation methods on hypertrophic obstructive cardiomyopathy

He,

Dong,

Yang

et al. 2024

Clinical Cardiology

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BackgroundRadiofrequency ablation has been applied for the treatment of hypertrophic obstructive cardiomyopathy (HOCM). The two known procedures are percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) and endocardial radiofrequency septal ablation (ERSA).MethodsThis study presents a retrospective analysis of the PIMSRA and ERSA procedures in patients with drug‐refractory HOCM. A total of 28 patients participated in the study, with 12 receiving PIMSRA and 16 receiving ERSA. The objective of our study was to compare the short‐term effects of these two radiofrequency ablation procedures.ResultsAt the 30‐day follow‐up, the PIMSRA group demonstrated a greater reduction in left ventricular outflow tract peak gradient at rest compared to the ERSA group (22.25 [16.72] mmHg versus 47.75 [21.94] mmHg) (p < .01). The values for the PIMSRA group decreased from 99.33 (32.00) mmHg to 22.25 (16.72) mmHg (p < .01), while the ERSA group decreased from 97.75 (30.24) mmHg to 47.75 (21.94) mmHg (p < .01). Only the PIMSRA group exhibited a decrease in mitral regurgitation (MR). The area of MR decreased from 10.13 (4.12) mm2 to 3.65 (2.80) mm2 in the PIMSRA group (p < .01). Additionally, the PIMSRA group experienced reductions in left atrial diameter (LAD) and left ventricular ejection fraction (LVEF)%. The values for LAD changed from 43.58 (7.53) mm to 37.08 (6.92) mm (p = .03), and the values for LVEF% decreased from 65.75 (6.12) pg/mL to 60.83 (4.06) pg/mL (p = .03).ConclusionIn terms of the two types of radiofrequency ablation methods used in HOCM, it has been observed that PIMSRA demonstrates a more favorable early treatment effect compared to ERSA.

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“…Both groups had significant reductions in NYHA class, similar resting LVOT gradients at follow-up, similar median times on bypass, and similar major complication rates. The mini-sternotomy group had a slightly longer (39 min versus 35 min; p = 0.017) time while on cross clamp [ 116 ].…”

Section: Minimally Invasive Surgerymentioning

confidence: 99%

Review of Contemporary Invasive Treatment Approaches and Critical Appraisal of Guidelines on Hypertrophic Obstructive Cardiomyopathy: State-of-the-Art Review

Lebowitz

Kowalewski

Raffa

et al. 2022

JCM

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Background: Hypertrophic obstructive cardiomyopathy (HOCM) is a heterogeneous disease with different clinical presentations, albeit producing similar dismal long-term outcomes if left untreated. Several approaches are available for the treatment of HOCM; e.g., alcohol septal ablation (ASA) and surgical myectomy (SM). The objectives of the current review were to (1) discuss the place of the standard invasive treatment modalities (ASA and SM) for HOCM; (2) summarize and compare novel techniques for the management of HOCM; (3) analyze current guidelines addressing HOCM management; and (4) offer suggestions for the treatment of complex HOCM presentations. Methods: We searched the literature and attempted to gather the most relevant and impactful available evidence on ASA, SM, and other invasive means of treatment of HOCM. The literature search yielded thousands of results, and 103 significant publications were ultimately included. Results: We critically analyzed available guidelines and provided context in the setting of patient selection for standard and novel treatment modalities. This review offers the most comprehensive analysis to-date of available invasive treatments for HOCM. These include the standard treatments, SM and ASA, as well as novel treatments such as dual-chamber pacing and radiofrequency catheter ablation. We also account for complex pathoanatomic presentations and current guidelines to offer suggestions for tailored care of patients with HOCM. Finally, we consider promising future therapies for HOCM. Conclusions: HOCM is a heterogeneous disease associated with poor outcomes if left untreated. Several strategies for treatment of HOCM are available but patient selection for the procedure is crucial.

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Minimally Invasive Surgery for Hypertrophic Obstructive Cardiomyopathy With Mitral Regurgitation

Cited by 4 publications

References 33 publications

Comparing long‐term outcomes of septal myectomy and mitral valve replacement in hypertrophic cardiomyopathy patients: A retrospective cohort study in Iran

Comparing long‐term outcomes of septal myectomy and mitral valve replacement in hypertrophic cardiomyopathy patients: A retrospective cohort study in Iran

Short time effects of two radiofrequency ablation methods on hypertrophic obstructive cardiomyopathy

Review of Contemporary Invasive Treatment Approaches and Critical Appraisal of Guidelines on Hypertrophic Obstructive Cardiomyopathy: State-of-the-Art Review

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