Optimal reconstruction of left ventricular outflow tract obstruction before surgical myectomy in a case with hypertrophic obstructive cardiomyopathy

2018 ◽  
Vol 35 (4) ◽  
pp. 537-540 ◽  
Author(s):  
Hiroyuki Toh ◽  
Shumpei Mori ◽  
Shinsuke Shimoyama ◽  
Yu Izawa ◽  
Shun Yokota ◽  
...  
Keyword(s):  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
Optimal Reconstruction ◽  
Left Ventricular Outflow ◽  
Surgical Myectomy

Hypertrophic obstructive cardiomyopathy: review of surgical treatment

2017 ◽  
Vol 25 (9) ◽  
pp. 594-607 ◽  
Author(s):  
Jonathan Price ◽  
Nicholas Clarke ◽  
Aslan Turer ◽  
Eduard Quintana ◽  
Carlos Mestres ◽  
...  
Keyword(s):  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Percutaneous Ablation ◽  
Pharmacologic Therapy ◽  
Ventricular Outflow Tract Obstruction ◽  
Left Ventricular Outflow ◽  
Surgical Myectomy

Hypertrophic cardiomyopathy ranks among the most common congenital cardiac diseases, affecting up to 1 in 200 of the general population. When it causes left ventricular outflow tract obstruction, treatment is guided to reduce symptoms and the risk of sudden cardiac death. Pharmacologic therapy is the first-line treatment, but when it fails, surgical myectomy or percutaneous ablation of the hypertrophic myocardium are the standard therapies to eliminate subaortic obstruction. Both surgical myectomy and percutaneous ablation are proven safe and effective treatments; however, myectomy is the gold standard with a significantly lower complication rate and more complete and lasting reduction of left ventricular outflow tract obstruction.

scholarly journals SEPTAL MYECTOMY WITH SUBVALVULAR APPARATUS INTERVENTION IN PATIENTS WITH HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY: IMMEDIATE RESULTS

2018 ◽  
Vol 33 (3) ◽  
pp. 71-77
Author(s):  
A. V. Afanasyev ◽  
A. V. Bogachev-Prokophiev ◽  
S. I. Zheleznev ◽  
R. M. Sharifulin ◽  
A. S. Zalesov ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Systolic Anterior Motion ◽  
Septal Myectomy ◽  
Ventricular Outflow Tract Obstruction ◽  
Left Ventricular Outflow

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.

scholarly journals Anomalous Papillary Muscle Insertion Causing Dynamic Left Ventricular Outflow Tract Obstruction without Hypertrophic Obstructive Cardiomyopathy

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Ravi Korabathina ◽  
Katherine Chiu ◽  
Hugh M. van Gelder ◽  
Arthur Labovitz
Keyword(s):  
Papillary Muscle ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Mitral Valve Leaflet ◽  
Ventricular Outflow Tract Obstruction ◽  
Muscle Insertion ◽  
Left Ventricular Outflow

Anomalous papillary muscle insertion directly into the surface of the mitral valve leaflet is rare, especially in a subject without apparent evidence of hypertrophic cardiomyopathy. We present a case of this isolated congenital malformation producing two hemodynamic sequelae of dynamic left ventricular outflow tract obstruction and severe mitral regurgitation.

Sign in / Sign up

Export Citation Format

Share Document