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Septal myectomy

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https://www.readbyqxmd.com/read/29764684/does-septal-myectomy-reduce-risk-of-sudden-cardiac-death-in-patients-with-hypertrophic-cardiomyopathy
#1
EDITORIAL
Hartzell V Schaff, Anita Nguyen
No abstract text is available yet for this article.
April 25, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29761339/-syncope-in-hypertrophic-obstructive-cardiomyopathy
#2
REVIEW
Hubert Seggewiß, Angelika Koljaja-Batzner, Kornelia Seggewiß, Malte Meesmann
Hypertrophic cardiomyopathy is the most common genetic cardiac disease. The most important pathophysiological finding is dynamic (outflow tract) obstruction of the left ventricle in about 70% of affected patients. Especially in younger patients, an increased risk of sudden cardiac death has been observed. Syncope and presyncope-in addition to extremely variable cardiac symptoms (dyspnea and angina)-are common. The etiology of syncope is complex. The most important aspect for diagnosis is a detailed history regarding the accompanying circumstances of the syncope...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29753818/routine-papillary-muscle-realignment-and-septal-myectomy-for-obstructive-hypertrophic-cardiomyopathy
#3
Howard K Song, Jason Turner, Rebekah Macfie, Suwen Kumar, Meghan J Mannello, Danielle Smith, Castigliano Bhamidipati, Jaishankar Raman, Frederick Tibayan, Stephen B Heitner
BACKGROUND: Septal myectomy has been the mainstay of the surgical treatment of obstructive hypertrophic cardiomyopathy (HCM), however recently there is growing appreciation for associated mitral valve abnormalities that contribute to left ventricular outflow tract (LVOT) obstruction. In this study, we describe our experience with combined papillary muscle realignment (PMR) and septal myectomy for the treatment of obstructive HCM. METHODS: We identified 44 patients undergoing surgery for obstructive HCM whose anatomy was amenable to combined PMR and septal myectomy at our institution over a 20-month period...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29736811/transcatheter-septal-ablation-in-hypertrophic-obstructive-cardiomyopathy-a-technical-guide-and-review-of-published-results
#4
REVIEW
Angelos G Rigopoulos, Stefanos Sakellaropoulos, Muhammad Ali, Sophie Mavrogeni, Athanassios Manginas, Matthias Pauschinger, Michel Noutsias
Transcatheter alcohol septal ablation (ASA) treatment of symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM) is based on the existence and degree of intraventricular obstruction. Patients with significant gradient and symptoms who do not respond to optimal medical therapy are eligible to gradient reduction through a surgical (septal myectomy) or a transcatheter (alcohol septal ablation) septal reduction. The latter encompasses occlusion of a septal branch perfusing the hypertrophied septum, which is involved in the generation of obstruction, by injecting ethanol into the supplying septal branch(es)...
May 8, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29679534/determinants-of-reverse-remodeling-of-the-left-atrium-following-transaortic-myectomy
#5
Anita Nguyen, Hartzell V Schaff, Rick A Nishimura, Joseph A Dearani, Jeffrey B Geske, Brian D Lahr, Steve R Ommen
BACKGROUND: In patients with hypertrophic cardiomyopathy (HCM), enlargement of the left atrium (LA) is associated with increased morbidity and mortality due to risk of atrial fibrillation (AF), stroke, and heart failure. In this study, we investigated whether LA reverse remodeling occurs following septal myectomy. METHODS: Between March 2007 and July 2015, 656 patients underwent myectomy at our institution and had pre- and postoperative transthoracic echocardiographic (TTE) recording of LA volume index (LAVI)...
April 18, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29655822/clinical-spectrum-and-management-of-heart-failure-in-hypertrophic-cardiomyopathy
#6
REVIEW
Barry J Maron, Ethan J Rowin, James E Udelson, Martin S Maron
Heart failure (HF), characterized by excessive exertional dyspnea, is a common complication within the broad clinical spectrum of hypertrophic cardiomyopathy (HCM). HF has become an increasingly prominent management issue with the reduction in sudden deaths due to use of implantable defibrillators in this disease. Exertional dyspnea ranges in severity from mild to severe (New York Heart Association functional classes II to IV) and not uncommonly becomes refractory to medical management, leading to progressive disability, but largely in the absence of pulmonary congestion and volume overload requiring hospitalization...
May 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29628474/preoperative-simulation-using-ct-virtual-endoscopy-for-minimally-invasive-surgery-of-hypertrophic-obstructive-cardiomyopathy
#7
Toshinori Totsugawa, Masatoshi Tsunoda, Nobuyuki Kagiyama, Yuki Otsuki, Hidenori Yoshitaka, Taichi Sakaguchi
Transaortic septal myectomy is a procedure that involves a learning curve for surgeons because the bulging interventricular septum usually interferes with the visualization of the deep parts of the left ventricular chamber. In this case report, we demonstrate computed tomography virtual endoscopy for preoperative simulation, which enabled us to clearly image the relationship among the bulging septum, the expected myectomy area, and the structures deep in the left ventricle, such as the papillary muscle and abnormal muscular bundles, which are hidden by the hypertrophic septum, thus preventing visualization...
April 6, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29607159/application-of-3d-printing-in-the-surgical-planning-of-hypertrophic-obstructive-cardiomyopathy-and-physician-patient-communication-a-preliminary-study
#8
Hong-Chang Guo, Yang Wang, Jiang Dai, Chang-Wei Ren, Jin-Hua Li, Yong-Qiang Lai
Background: The aim of this study was to evaluate the effect of 3-dimensional (3D) printing in treatment of hypertrophic obstructive cardiomyopathy (HOCM) and its roles in doctor-patient communication. Methods: 3D-printed models were constructed preoperatively and postoperatively in seven HOCM patients received surgical treatment. Based on multi-slice computed tomography (CT) images, regions of disorder were segmented using the Mimics 19.0 software (Materialise, Leuven, Belgium)...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29602755/pathoanatomic-findings-and-treatment-during-hypertrophic-obstructive-cardiomyopathy-surgery-the-role-of-mitral-valve
#9
Giuseppe M Raffa, Giuseppe Romano, Marco Turrisi, Marco Morsolini, Giovanni Gentile, Sergio Sciacca, Alessandro Armaro, Vincenzo Stringi, Gabriella Mattiucci, Serena Magro, Fabiola Cosentino, Francesco Clemenza, Michele Pilato
BACKGROUND: To assess the role of the mitral valve apparatus (leaflets, chordae and papillary muscles, PM) in left ventricle outflow tract (LVOT) obstruction, and results of the surgical treatment for hypertrophic obstructive cardiomyopathy (HOCM). METHODS: Twenty-eight consecutive patients (58±11years, 53% female) undergoing HOCM surgery from 2007 to 2016 at our institute were retrospectively reviewed. Endpoints included the involvement of the mitral valve in LVOT obstruction, mortality, and changes in clinical and echocardiographic characteristics after HOCM surgery...
February 14, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29571985/serotonin-syndrome-following-septal-myectomy-in-association-with-fentanyl-and-methylene-blue-a-case-report
#10
Lindsay Haacker, MaryJo Maliekel, Christina E Hantsch Bardsley, Ryan Bergren, Edwin Meresh, Angelos Halaris
No abstract text is available yet for this article.
February 13, 2018: Psychosomatics
https://www.readbyqxmd.com/read/29549506/minimally-invasive-trans-mitral-septal-myectomy-for-diffuse-type-hypertrophic-obstructive-cardiomyopathy
#11
Taichi Sakaguchi, Toshinori Totsugawa, Kentaro Tamura, Arudo Hiraoka, Genta Chikazawa, Hidenori Yoshitaka
OBJECTIVE: Despite excellent long-term results reported for a trans-aortic septal myectomy for hypertrophic obstructive cardiomyopathy (HOCM), surgery for patients with diffuse hypertrophy is very challenging. In addition, a left ventricular outflow obstruction is often aggravated by an abnormal mitral valve and subvalvular apparatus. METHODS: We performed video-assisted minimally invasive trans-mitral septal myectomy procedures in 3 patients with diffuse-type HOCM, who were highly symptomatic despite maximal medical therapy...
March 16, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29524602/surgical-approaches-to-hypertrophic-obstructive-cardiomyopathy
#12
Zachary Solomon, Catalina Breton, Ethan J Rowin, Barry J Maron, Martin S Maron, Frederick Y Chen, Hassan Rastegar
Left ventricular outflow tract obstruction secondary to hypertrophic obstructive cardiomyopathy remains a challenging entity facing clinicians. Despite the success of invasive therapies, some clinicians remain hesitant because of early results with unacceptable morbidity and mortality rates. However, current literature strongly suggests improved short- and long-term outcomes with extended septal myectomy and alcohol septal ablation compared with patients not undergoing such interventions. This review evaluates hypertrophic obstructive cardiomyopathy treatment with a focus on short- and long-term outcomes, perioperative complications, and major tenets of surgical intervention...
March 7, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29502589/intraoperative-two-and-three-dimensional-transesophageal-echocardiography-in-combined-myectomy-mitral-operations-for-hypertrophic-cardiomyopathy
#13
REVIEW
Robert G Nampiaparampil, Daniel G Swistel, Michael Schlame, Muhamed Saric, Mark V Sherrid
Transesophageal echocardiography is essential in guiding the surgical approach for patients with obstructive hypertrophic cardiomyopathy. Septal hypertrophy, elongated mitral valve leaflets, and abnormalities of the subvalvular apparatus are prominent features, all of which may contribute to left ventricular outflow tract obstruction. Surgery aims to alleviate the obstruction via an extended myectomy, often with an intervention on the mitral valve and subvalvular apparatus. The goal of intraoperative echocardiography is to assess the anatomic pathology and pathophysiology in order to achieve a safe intraoperative course and a successful repair...
March 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29496436/myectomy-and-la-to-lv-conduit-for-severe-calcific-mitral-stenosis-and-hypertrophic-cardiomyopathy
#14
Zahara Meghji, Anita Nguyen, Jeffrey B Geske, Hartzell V Schaff
Severe calcific mitral valve stenosis can rarely occur concomitantly with obstructive hypertrophic cardiomyopathy. In these patients, surgical decalcification of the stenotic mitral valve followed by mitral valve replacement carries significant operative risk and may result in paravalvular leakage, atrioventricular groove disruption, and excessive bleeding. We report the first 2 cases of obstructive hypertrophic cardiomyopathy with severe calcific mitral valve stenosis successfully treated with concomitant transaortic septal myectomy and bypass of the stenotic mitral valve using a valved left atrium to left ventricular conduit...
February 26, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29483385/comparison-of-clinical-effects-between-percutaneous-transluminal-septal-myocardial-ablation-and-modified-morrow-septal-myectomy-on-patients-with-hypertrophic-cardiomyopathy
#15
Hong-Chang Guo, Jin-Hua Li, Teng-Yong Jiang, Chang-Wei Ren, Jiang Dai, Yu-Jie Zhou, Yong-Qiang Lai
Background: Percutaneous transluminal septal myocardial ablation (PTSMA) and modified Morrow septal myectomy (MMSM) are two invasive strategies used to relieve obstruction in patients with hypertrophic cardiomyopathy (HCM). This study aimed to determine the clinical outcome of these two strategies. Methods: From January 2011 to January 2015, 226 patients with HCM were treated, 68 by PTSMA and 158 by MMSM. Both ultrasonic cardiograms and heart functional class were recorded before, after operations and in the follow-up...
March 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29453593/risk-marker-profiles-in-patients-treated-with-percutaneous-septal-ablation-for-symptomatic-hypertrophic-obstructive-cardiomyopathy
#16
Amelie Burghardt, Frank van Buuren, Zisis Dimitriadis, Tim Grübbel, Hubert Seggewiss, Smita Scholtz, Dieter Horstkotte, Lothar Faber
BACKGROUND AND STUDY OBJECTIVE: Different studies have shown a good long-term survival with improvement of symptoms and hemodynamics after percutaneous septal ablation (PTSMA), similar to myectomy considered to be the therapeutic "gold standard" for symptomatic hypertrophic obstructive cardiomyopathy (HOCM). Furthermore, desobliteration of left ventricular (LV) outflow may modify features of the disease considered to be risk-relevant, such as magnitude of LV hypertrophy, outflow gradient, and left atrial (LA) size...
February 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29453001/transmitral-septal-myectomy-for-hypertrophic-obstructive-cardiomyopathy
#17
Brody Wehman, Mehrdad Ghoreishi, Nathaniel Foster, Libin Wang, Michael N D'Ambra, Nathan Maassel, Sam Maghami, Rachael Quinn, Murtaza Dawood, Stacy Fisher, James S Gammie
BACKGROUND: Intrinsic abnormalities of the mitral valve are common in patients with hypertrophic cardiomyopathy and may need to be addressed at operation. METHODS: Consecutive patients undergoing transmitral septal myectomy were retrospectively reviewed. The ventricular septum was exposed through a left atriotomy, and the anterior leaflet of the mitral valve was detached from its annulus. An extended myectomy was performed to the base of the papillary muscles. After myectomy, the anterior leaflet was reattached and concomitant mitral valve repair or replacement was performed...
April 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29450766/septal-myectomy-for-hypertrophic-cardiomyopathy-important-surgical-knowledge-and-technical-tips-in-the-era-of-increasing-alcohol-septal-ablation
#18
REVIEW
Yuting P Chiang, Yuichi J Shimada, Jonathan Ginns, Shepard D Weiner, Hiroo Takayama
Hypertrophic cardiomyopathy (HCM) is the most commonly inherited cardiac disease-recent studies suggest a prevalence as high as 1 in 200. For symptomatic patients with obstructive HCM who are refractory to medical therapy, septal reduction is indicated. Septal myectomy (SM) is considered the gold standard septal reduction technique. However, due to a shortage of surgeons who are experienced in this technique, alcohol septal ablation (ASA) has overtaken SM as the most commonly performed procedure for obstructive HCM...
April 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29438530/hypertrophic-obstructive-cardiomyopathy-what-when-why-for-whom
#19
Carlos A Mestres, Thomas Bartel, Antonio Sorgente, Silvana Müller, Christiane Gruner, Joseph Dearani, Eduard Quintana
Hypertrophic cardiomyopathy is the most common genetic cardiovascular disorder and is associated with symptoms of heart failure and increased risk of sudden cardiac death. The most common condition is obstruction of the left ventricular outflow tract. Surgical septal myectomy and alcohol septal ablation are the 2 accepted modes of septal reduction therapy and are indicated when there are advanced symptoms and a peak left ventricular outflow gradient ≥50 mmHg. Advantages of alcohol septal ablation are limited groin approach, reduction of obstruction of the left ventricular outflow tract and functional improvement, but there are higher chances for intracardiac device implantation and residual obstruction...
April 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29414430/surgical-pathology-of-subaortic-septal-myectomy-histology-skips-over-clinical-diagnosis
#20
João Abecasis, Rosa Gouveia, Mariana Castro, Maria João Andrade, Regina Ribeiras, Sância Ramos, Miguel Abecasis, Nuno Cardim, Victor Gil
BACKGROUND: Subaortic septal myectomy is usually performed to mitigate obstruction in patients with the obstructive form of hypertrophic cardiomyopathy (HCM) or in those with congenital subaortic stenosis. Moreover, it is combined with aortic valve replacement in patients with severe aortic valve stenosis (SAS) and asymmetrical septal hypertrophy causing concomitant left ventricular outflow tract obstruction. When both conditions coexist, it is conceptually difficult to identify a cardiomyopathy beyond an adaptive myocardial hypertrophy, strictly related to pressure overload...
March 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
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