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Septal myectomy

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https://www.readbyqxmd.com/read/29325129/transaortic-septal-myectomy-using-direct-septal-echography
#1
Kanji Matsuzaki, Toru Tsukada, Masataka Sato, Yasunori Watanabe
We applied direct septal echography in transaortic septal myectomy for left ventricular outflow tract obstruction due to hypertrophic obstructive cardiomyopathy and asymmetric septal hypertrophy. A small L-shaped probe was inserted into the right ventricle through a 2-cm incision on the right ventricular outflow tract. The probe was placed directly on the interventricular septum to visualize its actual thickness. It was also helpful to push and expose the septum into a direct field of vision through the aortic annulus...
January 8, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29281016/virtual-and-real-septal-myectomy-using-3-dimensional-printed-models
#2
Uladzimir Andrushchuk, Vitali Adzintsou, Artem Nevyglas, Hanna Model
We present 2 cases of extended septal myectomy using low-cost 3-dimensional (3D) printed models of the interventricular septum with its fragment cut out mechanically or by initial 'virtual' myectomy. 3D prints exhibited excellent cardiac imaging and planning of the 'optimal' volume and shape of the resection, as well as intraoperative quality control of septal myectomy by filling a trough in the 3D-printed interventricular septum with excised myocardium.
December 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29276437/continuous-suture-technique-for-aortic-valve-replacement-shortens-cross-clamp-and-bypass-times
#3
Tadashi Kitamura, James Edwards, Kagami Miyaji
The interrupted noneverting mattress suture technique is typically used in conventional surgical aortic valve replacement. The continuous suture technique, although faster, has been associated with a higher incidence of paravalvular leak. Using a slightly modified technique to minimize this risk, we investigated whether continuous suturing would shorten aortic cross-clamp time in aortic valve replacement in comparison with interrupted suturing. We reviewed the cases and compared the perioperative data of 60 consecutive patients in Japan and Australia (35 men and 25 women; median age, 70 yr) who had undergone aortic valve replacement with or without septal myectomy...
December 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29275594/-comparison-of-early-clinical-effects-of-ablation-with-surgery-treatment-in-patients-with-hypertrophic-cardiomyopathy
#4
Y P Ruan, X W Liu, Y Zhang, J C Han, Y Q Lai, J Lü, Y H He
Objective: To compare the early clinical effect of septal myectomy and percutaneous transluminal septal myocardial ablation (PTMSA) on the left ventricular outflow obstruction and the rate of complication in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: A total of 204 patients with HOCM who received septal reduction treatment were recruited. These patients were divided into two groups, surgery group (n=135) (65 patients with modified Morrow procedure, 70 patients with non-Morrow myomectomy) and PTMSA group (n=69)...
December 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29249790/-ascending-aorta-replacement-and-extended-myectomy-for-acute-aortic-dissection-and-coexistent-hypertrophic-obstructive-cardiomyopathy-report-of-a-case
#5
Tomoyuki Suzuki, Masaki Hata, Kazuhiro Yamaya, Takeshi Saitou, Fumiya Haba, Masahiro Matsuno
Emergent ascending aortic replacement and extended myectomy were performed in a woman with acute aortic dissection who was aged 63 years. Preoperative transthoracic echocardiography performed in the intensive care unit showed only slight left ventricular outflow tract (LVOT) obstruction, but intraoperative transesophageal echocardiography after induction of anesthesia revealed pericardial effusion, systolic anterior motion(SAM), and associated mitral regurgitation(MR). Perioperative SAM and MR are sometimes facilitated under various hemodynamic conditions, but in this case, the left ventricular wall was thick and LVOT appeared to be obstructive by a hypertrophied septum...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29232302/minimally-invasive-septal-myectomy-for-hypertrophic-obstructive-cardiomyopathy
#6
Farah N Musharbash, Matthew R Schill, Matthew C Henn, Ralph J Damiano
Surgical septal myectomy is the treatment of choice for patients with symptomatic hypertrophic obstructive cardiomyopathy refractory to medications. This report describes our minimally invasive approach for performing a septal myectomy via a ministernotomy that has been used at our institution for more than a decade. In particular, patient preparation, surgical technique, and clinical considerations are highlighted. Performed properly, this minimally invasive technique is a feasible and effective approach in our experience...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29231770/pharmacological-and-non-pharmacological-treatment-of-obstructive-hypertrophic-cardiomyopathy
#7
Luis F Hidalgo, Srihari S Naidu, Wilbert S Aronow
Hypertrophic obstructive cardiomyopathy has been rising in prevalence, due to increased awareness and advanced imaging. For the symptomatic patient, pharmacological management remains an effective approach to the majority of patients with obstructive hypertrophic cardiomyopathy. However, a significant subset fails to improve sufficiently with medical therapy initially, or progressively becomes more symptomatic despite augmented medications over time. Most of the advances in the treatment of obstructive hypertrophic cardiomyopathy have therefore been made in the area of non-pharmacologic management, particularly septal reduction therapy...
December 12, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29211880/corrigendum-to-clinical-long-term-outcome-of-septal-myectomy-for-obstructive-hypertrophic-cardiomyopathy-in-infants-eur-j-cardiothorac-surg-2017-doi-10-1093-ejcts-ezx369
#8
Julia Schleihauf, Julie Cleuziou, Jelena Pabst von Ohain, Christian Meierhofer, Heiko Stern, Nerejda Shehu, Naira Mkrtchyan, Emanuel Kaltenecker, Andreas Kühn, Nicole Nagdyman, Alfred Hager, Heide Seidel, Rüdiger Lange, Peter Ewert, Cordula M Wolf
No abstract text is available yet for this article.
December 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29198807/use-of-cutting-edge-technology-to-learn-myocardial-cutting-edge-in-septal-myectomy
#9
EDITORIAL
Yuting P Chiang, Jonathan N Ginns, Hiroo Takayama
No abstract text is available yet for this article.
November 7, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29182736/does-septal-thickness-influence-outcome-of-myectomy-for-hypertrophic-obstructive-cardiomyopathy
#10
Anita Nguyen, Hartzell V Schaff, Rick A Nishimura, Joseph A Dearani, Jeffrey B Geske, Brian D Lahr, Steve R Ommen
OBJECTIVES: Patients with hypertrophic obstructive cardiomyopathy and basal septal thickness <18 mm are often considered unsuitable candidates for myectomy. Mitral valve (MV) replacement is frequently performed instead. We aimed to determine whether septal thickness affects outcomes and adequacy of myectomy. METHODS: Clinical and echocardiographic data were reviewed for 1486 consecutive adult patients with hypertrophic obstructive cardiomyopathy who underwent transaortic septal myectomy from January 2005 through December 2014...
November 22, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29168204/early-and-medium-term-outcomes-of-alfieri-mitral-valve-repair-in-the-management-of-systolic-anterior-motion-during-septal-myectomy
#11
Richard Collis, Oliver Watkinson, Antonis Pantazis, Maria Tome-Esteban, Perry M Elliott, Christopher G A McGregor
BACKGROUND: This report studies the early and medium-term clinical and echocardiographic outcomes of the Alfieri edge-to-edge mitral valve repair, as adjunctive therapy, to prevent and treat systolic anterior motion (SAM) at the time of septal myectomy (SM) for left ventricular outflow tract obstruction in hypertrophic cardiomyopathy. METHODS: From 2009-2015, 11 consecutive patients had a trans-atrial Alfieri repair, to prevent (n = 7) or treat (n = 4) SAM at the time of SM...
November 23, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29154429/contrast-enhanced-computed-tomography-with-myocardial-three-dimensional-printing-can-guide-treatment-in-symptomatic-hypertrophic-obstructive-cardiomyopathy
#12
Yasuhiro Hamatani, Makoto Amaki, Hideaki Kanzaki, Kizuku Yamashita, Yasuteru Nakashima, Atsushi Shibata, Atsushi Okada, Hiroyuki Takahama, Takuya Hasegawa, Yusuke Shimahara, Yasuo Sugano, Tomoyuki Fujita, Isao Shiraishi, Satoshi Yasuda, Junjiro Kobayashi, Toshihisa Anzai
Both surgical myectomy and percutaneous transluminal septal myocardial ablation are effective treatments for drug-refractory symptomatic hypertrophic obstructive cardiomyopathy (HOCM). However, in some cases, it is not easy to elucidate the abnormal structure of left ventricular outflow obstruction to adopt these treatments. Here, we presented a young female patient with drug-refractory symptomatic HOCM. In this case, contrast-enhanced computed tomography enabled us to assess the suitability of percutaneous transluminal septal myocardial ablation...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29153286/combined-transaortic-and-transapical-approach-to-septal-myectomy-in-patients-with-complex-hypertrophic-cardiomyopathy
#13
Dustin Hang, Hartzell V Schaff, Steve R Ommen, Joseph A Dearani, Rick A Nishimura
OBJECTIVES: Residual midventricular obstruction after transaortic myectomy may lead to recurrent symptoms and reoperation in patients with hypertrophic cardiomyopathy and long-segment septal hypertrophy. A combined transaortic and transapical approach to septal myectomy during initial operation allows for the complete relief of subaortic and midventricular gradients and may reduce the risk of poor late functional results. METHODS: We analyzed the early outcomes of 86 patients aged 18 years or more who underwent combined transaortic and transapical septal myectomy for left ventricular outflow tract obstruction due to systolic anterior motion and midventricular obstruction or cavitary obliteration due to apical hypertrophic cardiomyopathy...
October 27, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29148156/long-term-outcomes-for-different-surgical-strategies-to-treat-left-ventricular-outflow-tract-obstruction-in-hypertrophic-cardiomyopathy
#14
Richard Collis, Oliver Watkinson, Constantinos O'Mahony, Oliver P Guttmann, Antonis Pantazis, Maria Tome-Esteban, Victor Tsang, Venkatachalam Chandrasekaran, Christopher G A McGregor, Perry M Elliott
AIMS: Surgical intervention is used to treat dynamic left ventricular outflow tract obstruction (LVOTO) in hypertrophic cardiomyopathy. This study assesses the effect of different surgical strategies on long-term mortality and morbidity. METHODS AND RESULTS: In total, 347 patients underwent surgical intervention for LVOTO (1988-2015). Group A (n = 272) underwent septal myectomy; Group B (n = 33), septal myectomy and mitral valve (MV) repair; Group C (n = 22), myectomy and MV replacement; and Group D (n = 20), MV replacement alone...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29122139/role-of-exercise-testing-in-hypertrophic%C3%A2-cardiomyopathy
#15
REVIEW
Ethan J Rowin, Barry J Maron, Iacopo Olivotto, Martin S Maron
Over the last 25 years, patients with hypertrophic cardiomyopathy (HCM) have been studied with a variety of methods employing physiological exercise that have made major contributions to disease management and are performed without increased risk. Previously under-utilized in HCM, exercise (stress) echocardiography has become incorporated into the standard clinical assessment and diagnostic armamentarium of HCM using upright or supine symptom-limited treadmill or bicycle modalities. In patients without outflow gradients at rest, exercise echocardiography is the most appropriate method for provoking obstruction, with the capability of predicting future development of progressive heart failure symptoms, and differentiating patients with provocable obstruction from those without obstruction, with major implications for dictating treatment options, that is, surgical myectomy (alternatively, alcohol septal ablation) versus heart transplant...
November 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29106577/pacing-for-hypertrophic-obstructive-cardiomyopathy-an-update-and-future-directions
#16
Claude Daubert, Fredrik Gadler, Philippe Mabo, Cecilia Linde
In hypertrophic cardiomyopathy (HCM) patients with symptoms caused by left ventricular outflow tract obstruction (LVOTO), treatment options include negative inotropic drugs, myectomy, septal alcohol ablation and AV sequential pacing with or without an implantable cardioverter defibrillator (ICD). Pacing is rarely used in spite of its relative simplicity and promising results. In this review the current evidence of AV sequential pacing from observational, randomised studies and long and very long-term follow-up studies is given and put in the context of present guidelines recommendations...
June 30, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29021349/activation-of-autophagy-ameliorates-cardiomyopathy-in-mybpc3-targeted-knockin-mice
#17
Sonia R Singh, Antonia T L Zech, Birgit Geertz, Silke Reischmann-Düsener, Hanna Osinska, Maksymilian Prondzynski, Elisabeth Krämer, Qinghang Meng, Charles Redwood, Jolanda van der Velden, Jeffrey Robbins, Saskia Schlossarek, Lucie Carrier
BACKGROUND: Alterations in autophagy have been reported in hypertrophic cardiomyopathy (HCM) caused by Danon disease, Vici syndrome, or LEOPARD syndrome, but not in HCM caused by mutations in genes encoding sarcomeric proteins, which account for most of HCM cases. MYBPC3, encoding cMyBP-C (cardiac myosin-binding protein C), is the most frequently mutated HCM gene. METHODS AND RESULTS: We evaluated autophagy in patients with HCM carrying MYBPC3 mutations and in a Mybpc3-targeted knockin HCM mouse model, as well as the effect of autophagy modulators on the development of cardiomyopathy in knockin mice...
October 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29020402/women-with-hypertrophic-cardiomyopathy-have-worse-survival
#18
Jeffrey B Geske, Kevin C Ong, Konstantinos C Siontis, Virginia B Hebl, Michael J Ackerman, David O Hodge, Virginia M Miller, Rick A Nishimura, Jae K Oh, Hartzell V Schaff, Bernard J Gersh, Steve R Ommen
Aims: Sex differences in hypertrophic cardiomyopathy (HCM) remain unclear. We sought to characterize sex differences in a large HCM referral centre population. Methods and results: Three thousand six hundred and seventy-three adult patients with HCM underwent evaluation between January 1975 and September 2012 with 1661 (45.2%) female. Kaplan-Meier survival curves were assessed via log-rank test. Cox proportional hazard regression analyses evaluated the relation of sex with survival...
September 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28977350/e-e-ratio-and-outcome-prediction-in-hypertrophic-cardiomyopathy-the-influence-of-outflow-tract-obstruction
#19
Dai-Yin Lu, Bereketeab Hailesealassie, Ioannis Ventoulis, Hong-Yun Liu, Hsin-Yueh Liang, Iraklis Pozios, Marco Canepa, Susan Phillip, M Roselle Abraham, Theodore Abraham
Aims: Diastolic dysfunction is thought to be an important pathophysiologic component of hypertrophic cardiomyopathy (HCM). However, there are conflicting data on the potential value of the mitral E/e' ratio. We examined whether left ventricular outflow tract (LVOT) obstruction influences the value of E/e' in predicting outcomes in HCM. Methods and results: Patients who met diagnostic criteria for HCM were enrolled. Diastolic function was assessed with complete two-dimensional and Doppler echocardiography...
July 11, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28947201/concomitant-ablation-for-atrial-fibrillation-during-septal-myectomy-in-patients-with-hypertrophic-obstructive-cardiomyopathy
#20
Alexander V Bogachev-Prokophiev, Alexander V Afanasyev, Sergei I Zheleznev, Alexei N Pivkin, Michael S Fomenko, Ravil M Sharifulin, Alexander M Karaskov
OBJECTIVE: The appearance of atrial fibrillation is associated with significant clinical deterioration in patients with obstructive hypertrophic cardiomyopathy; therefore, maintenance of sinus rhythm is desirable. Guidelines and most articles have reported the results of catheter ablation and pharmacologic atrial fibrillation treatment; nevertheless, data regarding concomitant procedures during septal myectomy are limited. The aim of this study was to assess the outcomes of concomitant atrial fibrillation treatment in patients with obstructive hypertrophic cardiomyopathy...
September 1, 2017: Journal of Thoracic and Cardiovascular Surgery
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