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Septal myectomy

Josef Veselka, Nandan S Anavekar, Philippe Charron
Hypertrophic obstructive cardiomyopathy is an inherited myocardial disease defined by cardiac hypertrophy (wall thickness ≥15 mm) that is not explained by abnormal loading conditions, and left ventricular obstruction greater than or equal to 30 mm Hg. Typical symptoms include dyspnoea, chest pain, palpitations, and syncope. The diagnosis is usually suspected on clinical examination and confirmed by imaging. Some patients are at increased risk of sudden cardiac death, heart failure, and atrial fibrillation...
November 29, 2016: Lancet
Tolga Aksu, Tumer Guler, Kivanc Yalin, Sukriye Ebru Golcuk, Kazim Ozcan
Septal reduction therapy is the gold standard treatment method for symptomatic, hypertrophic obstructive cardiomyopathy. Although surgical myectomy is a well-established and effective technique with decades of experience in its application, use of transcoronary alcohol septal ablation has increased precipitously owing to the less-invasive nature of the procedure. Moreover, endocardial septal ablation therapy is a relatively newly defined modality, and outcomes of the procedure are not clearly elucidated yet...
November 2016: American Journal of the Medical Sciences
Abhijeet B Shelke, Rajeev Menon, Anuj Kapadiya, Sachin Yalagudri, Daljeet Saggu, Sandeep Nair, C Narasimhan
OBJECTIVE: Alcohol septal ablation (ASA) is a therapeutic alternative to surgical myectomy in patients with hypertrophic obstructive cardiomyopathy (HOCM). However, the anatomical variability of the septal branch, risk of complete heart block, and late onset ventricular arrhythmias are limitations to its therapeutic usage. There is recent interest in the use of radiofrequency catheter ablation (RFCA) as a therapeutic option in HOCM. We aimed to assess the safety and efficacy of RFCA in the treatment of symptomatic HOCM...
September 2016: Indian Heart Journal
Kevin Fu Hong Yee, Marcin Wasowicz
BACKGROUND: The aim of this paper is to describe clinical management in a situation where a patient has experienced anaphylaxis while undergoing surgical septal myectomy for hypertrophic obstructive cardiomyopathy (HOCM). CASE REPORT: A 40-yr-old female was scheduled to undergo surgical septal myectomy for the treatment of HOCM. After induction, the patient developed refractory hypotension that did not respond to escalating doses of vasopressors and volume therapy...
September 30, 2016: Anaesthesiology Intensive Therapy
Joon Hwa Hong, Hartzell V Schaff, Rick A Nishimura, Martin D Abel, Joseph A Dearani, Zhuo Li, Steve R Ommen
BACKGROUND: Incidence and outcome of mitral valve (MV) surgery are unknown in patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing extended transaortic septal myectomy. OBJECTIVES: This study sought to define indications and suitable operative strategy for mitral regurgitation (MR) in patients with HOCM. METHODS: A total of 2,107 septal myectomy operations performed in adults from January 1993 to May 2014 at Mayo Clinic in Rochester, Minnesota, were retrospectively reviewed...
October 4, 2016: Journal of the American College of Cardiology
Joshua L Hermsen, Thomas M Burke, Stephen P Seslar, David S Owens, Beth A Ripley, Nahush A Mokadam, Edward D Verrier
OBJECTIVE: Static 3-dimensional printing is used for operative planning in cases that involve difficult anatomy. An interactive 3D print allowing deliberate surgical practice would represent an advance. METHODS: Two patients with hypertrophic cardiomyopathy had 3-dimensional prints constructed preoperatively. Stereolithography files were generated by segmentation of chest computed tomographic scans. Prints were made with hydrogel material, yielding tissue-like models that can be surgically manipulated...
August 20, 2016: Journal of Thoracic and Cardiovascular Surgery
Tolga Aksu, Tümer Erdem Güler, Kıvanç Yalın, Şükriye Ebru Gölcük, Kazım Serhan Özcan
Septal reduction therapy is accepted as a first therapeutic option for symptomatic drug-resistant hypertrophic obstructive cardiomyopathy (HOCM). Although, surgical septal myectomy is the gold standard method, alcohol septal ablation is a well-studied alternative approach in the patients with suitable anatomy. Endocardial septal ablation (ESA) therapy was relatively new defined modality and outcomes of the procedure were not clearly elucidated yet. We aimed to review the clinical aspects of ESA procedure and provide some historical background...
September 2016: Anatolian Journal of Cardiology
Yin-Jian Yang, Chao-Mei Fan, Jin-Qing Yuan, Shui-Yun Wang, Yun-Hu Song, Shu-Bin Qiao, Shi-Jie You, Zhi-Min Wang, Fu-Jian Duan, Yi-Shi Li
OBJECTIVES: Investigate the effectiveness of alcohol septal ablation (ASA) and transaortic extended myectomy (TEM) in hypertrophic cardiomyopathy (HCM) with midventricular obstruction (MVO). BACKGROUND: MVO is less common than subaortic obstruction. Data on the effectiveness of ASA and TEM in MVO are lacking. METHODS: The clinical profiles of 22 patients undergoing ASA and 37 patients undergoing TEM were compared. No patient had apical aneurysm, abnormal chordae, mitral valve replacement or repair...
December 2016: Journal of Interventional Cardiology
Younes Moutakiallah, Ilham Maaroufi, Mahdi Aithoussa, Mehdi Bamous, Abdessamad Abdou, Noureddine Atmani, Abdedaïm Hatim, Brahim Amahzoune, Youssef El Bekkali, Abdelatif Boulahya
Subaortic diaphragm is characterized by a certain clinical latency and low morbi-mortality. Surgery remains the treatment of choice despite the real risk of long-term recurrence. Our study involved 18 patients with subaortic diaphragm operated between April 1994 and March 2011. The average age was 18.1 ± 9.7 years, 11 patients were male. The diaphragm was fibrous in 13 patients and fibromuscular in 5 patients. All patients underwent diaphragm resection associated with myectomy, aortic plasty, closure of ventricular septal defect and permeable ductus arteriosus ligation in 3, 3, 2 and 2 patients respectively...
2016: Pan African Medical Journal
André Viveiros Monteiro, António Fiarresga, Duarte Cacela, Lídia de Sousa, Ruben Ramos, Ana Galrinho, Luísa Branco, Rui Cruz Ferreira
Acromegaly is a rare disease, mostly caused by a growth hormone (GH)-secreting benign pituitary tumor, with an increased production of GH and insulin-like growth factor 1 (IGF-1). Cardiovascular complications are common and are associated with cardiomyocyte apoptosis and concentric cardiac hypertrophy. Suppression of GH and IGF-1 appears to improve cardiac function only in the short term, with little or no decrease in left ventricular mass or improvement in cardiac function after prolonged treatment. Alcohol septal ablation (ASA) has emerged as a minimally invasive alternative to septal myectomy, with significant improvement in symptoms, gradients and left ventricular remodeling...
September 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Luke K Kim, Rajesh V Swaminathan, Patrick Looser, Robert M Minutello, S Chiu Wong, Geoffrey Bergman, Srihari S Naidu, Christopher L F Gade, Konstantinos Charitakis, Harsimran S Singh, Dmitriy N Feldman
IMPORTANCE: Previous data on septal myectomy (SM) and alcohol septal ablation (ASA) in obstructive hypertrophic cardiomyopathy have been limited to small, nonrandomized, single-center studies. Use of septal reduction therapy and the effect of institutional experience on procedural outcomes nationally are unknown. OBJECTIVE: To examine in-hospital outcomes after SM and ASA stratified by hospital volume within a large, national inpatient database. DESIGN, SETTING, AND PARTICIPANTS: This study analyzed all patients who were hospitalized for SM or ASA in a nationwide inpatient database from January 1, 2003, through December 31, 2011...
June 1, 2016: JAMA Cardiology
Asad A Shah, Donald D Glower, Jeffrey G Gaca
BACKGROUND: Systolic anterior motion (SAM) of the mitral valve, left ventricular outflow tract (LVOT) obstruction, and mitral regurgitation (MR) are known adverse outcomes that can occur after septal myectomy for hypertrophic obstructive cardiomyopathy. The objective of this study was to describe outcomes of a surgical technique to prevent these complications. METHODS: We have adopted a technique where we place an Alfieri stitch in the mitral valve through the aortotomy while performing septal myectomy...
August 2016: Journal of Cardiac Surgery
Yousef Bader, Carey Kimmelstiel
Retrospective comparison of alcohol septal ablation with surgical myectomy suggests that although there is a greater reduction in LVOT gradient with surgical myectomy, symptom relief and survival are similar between the two treatment strategies. In patients who don't have an anatomic indication for surgical myectomy, alcohol septal ablation appears to be a safe and effective alternative. Patients with medication-refractory HOCM require a multi-disciplinary assessment, which is best performed at specialized treatment centers, to assess which therapy is best suited to treat them...
July 2016: Catheterization and Cardiovascular Interventions
Barry J Maron, William C Roberts
No abstract text is available yet for this article.
June 21, 2016: Journal of the American College of Cardiology
Paul Sorajja, Wesley A Pedersen, Richard Bae, John R Lesser, Desmond Jay, David Lin, Kevin Harris, Barry J Maron
BACKGROUND: Few therapeutic options exist for patients with severe heart failure due to obstructive hypertrophic cardiomyopathy (HCM) who are at unacceptable surgical risk. We hypothesized that percutaneous plication of the mitral valve could reduce left ventricular outflow tract (LVOT) obstruction and associated mitral regurgitation, thereby leading to amelioration of heart failure symptoms. OBJECTIVES: This study sought to evaluate the potential effectiveness of percutaneous mitral valve plication as a therapy for patients with symptomatic, obstructive HCM...
June 21, 2016: Journal of the American College of Cardiology
Lei Yao, Li Li, Xiong-Jun Lu, Yan-Ling Miao, Xiao-Ning Kang, Fu-Jian Duan
BACKGROUND: There has been limited data addressing outcomes of extensive septal myectomy in Chinese patients with hypertrophic obstructive cardiomyopathy (HOCM). In this study, the objective was to evaluate the clinical and echocardiographic outcomes of extensive septal myectomy in a relative large number of Chinese HOCM patients over long-term follow-up. METHODS: We retrospectively studied 139 consecutive HOCM patients (age 43 ± 15 years, 37 % male) who underwent extensive left ventricular septal myectomy...
2016: Cardiovascular Ultrasound
Haitao Xu, Jun Yan, Qiang Wang, Dianyuan Li, Hongwei Guo, Shoujun Li, Ju Wang, Song Lou, Qingdong Zeng
Extended septal myectomy for children and adolescents with hypertrophic obstructive cardiomyopathy (HOCM) is a challenging procedure, and related data are currently limited. Our study objective was to assess the early outcomes in children and adolescents with HOCM after extended septal myectomy. From October 2007 to August 2015, 40 consecutive patients with HOCM underwent transaortic extended septal myectomy in Fuwai Hospital, Beijing, China. Patients clinical data were analyzed retrospectively. Mean age at the time of operation was 11...
August 2016: Pediatric Cardiology
Sidakpal S Panaich, Nilay Patel, Shilpkumar Arora, Nileshkumar J Patel, Samir V Patel, Chirag Savani, Vikas Singh, Rajesh Sonani, Abhishek Deshmukh, Michael Cleman, Abeel Mangi, John K Forrest, Apurva O Badheka
Hospital volume is regarded amongst many in the medical community as an important quality metric. This is especially true in more complicated and less commonly performed procedures such as structural heart disease interventions. Seminal work on hospital volume relationships was done by Luft et al more than 4 decades ago, when they demonstrated that hospitals performing > 200 surgical procedures a year had 25%-41% lower mortality than those performing fewer procedures. Numerous volume-outcome studies have since been done for varied surgical procedures...
April 26, 2016: World Journal of Cardiology
Silvia Fortunato de Cano, Manuel Nicolas Cano, José de Ribamar Costa, Jairo Alves Pinheiro, Rodrigo Bellio de Mattos Barretto, David Costa de Souza Le Bihan, Alexandre Abizaid, Amanda Sousa, J Eduardo Sousa
BACKGROUND: Alcohol septal ablation (ASA) is an alternative treatment for symptomatic hypertrophic obstructive cardiomyopathy (HOCM) patients refractory to pharmacological therapy. We sought to evaluate the immediate and long-term incidence of death and changes in life quality in a consecutive cohort submitted to ASA. METHODS AND RESULTS: Between October 1998 and December 2013, a total of 56 patients (mean age 53.2 ± 15.5) with symptomatic refractory HOCM were treated with ASA and followed during 15 years (mean 8 ± 4 years)...
May 3, 2016: Catheterization and Cardiovascular Interventions
Selin Bayburt, Sahin Senay, Ahmet Umit Gullu, Muharrem Kocyigit, Gultekin Karakus, Mustafa Kemal Batur, Cem Alhan
Combined therapeutic approach with performing mitral valve repair may be necessitated for the treatment of idiopathic hypertrophic subaortic stenosis (IHSS) with systolic anterior motion. This report includes operative technique for combined robotic septal myectomy and mitral valve repair. A 45-year-old man with IHSS was admitted to our center for surgical intervention. The transthoracic echocardiography showed typical asymmetric ventricular hypertrophy. Left ventricle posterior wall thickness was 11 mm, and interventricular septum thickness was 21 mm...
March 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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