1. Do alternative approaches work in surgical septal myectomy?
- Author
-
Varma PK, Krishna N, Jose R, Gopal K, and Ahamed H
- Subjects
- Humans, Quality of Life, Treatment Outcome, Cardiac Surgical Procedures adverse effects, Cardiac Surgical Procedures methods, Cardiomyopathy, Hypertrophic complications, Cardiomyopathy, Hypertrophic diagnostic imaging, Cardiomyopathy, Hypertrophic surgery, Mitral Valve Insufficiency complications, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency surgery, Ventricular Outflow Obstruction diagnostic imaging, Ventricular Outflow Obstruction etiology, Ventricular Outflow Obstruction surgery
- Abstract
Trans-aortic septal myectomy is the gold standard for septal reduction therapy. This technique has low peri-procedural mortality and excellent long-term survival. Moreover, it relieves the heart failure symptoms and improves the quality of life. Secondary chordal cutting along with septal myectomy has shown to improve the outcome but can potentially cause deterioration of left ventricular function. In patients with relatively thin inter-ventricular septum, abnormalities of mitral valve apparatus may be the main reason for systolic anterior motion and left ventricular outflow tract obstruction. These patients may require additional procedures on the mitral valve to shift the coaptation plane away from outflow tract. Mitral valve replacement should be performed only in patients with intrinsic mitral valve abnormalities that are not suitable for repair and its routine use along with limited septal myectomy should be discouraged. Minimal access surgery although attractive in concept requires more robust data before universal application.
- Published
- 2022
- Full Text
- View/download PDF