Concomitant septal myectomy at the time of aortic valve replacement for severe aortic stenosis

The Annals of Thoracic Surgery
Nihan KayalarSoon J Park

Abstract

Left ventricular outflow tract obstruction may be unmasked after a successful aortic valve replacement (AVR) for severe aortic stenosis in the setting of asymmetrical basal septal hypertrophy (ABSH). The quantitative assessment of the obstructive potential of ABSH adjacent to a severely stenotic valve can be challenging. We reviewed our experience with patients who underwent concomitant septal myectomy at the time of AVR for severe aortic stenosis. During the 10-year period ending January 2009, 3,523 patients underwent AVR for the primary indication of severe aortic stenosis. Forty-seven of these patients underwent concomitant septal myectomy. Preoperative and postoperative echocardiograms, operative data, hospital course, morbidity, and mortality were assessed. The mean age of the group was 73 +/- 11 years. The mean aortic valve area was 0.74 cm(2) preoperatively. On preoperative transthoracic echocardiography, only 28% of the patients were considered to be at risk for possible left ventricular outflow tract obstruction. The mean left ventricular mass index decreased from 113.7 +/- 24.3 g preoperatively to 90.0 +/- 17.2 g at 1 year after the surgery (p < 0.001). The operative mortality was 2%. Complete heart block was observed...Continue Reading

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Citations

Dec 17, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Ju Yong LimSoon J Park
Dec 14, 2011·The Journal of Thoracic and Cardiovascular Surgery·Hartzell V SchaffRick A Nishimura
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Jul 27, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiroaki KitaokaUNKNOWN Japanese Circulation Society Joint Working Group

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