Routine Papillary Muscle Realignment and Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy

The Annals of Thoracic Surgery
Howard K SongStephen B Heitner

Abstract

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. 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. All patients underwent resting and stress echocardiography preoperatively and postoperatively. Demographic, clinical, and imaging data were prospectively collected in a cardiac surgery database. Patient age ranged broadly, with mean age of 54 (range, 18 to 76) years. Preoperatively, 70% of patients were New York Heart Association functional class III or IV, the mean stress LVOT gradient was 144 mm Hg, and severe mitral regurgitation (MR) with stress was seen in 81%. Additional procedures included division of myocardial bands (50%) and chordae (43%) and resection of accessory papillary muscles (25%). Following the procedure, mean resting and stre...Continue Reading

Citations

Jan 11, 2020·European Journal of Heart Failure·C Vaughan TuohyStephen B Heitner
Oct 17, 2020·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Joon Hwa HongHartzell Vernon Schaff
Jun 18, 2021·The Annals of Thoracic Surgery·Lye-Yeng WongHoward K Song
Nov 13, 2020·Seminars in Thoracic and Cardiovascular Surgery·Alicia M BonannoHoward K Song

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