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Isolation and Functional Characterization of Human Ventricular Cardiomyocytes from Fresh Surgical Samples
Published on: April 21, 2014
[Surgical treatment of obstructive hypertrophic cardiomyopathy with ventricular septal myectomy concomitant mitral
1Nanjing Cardiovascular Hospital, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China.
Insights
This study shows that combining ventricular septal myectomy with mitral valve replacement (MVR) is a safe and effective treatment for obstructive hypertrophic cardiomyopathy (OHCM). The procedure significantly reduces left ventricular outflow tract gradient pressure and interventricular septal thickness.
Area of Science:
- Cardiovascular Surgery
- Cardiology
- Medical Research
Context:
- Obstructive hypertrophic cardiomyopathy (OHCM) can lead to severe mitral regurgitation.
- Surgical intervention is often necessary for symptomatic patients.
- Combined ventricular septal myectomy and mitral valve replacement (MVR) is a complex procedure for OHCM.
Purpose:
- To evaluate the efficacy and safety of concomitant ventricular septal myectomy and MVR in patients with OHCM and moderate to severe mitral regurgitation.
- To analyze the short- and mid-term outcomes of this combined surgical approach.
Summary:
- Twenty-two patients with OHCM and mitral regurgitation underwent combined ventricular septal myectomy and MVR between 2000 and 2007.
- One in-hospital mortality occurred due to ventricular arrhythmias.
- Post-operative assessments showed a significant reduction in left ventricular outflow tract gradient pressure (LVOTGP) and interventricular septal thickness (IVST) (P < 0.01).
- Systolic anterior motion of the mitral valve resolved in all patients.
Impact:
- Concomitant ventricular septal myectomy and MVR is a safe and effective treatment for OHCM with moderate or severe mitral regurgitation.
- The procedure yields excellent short- and mid-term outcomes.
- This surgical strategy effectively addresses the obstructive component and mitral valve dysfunction in OHCM.
Objective:
To summarize the experiences and results of ventricular septal myectomy concomitant mitral valve replacement (MVR) for obstructive hypertrophic cardiomyopathy (OHCM).
Methods:
From January 2000 to June 2007, 22 patients of OHCM with moderate or severe mitral regurgitation underwent concomitant ventricular septal myectomy concomitant MVR. There were 20 male and 2 female patients. The age ranged from 28 to 51 years old with a mean of (36 + or - 5) years old. The left ventricular out tract gradient pressure (LVOTGP) was 55 to 120 mm Hg (1 mm Hg = 0.133 kPa), with a mean of (88.0 + or - 15.8) mm Hg. The manifestation of pre-operative UCG, intra-operative transesophageal echocardiography (TEE) and post-operative UCG in 10 d, 6 months and 1 year were compared and analyzed.
Results:
One patient died in hospital due to serious ventricular arrhythmias. The intra-operative TEE showed that the phenomenon of systolic anterior motion (SAM) of mitral valve disappeared in all patients. Twenty-one cases were followed-up. The intra-operative TEE and post-operative UCG in every period of all 21 cases survived indicated that the mean LVOTGP and interventricular septal thickness (IVST) decreased obviously (P < 0.01).
Conclusion:
Concomitant ventricular septal myectomy concomitant MVR is an effective and safe treatment for OHCM with moderate or severe mitral regurgitation, the short and mid-term outcome is excellent.
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