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Keynote Lecture-Transmitral hypertrophic obstructive cardiomyopathy (HOCM) repair

Friedrich W Mohr1, Joerg Seeburger1, Martin Misfeld1

  • 1Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany.

Annals of Cardiothoracic Surgery
|December 19, 2013
PubMed

Insights

Hypertrophic obstructive cardiomyopathy (HOCM) surgery aims to relieve left ventricular outflow tract obstruction and mitral valve issues. Minimally invasive techniques focusing on preserving the mitral valve offer improved long-term outcomes for HOCM patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Devices

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is a disease characterized by left/right ventricular outflow tract obstruction.
  • Symptoms include dyspnea, syncope, and potentially end-stage heart failure.
  • Pharmacological or transcoronary ablation of septal hypertrophy (TASH) may not alleviate symptoms, necessitating surgical intervention.

Purpose of the Study:

  • To describe current operative strategies for HOCM treatment.
  • To emphasize relieving left ventricular outflow tract (LVOT) obstruction.
  • To address systolic anterior movement (SAM) of the anterior mitral leaflet (AML) and mitral valve (MV) regurgitation.

Main Methods:

  • Review of current surgical techniques for HOCM.
  • Focus on myectomy with or without mitral valve replacement as a standard approach.
  • Special consideration for minimally invasive subaortic LVOT myectomy with AML resuspension.

Main Results:

  • Myectomy with or without MV replacement is the gold standard for HOCM.
  • Mitral valve preserving techniques may improve long-term outcomes and reduce adverse events.
  • Minimally invasive approaches aim to treat both HOCM and associated MV regurgitation.

Conclusions:

  • Surgical intervention is crucial for symptomatic HOCM unresponsive to other treatments.
  • Mitral valve preservation is preferred over replacement to minimize long-term complications.
  • Minimally invasive subaortic myectomy with AML resuspension offers a promising approach for HOCM and MV regurgitation.

Keywords:
Hypertrophic obstructive cardiomyopathyleft ventricular outflow tract obstructionminimally invasivemitral valve regurgitation

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