Related Experiment Video

Updated: Feb 18, 2026

Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy
07:02

Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy

Published on: September 9, 2020

7.0K

Combined transaortic and transapical approach to septal myectomy in patients with complex hypertrophic cardiomyopathy

Dustin Hang1, Hartzell V Schaff1, Steve R Ommen2

  • 1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.

The Journal of Thoracic and Cardiovascular Surgery
|November 21, 2017
PubMed

Insights

A combined transaortic and transapical septal myectomy effectively treats hypertrophic cardiomyopathy, significantly reducing obstruction and improving patient symptoms. This approach offers a safe and effective solution for complex septal hypertrophy, preventing residual obstruction and enhancing cardiac function.

Area of Science:

  • Cardiovascular Surgery
  • Cardiology
  • Medical Devices

Background:

  • Hypertrophic cardiomyopathy (HCM) can cause significant left ventricular outflow tract (LVOT) obstruction.
  • Residual midventricular obstruction after standard myectomy may lead to recurrent symptoms and reoperation.
  • Long-segment septal hypertrophy presents a surgical challenge in HCM patients.

Purpose of the Study:

  • To evaluate the early outcomes of a combined transaortic and transapical septal myectomy approach.
  • To assess the effectiveness of this combined approach in relieving LVOT obstruction in HCM patients.
  • To determine the safety and functional impact of this technique.

Main Methods:

  • Analysis of 86 adult patients undergoing combined transaortic and transapical septal myectomy.
  • Focus on patients with LVOT obstruction due to systolic anterior motion, midventricular obstruction, or cavitary obliteration.
  • Measurement of intracavitary gradients, LVOT gradients, and assessment of survival and functional status.

Main Results:

  • Significant reduction in pre- and post-bypass gradients, with median post-bypass gradients near zero.
  • High survival rates at 30 days (95%) and 1 year (95%), with 2 early deaths.
  • Marked improvement in functional status, with 41 of 42 patients reporting symptom improvement (New York Heart Association class I/II).

Conclusions:

  • Combined transaortic and transapical septal myectomy is effective and safe for HCM with complex septal hypertrophy.
  • This approach can prevent residual midventricular obstruction.
  • It may improve diastolic filling and left ventricular stroke volume in apical HCM.
Abstract

Keywords:
hypertrophic cardiomyopathysurgery/incisions/exposure/techniques

More Related Videos

Isolation and Functional Characterization of Human Ventricular Cardiomyocytes from Fresh Surgical Samples14:39

Isolation and Functional Characterization of Human Ventricular Cardiomyocytes from Fresh Surgical Samples

Published on: April 21, 2014

18.0K
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

4.4K

Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
493
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
540
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
381
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
322