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Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy
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[Surgical treatment of patients with obstructive hypertrophic cardiomyopathy]

A V Lysenko1, P V Lednev1, G I Salagaev1

  • 1Petrovsky Russian Research Center for Surgery, Moscow, Russia.

Khirurgiia
|November 13, 2019
PubMed

Insights

Surgical treatment effectively corrected obstructive hypertrophic cardiomyopathy and mitral valve issues in 15 patients. All patients experienced improved heart failure symptoms post-surgery, avoiding mitral valve replacement.

Area of Science:

  • Cardiovascular Surgery
  • Cardiology
  • Cardiac Surgery

Background:

  • Obstructive hypertrophic cardiomyopathy (oHCM) presents significant challenges.
  • Patients often suffer from severe mitral insufficiency and chronic heart failure.

Purpose of the Study:

  • To evaluate the in-hospital outcomes of surgical intervention for obstructive hypertrophic cardiomyopathy.
  • To assess the efficacy of mitral valve repair in conjunction with left ventricular outflow tract (LVOT) obstruction correction.

Main Methods:

  • A cohort of 15 patients (8 female, 6 male) with oHCM and severe mitral insufficiency underwent surgical treatment between November 2017 and March 2019.
  • Patients had a mean age of 55.9±7.1 years and presented with NYHA class III chronic heart failure and secondary coronary insufficiency.
  • Surgical procedures focused on correcting LVOT obstruction and performing mitral valve repair to address systolic anterior motion (SAM).

Main Results:

  • All surgical procedures achieved technical success in correcting LVOT obstruction and eliminating SAM.
  • Mitral valve repair was successful in all patients, obviating the need for valve replacement.
  • Postoperative outcomes showed significant improvement, with all patients presenting with NYHA class I-II heart failure in the early postoperative period.

Conclusions:

  • Comprehensive preoperative assessment, including detailed hemodynamic and anatomical analysis of the left ventricle (LV), is crucial.
  • Surgical expertise is essential for successful LVOT obstruction correction and mitral valve repair.
  • Effective surgical management can significantly improve heart failure symptoms and functional class in patients with oHCM.
Abstract

Keywords:
LVOT obstructionSAM syndromemitral insufficiencymitral valve repairobstructive hypertrophic cardiomyopathysurgical treatment

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