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Septal myectomy and mitral plication through a transaortic approach
Guillermo Gutierrez1, Franco Gutierrez2, Gustavo Bastianelli1
1Cardiovascular Surgery, Hospital Universitario Austral, Buenos Aires, Argentina.
Multimedia Manual of Cardiothoracic Surgery : MMCTS
|October 1, 2020
Summary
Obstructive hypertrophic cardiomyopathy is treated with septal myectomy. This tutorial details a transaortic approach resolving both septal hypertrophy and mitral regurgitation using septal resection and mitral valve plication.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Obstructive hypertrophic cardiomyopathy (HCM) is a significant cause of heart disease.
- Transaortic septal myectomy is the current gold standard surgical treatment for obstructive HCM.
Observation:
- Systolic anterior movement of the anterior mitral leaflet can lead to secondary mitral regurgitation in HCM.
- Concomitant procedures are sometimes necessary to address both septal hypertrophy and mitral regurgitation.
Findings:
- This tutorial presents a case of HCM with systolic anterior movement and mitral regurgitation.
- The condition was successfully treated with a transaortic septal resection combined with plication of the anterior mitral leaflet.
Implications:
- This combined surgical technique offers a potential solution for complex HCM cases involving mitral regurgitation.
- Further research may explore the long-term efficacy and broader applicability of this approach in managing HCM.
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