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Does a standard myectomy exist for obstructive hypertrophic cardiomyopathy? From the Morrow variations to precision

Pierluigi Stefàno1, Alessia Argirò2, Beatrice Bacchi1

  • 1Cardiac Surgery, Careggi University Hospital, Florence, Italy.

International Journal of Cardiology
|September 21, 2022
PubMed

Insights

Septal myectomy is the gold standard surgical treatment for obstructive hypertrophic cardiomyopathy (oHCM). Decades of surgical innovation have refined techniques to address specific causes of left ventricular outflow tract obstruction in oHCM patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical History

Background:

  • Obstructive hypertrophic cardiomyopathy (oHCM) is a complex condition.
  • Understanding the pathophysiology of obstruction is key to effective treatment.

Purpose of the Study:

  • To review the historical evolution of surgical treatments for oHCM over the past 60 years.
  • To correlate surgical advancements with evolving knowledge of oHCM pathophysiology.

Main Methods:

  • A narrative review of surgical approaches for oHCM.
  • Assessment based on personal experience from Florence.
  • Analysis of historical and contemporary surgical techniques.

Main Results:

  • Septal myectomy remains the primary surgical intervention for symptomatic oHCM patients unresponsive to medical therapy.
  • Numerous variations of the Morrow operation have been developed to target specific pathophysiological aspects of left ventricular outflow tract obstruction.

Conclusions:

  • Modern precision surgery for oHCM requires surgeons to integrate and master various surgical techniques.
  • A comprehensive understanding of historical developments and pathophysiological determinants is crucial for optimal surgical outcomes in oHCM.
Abstract

Keywords:
Hypertrophic cardiomyopathyPrecision surgerySeptal myectomy

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