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Related Concept Videos

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...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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...
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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...
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...

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Related Experiment Video

Updated: Jun 19, 2026

Isolation and Functional Characterization of Human Ventricular Cardiomyocytes from Fresh Surgical Samples
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Transapical Beating-Heart Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy: Lessons Learned After the

Jing Fang1,2,3, Yue Chen1,2,3, Yani Liu4

  • 1Division of Cardiovascular Surgery (J.F., Y.C., R.L., L.C., Q.W., J.S., Y.M., S.W., X.W.), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Circulation. Cardiovascular Interventions
|May 2, 2025
PubMed
Summary

The transapical beating-heart septal myectomy (TA-BSM) procedure offers an effective and safe surgical option for obstructive hypertrophic cardiomyopathy. Midterm outcomes show significant reduction in left ventricular outflow tract gradients and improved mitral regurgitation.

Keywords:
cardiomyopathy, hypertrophicminimally invasive surgical proceduresmitral valve insufficiencyventricular outflow obstruction, leftventricular septum

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • Obstructive hypertrophic cardiomyopathy (oHCM) presents significant challenges for surgical intervention.
  • Conventional septal myectomy carries risks and surgical trauma.
  • Transapical beating-heart septal myectomy (TA-BSM) was developed to improve upon existing surgical techniques for oHCM.

Purpose of the Study:

  • To refine the TA-BSM surgical technique for oHCM.
  • To evaluate the midterm outcomes of TA-BSM following the initial learning curve.
  • To assess the safety and efficacy of TA-BSM in a large patient cohort.

Main Methods:

  • TA-BSM performed via left mini-thoracotomy using a beating-heart myectomy device.
  • Real-time transesophageal echocardiography guided tailored septal resections.
  • Procedural success defined by post-operative left ventricular outflow tract gradient <30/50 mmHg and mitral regurgitation ≤grade 2+.

Main Results:

  • 418 patients with diverse oHCM anatomies underwent TA-BSM.
  • Median LVOT gradient reduced from 85 mmHg to 19 mmHg; 98.8% achieved MR ≤grade 2+.
  • Procedural success in 91.1%; low rates of major adverse events (0.7%-2.4%); 30-day mortality 0.2%; 1-year survival 98.7%.

Conclusions:

  • Individualized TA-BSM, guided by echocardiography, enables precise septal myectomy.
  • The technique demonstrates significant midterm therapeutic advantages for oHCM.
  • TA-BSM may expand surgical treatment options for obstructive hypertrophic cardiomyopathy.