Combined anterior mitral leaflet extension and spark erosion myectomy in hypertrophic obstructive cardiomyopathy: Echo-enhanced surgery

Herwerden, Lex A. van; Cate, Folkert J. ten

doi:10.1053/j.optechstcvs.2004.10.004

Cited by 5 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,3 In brief, an autologous pericardial patch is harvested, trimmed of fat and extraneous tissue, immersed for 6 minutes in 0.4% glutaraldehyde, and then placed in a normal saline bath. After opening the ascending aorta by an oblique incision, myectomy is performed to the left of an imaginary line through the nadir of the right coronary cusp in the beginning with a locally designed electrocautery device, 4 later by excision with scissors and a rongeur or surgical knife.…”

Section: Methodsmentioning

confidence: 99%

Long-Term Benefit of Myectomy and Anterior Mitral Leaflet Extension in Obstructive Hypertrophic Cardiomyopathy

Vriesendorp¹,

Schinkel²,

Soliman³

et al. 2015

The American Journal of Cardiology

Self Cite

View full text Add to dashboard Cite

Section: Methodsmentioning

confidence: 99%

Long-Term Benefit of Myectomy and Anterior Mitral Leaflet Extension in Obstructive Hypertrophic Cardiomyopathy

Vriesendorp¹,

Schinkel²,

Soliman³

et al. 2015

The American Journal of Cardiology

Self Cite

View full text Add to dashboard Cite

“…This area is considered the region where inward bending and protrusion of the leaflet into the LVOT occurs (57,78). By stiffening the base and mid-body of the AML, the technique effectively decreases SAM, reestablishes a posterolateral coaptation point away from the LVOT, and increases chordal tensor forces (79)(80)(81)(82). Vriesendorp and colleagues reported on 98 obstructive HCM patients who underwent combined myectomy and AML extension (82).…”

Section: Anterior Mitral Leaflet Extensionmentioning

confidence: 99%

Systolic anterior motion of the mitral valve in hypertrophic cardiomyopathy: a narrative review

Guigui¹,

Torres²,

Escolar³

et al. 2022

J Thorac Dis

View full text Add to dashboard Cite

Background and Objective: The prevalence of hypertrophic cardiomyopathy (HCM) is estimated to be 1 in 200 to 500 individuals, with systolic anterior motion (SAM) of the mitral valve (MV) and left ventricular outflow tract (LVOT) obstruction present in 60% to 70%. In this narrative review, we aim to elucidate the pathophysiology of SAM-septal contact and LVOT obstruction in HCM by presenting a detailed review on the anatomy of the MV apparatus in HCM, examining the various existing theories pertaining to the SAM phenomenon as supported by cardiac imaging, and providing a critical assessment of management strategies for SAM in HCM.Methods: A literature review was performed using PubMed, EMBASE, Ovid, and the Cochrane Library, of all scientific articles published through December 2021. A focus was placed on descriptive studies, reports correlating echocardiographic findings with pathologic diagnosis, and outcomes studies.

show abstract

“…If myectomy had been completed, the surgeon performed MLE ( Figure 1). 16,20 In this procedure, an autologous pericardial patch is placed across the bending point of the mitral valve where SAM is maximal to stiffen the buckling AMVL (Figure 2). The patch extends the width but not the length of the AMVL, which shifts the centrally attached chordae laterally.…”

Section: Surgical Myectomy In Combination With Mlementioning

confidence: 99%

Percutaneous Versus Surgical Treatment for Patients With Hypertrophic Obstructive Cardiomyopathy and Enlarged Anterior Mitral Valve Leaflets

et al. 2005

Self Cite

View full text Add to dashboard Cite

Background-The purpose of this study was to compare percutaneous transluminal septal myocardial ablation (PTSMA) and septal myectomy combined with mitral leaflet extension (MLE) in symptomatic hypertrophic obstructive cardiomyopathy patients with an enlarged anterior mitral valve leaflet (AMVL). Both PTSMA and myectomy reduce septal thickness and left ventricular outflow tract (LVOT) gradient; however, an uncorrected enlarged AMVL may predispose to residual systolic anterior motion (SAM) after successful standard myectomy or PTSMA. Myectomy with MLE previously demonstrated superior hemodynamic results compared with standard myectomy, but its value relative to PTSMA is unknown. Methods and Results-Twenty-nine patients (aged 44Ϯ12 years) underwent myectomy with MLE, and 43 patients (aged 52Ϯ17 years) underwent PTSMA. Mitral leaflet area was similar in both groups (16.7Ϯ3.4 versus 15.9Ϯ2.7 cm 2 , respectively). After PTSMA, 2 patients died, 4 needed a reintervention, and 4 required a permanent pacemaker for complete heart block. After surgery, only 1 patient needed a reintervention. At 1-year follow-up, LVOT gradients did not differ between surgical and PTSMA patients (17Ϯ14 versus 23Ϯ19 mm Hg, respectively). Preinterventional mitral regurgitation grade was more severe in the surgical group, but with myectomy combined with MLE, the residual grade was similar to that of PTSMA. Mean SAM grade decreased significantly more after surgery (from 2.9Ϯ0.3 to 0.5Ϯ0.7 mm Hg versus from 2.8Ϯ0.5 to 1.3Ϯ0.9 mm Hg, PϽ0.05). Conclusions-PTSMA in these selected patients with hypertrophic obstructive cardiomyopathy had more periprocedural complications and resulted in more reinterventions. Hemodynamic results (SAM grade and reduction in mitral regurgitation) were better in surgical patients. (Circulation. 2005;112:482-488.)

show abstract

Combined anterior mitral leaflet extension and spark erosion myectomy in hypertrophic obstructive cardiomyopathy: Echo-enhanced surgery

Cited by 5 publications

References 18 publications

Long-Term Benefit of Myectomy and Anterior Mitral Leaflet Extension in Obstructive Hypertrophic Cardiomyopathy

Long-Term Benefit of Myectomy and Anterior Mitral Leaflet Extension in Obstructive Hypertrophic Cardiomyopathy

Systolic anterior motion of the mitral valve in hypertrophic cardiomyopathy: a narrative review

Percutaneous Versus Surgical Treatment for Patients With Hypertrophic Obstructive Cardiomyopathy and Enlarged Anterior Mitral Valve Leaflets

Contact Info

Product

Resources

About