Robot-assisted septal myectomy for hypertrophic cardiomyopathy with left ventricular outflow tract obstruction

Khalpey, Zain; Korovin, Lev N.; Chitwood, W. Randolph; Poston, Robert

doi:10.1016/j.jtcvs.2013.12.017

Cited by 26 publications

(24 citation statements)

References 5 publications

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“…As we all know, a satisfactory procedure for HOCM consists of three major goals: completely thickened septal muscle resection, dealing with the anterior mitral valve lea et in avoid of postoperative SAM, and release of abnormal papillary muscle and chordae attachments [8,9,11,12,13]. Compared with the traditional trans-aortic approach via the aortic incision, the trans-mitral approach via the base of the anterior mitral lea et provided a more clear panoramic exposure of the interventricular septum, making myectomy easily and avoiding heart block [14,15], through this approach, experienced surgeons could even identify the pale brous hinges subaortic hit caused by SAM [16,17,18]. Also this approach provided a wide vision of the anterior papillary muscles and its base.…”

Section: Discussionmentioning

confidence: 99%

Enlargement Of Left Ventricular Outflow Tract Using An Autologous Pericardial Patch For The Anterior Mitral Valve Leaflet And Septal Myectomy Through Trans-mitral Approach For The Treatment Of Hypertrophic Obstructive Cardiomyopathy

Zhang

Zhu

Wang

et al. 2020

Preprint

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Background: Modified Morrow procedure is the gold standard of surgical intervention for hypertrophic obstructive cardiomyopathy (HOCM). However, there are certain cases without clear exposure through the traditional trans-aortic approach; we therefore described a trans-mitral approach by enlarging left ventricular outflow tract (LVOT) using an autologous pericardial patch for the anterior mitral valve leaflet and septal myectomy. We aimed to retrospectively analyze this series of patients to reveal its safety and efficiency.Methods: We retrospectively analyzed 16 HOCM patients underwent enlargement of LVOT using an autologous pericardial patch for the anterior mitral valve leaflet and septal myectomy through trans-mitral approach in our center from January, 2016 to December, 2019. Baseline characteristics, operative details and postoperative data were extracted from our hospital medical records. Results: Of the 16 patients, there was no operative mortality. No new onset atrial fibrillation, no new onset stroke with symptoms, no permanent pacemaker implantation and no ventricular septal defects formation were observed during operation and three months follow-up. The peak pressure gradient of LVOT decreased from 97.56±23.81 mmHg to 7.56±2.13 mmHg (P < 0.01) after operation and 10.19±2.93 mmHg (P < 0.01) three months after operation. The average aortic cross-clamp time was 54.56±6.10 mins (range, 48 to 69 minutes). The systolic anterior motion (SAM) sign disappeared uneventfully in all cases. No patients had more than moderate MR.Conclusions: Enlargement of LVOT using an autologous pericardial patch for the anterior mitral valve leaflet and septal myectomy through trans-mitral approach is feasible and reliable for the treatment of certain types of HOCM cases.Trial registration: Not applicable.

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Section: Discussionmentioning

confidence: 99%

Enlargement Of Left Ventricular Outflow Tract Using An Autologous Pericardial Patch For The Anterior Mitral Valve Leaflet And Septal Myectomy Through Trans-mitral Approach For The Treatment Of Hypertrophic Obstructive Cardiomyopathy

Zhang

Zhu

Wang

et al. 2020

Preprint

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“…109,110 The remote image-guided magnetic catheter guidance system has been used in ablation operation for the treatment of AF 111,112 and tachycardia. [113][114][115] Robotic-assisted catheter technology has also been widely used in mitral valve repair, 116,117 and robotics have been used in minimally invasive surgery to treat coronary artery stenosis 118,119 or to assist in navigation in thickened hypertrophic obstructive cardiomyopathy with septum myectomy, 120 which is associated with sudden cardiac death syndrome.…”

Section: Application Of Nanotechnology In Cardiac and Cardiothoracic mentioning

confidence: 99%

Nanotechnology, an alternative with promising prospects and advantages for the treatment of cardiovascular diseases

Li¹,

Liang²,

Xiao³

et al. 2018

IJN

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Cardiovascular diseases (CVDs) are one of the most important causes of mortality and affecting the health status of patients. At the same time, CVDs cause a huge health and economic burden to the whole world. Although a variety of therapeutic drugs and measures have been produced to delay the progress of the disease and improve the quality of life of patients, most of the traditional therapeutic strategies can only cure the symptoms and cannot repair or regenerate the damaged ischemic myocardium. In addition, they may bring some unpleasant side effects. Therefore, it is vital to find and explore new technologies and drugs to solve the shortcomings of conventional treatments. Nanotechnology is a new way of using and manipulating the matter at the molecular scale, whose functional organization is measured in nanometers. Because nanoscale phenomena play an important role in cell signal transduction, enzyme action and cell cycle, nanotechnology is closely related to medical research. The application of nanotechnology in the field of medicine provides an alternative and novel direction for the treatment of CVDs, and shows excellent performance in the field of targeted drug therapy and the development of biomaterials. This review will briefly introduce the latest applications of nanotechnology in the diagnosis and treatment of common CVDs.

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“…There are several case reports of minimally invasive transmitral septal myectomy through right thoracotomy, either with video-assisted methods or robotic platform [20][21][22][23].…”

Section: Transmitral Septal Myectomymentioning

confidence: 99%

Contemporary Surgical Treatment for Hypertrophic Cardiomyopathy

Murashita¹

2018

Current Perspectives on Cardiomyopathies

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Hypertrophic cardiomyopathy is the most common cause of sudden death in young athletes. Surgical septal myectomy is highly effective for the patients with hypertrophic obstructive cardiomyopathy, which is refractory to medical treatment. The perioperative mortality rate for isolated septal myectomy is less than 1% in high volume centers. The long-term outcomes have been reported to be outstanding with >90% of patients being free of significant symptoms and most being able to return to a normal lifestyle. There is a documented survival benefit after surgical septal myectomy. There is a wide variation of pathophysiology in hypertrophic cardiomyopathy including diffuse midventricular obstruction or subvalvular abnormalities. Several surgical approaches have been applied in accordance with the pathophysiology, such as transaortic, transapical, and transmitral septal myectomy. There is a controversy how to manage concomitant mitral valve regurgitation. The most recent Society of Thoracic Surgeons database showed that operative mortality of concomitant septal myectomy and mitral valve operations was double compared with isolated septal myectomy.

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Robot-assisted septal myectomy for hypertrophic cardiomyopathy with left ventricular outflow tract obstruction

Cited by 26 publications

References 5 publications

Enlargement Of Left Ventricular Outflow Tract Using An Autologous Pericardial Patch For The Anterior Mitral Valve Leaflet And Septal Myectomy Through Trans-mitral Approach For The Treatment Of Hypertrophic Obstructive Cardiomyopathy

Enlargement Of Left Ventricular Outflow Tract Using An Autologous Pericardial Patch For The Anterior Mitral Valve Leaflet And Septal Myectomy Through Trans-mitral Approach For The Treatment Of Hypertrophic Obstructive Cardiomyopathy

Nanotechnology, an alternative with promising prospects and advantages for the treatment of cardiovascular diseases

Contemporary Surgical Treatment for Hypertrophic Cardiomyopathy

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