Transcatheter Mitral Valve Plication

An Evolution of Management in Hypertrophic Cardiomyopathy: Myectomy, Alcohol Septal Ablation, Mitral Valve Replacement, MitraClip

“…In certain cases, however, septal myectomy alone does not eliminate SAM of the mitral valve, which is essential for optimal hemodynamic results, especially if elongation of mitral valve leaflets is present. In order to address this problem in select patients, a second procedure may be required [4,13,14]. …”

“…Although, as a general rule, good results have been reported after septal myectomy in patients with HCM, studies suggest that SAM may persist in a proportion of patients requiring a second procedure [4,13,14,15]. More recently, the Alfieri stitch (edge-to-edge repair with placement of a suture between the anterior and posterior mitral valve leaflets) was used in 23 patients with HCM at the time of septal myectomy [16].…”