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Surgery for Left Ventricular Outflow Tract Obstruction with a Relatively Thin Interventricular Septum

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Title: Surgery for Left Ventricular Outflow Tract Obstruction with a Relatively Thin Interventricular Septum
Authors: Shingu, Yasushige Browse this author →KAKEN DB
Sugiki, Hiroshi Browse this author
Ooka, Tomonori Browse this author →KAKEN DB
Kato, Hiroki Browse this author
Wakasa, Satoru Browse this author →KAKEN DB
Tachibana, Tsuyoshi Browse this author
Matsui, Yoshiro Browse this author →KAKEN DB
Keywords: cardiomyopathy
mitral valve surgery
systolic anterior motion
Issue Date: Jun-2018
Publisher: Georg Thieme Verlag
Journal Title: The Thoracic and cardiovascular surgeon
Volume: 66
Issue: 04
Start Page: 307
End Page: 312
Publisher DOI: 10.1055/s-0035-1570748
PMID: 26757211
Abstract: Background: To examine the results of myectomy and mitral valve surgery for systolic anterior motion (SAM) of the mitral valve and left ventricular outflow tract obstruction (LVOTO) with a relatively thin interventricular septum. Methods: The subjects were 12 patients with SAM and LVOTO. Eight had hypertrophic obstructive cardiomyopathy (HOCM) with a mean interventricular septal thickness of 16 mm. Three had sigmoid septum and one had an unknown etiology. For HOCM, isolated extended myectomy was performed when mitral regurgitation was mild (n = 1) and extended myectomy plus mitral valve surgery was performed when mitral regurgitation was more than mild (n = 4) or primary valve etiologies existed (n = 3). Myectomy was performed for the three cases with sigmoid septum. Myectomy plus height reduction of the posterior mitral leaflet was performed for the one case with the unknown etiology of SAM. Results: In the patients with HOCM, the maximum LVOT pressure gradient significantly decreased from 140 ± 18 to 16 ± 6 and 3 ± 3 mm Hg, while mitral regurgitation significantly decreased from 2.3 ± 0.5 to 0.5 ± 0.3 and 0.4 ± 0.2 at pre-op, early post-op, and last follow-up (3 ± 1 years), respectively. In the other etiologies, the maximum LVOT pressure gradient changed from 56 ± 15 to 25 ± 15 and 5 ± 4 mm Hg; mitral regurgitation changed from 2.0 ± 0.6 to 1.3 ± 0.3 and 1.3 ± 0.8, at pre-op, early post-op, and the last follow-up (3 ± 2 years), respectively. Conclusion: Myectomy with mitral valve surgery is an option for SAM and LVOTO in patients with a relatively thin interventricular septum.
Rights: This is an Accepted Manuscript of an article published by Thieme Publishing Group in Journal Title on Publication Date, available online at https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0035-1570748
Type: article (author version)
URI: http://hdl.handle.net/2115/71265
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 新宮 康栄

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