Mini-invasive surgical instruments in transaortic myectomy for hypertrophic obstructive cardiomyopathy: a single-center experience with 168 cases
| Autor: | Ye Yang, Yulin Wang, WenJun Ding, Li Min Xia, Hao Lai, Chun Sheng Wang, Qiang Ji |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty lcsh:Surgery 030204 cardiovascular system & hematology Single Center Obstructive cardiomyopathy lcsh:RD78.3-87.3 03 medical and health sciences Mini invasive surgery 0302 clinical medicine Hypertrophic obstructive cardiomyopathy Heart Septum Left ventricular outflow tract gradient Humans Medicine 030212 general & internal medicine Cardiac Surgical Procedures Mitral regurgitation business.industry Endovascular Procedures Mini-invasive surgical instruments General Medicine lcsh:RD1-811 Cardiomyopathy Hypertrophic Middle Aged Plastic Surgery Procedures Septal myectomy medicine.disease Surgery Cardiac surgery Treatment Outcome Cardiothoracic surgery lcsh:Anesthesiology Female Cardiology and Cardiovascular Medicine business Atrioventricular block Research Article |
| Zdroj: | Journal of Cardiothoracic Surgery, Vol 16, Iss 1, Pp 1-8 (2021) Journal of Cardiothoracic Surgery |
| ISSN: | 1749-8090 |
| Popis: | Background Although septal myectomy is a standard strategy for managing patients with hypertrophic obstructive cardiomyopathy (HOCM) and drug-refractory symptoms, so far, only a few experienced myectomy centers exist globally. Mainly, this can be explained by the many technical challenges presented by myectomy. From our clinical experience, applying the mini-invasive surgical instruments during myectomy potentially reduces the technical difficulty. This study reports the preliminary experience regarding transaortic septal myectomy using mini-invasive surgical instruments for managing patients with HOCM and drug-refractory symptoms; also, we evaluate the early results following myectomy. Methods Between March 2016 and March 2019, consecutive HOCM patients who underwent isolated transaortic septal myectomy using the mini-invasive surgical instruments were enrolled in this analysis. Intraoperative, in-hospital and follow-up results were analyzed. Results We included 168 eligible patients (83 males, mean 56.8 ± 12.3 years). The midventricular obstruction was recorded in 7 (4.2%) patients. All patients underwent transaortic septal myectomy with a mean aortic cross-clamping time of 36.0 ± 8.1 min. During myectomy, 9 (5.4%) patients received repeat aortic cross-clamping. Surgical mortality was 0.6%. Notably, 5 (3.0%) patients developed complete atrioventricular block, they needed permanent pacemaker implantation. The median follow-up time was 6 months; however, no follow-up deaths occurred with a significant improvement in New York Heart Association functional status. We reported a sharp decrease in the maximum gradients from the preoperative value (11.6 ± 7.4 mmHg vs. 94.4 ± 22.6 mmHg, p p p Conclusions Mini-invasive surgical instruments may be beneficial in reducing the technical challenges of transaortic septal myectomy procedure. Of note, transaortic septal myectomy using the mini-invasive surgical instruments may present with favorable results. |
| Databáze: | OpenAIRE |
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