Resection of hypertrophic papillary muscles and mitral valve replacement in a patient with midventricular hypertrophic obstructive cardiomyopathy – a new approach

Autor: Julian J. Berg, Jan Eckstein, Marcus-André Deutsch, Jan F. Gummert, Masatoshi Hata
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Cardiothoracic Surgery, Vol 19, Iss 1, Pp 1-3 (2024)
Druh dokumentu: article
ISSN: 1749-8090
DOI: 10.1186/s13019-024-02529-w
Popis: Abstract Midventricular hypertrophic obstructive cardiomyopathy (HOCM) is characterized by hypertrophy of the interventricular septum (IVS) and - in rare cases - of the papillary muscles (PM), which subsequently can cause dynamic left ventricular outflow tract obstruction (LVOTO) and severe heart failure symptoms. We report on a rare case of a 44-year-old patient suffering from midventricular HOCM with hypertrophic anterolateral PM and an additional chorda between the PM and the IVS. We describe a new surgical approach via right anterolateral thoracotomy in 3-dimensional (3D) video-assisted minimal-invasive technique with resection of hypertrophic PMs as well as the entire mitral valve-apparatus and valve replacement avoiding septal myectomy and potentially associated complications. After an uneventful procedure clinical symptoms improved from NYHA III-IV at baseline to NYHA 0-I postoperatively and remained stable over a follow-up period of 24 months. Therefore, the presented technique may be considered as a new and alternative approach in patients with hypertrophic PMs and hypertrophic IVS as subtype of midventricular HOCM.
Databáze: Directory of Open Access Journals
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