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Lysenko A.V.

Pervyĭ MGMU im. I.M. Sechenova;
Moskovskiĭ NII pediatrii i detskoĭ khirurgii

Lednev P.V.

Otdelenie kardiokhirurgii kliniki aortal'noĭ i serdechno-sosudistoĭ khirurgii Pervogo MGMU im. I.M. Sechenova

Salagaev G.I.

Chair of Cardiovascular Surgery and Interventional Cardiology, I.M. Sechenov First Moscow State Medical University (head — MD R.N. Komarov), acad. B.V. Petrovsky Russian Research Center for Surgery (director — acad. of RAS Yu.V. Belov), Moscow, Russia

Belov Yu.V.

RNTsKh im. akad. B.V. Petrovskogo RAMN

Surgical treatment of patients with obstructive hypertrophic cardiomyopathy

Authors:

Lysenko A.V., Lednev P.V., Salagaev G.I., Belov Yu.V.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2019;(11): 52‑56

DOI: 10.17116/hirurgia201911152

Views: 1078

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To cite this article:

Lysenko AV, Lednev PV, Salagaev GI, Belov YuV. Surgical treatment of patients with obstructive hypertrophic cardiomyopathy. Pirogov Russian Journal of Surgery. 2019;(11):52‑56. (In Russ.)
https://doi.org/10.17116/hirurgia201911152

Подписка 2025 (Pirogov Russian Journal of Surgery)
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Objective — to analyze in-hospital results of surgical treatment of patients with obstructive hypertrophic cardiomyopathy. Material and methods. There were 15 patients (8 women and 6 men) with obstructive hypertrophic cardiomyopathy and severe mitral insufficiency for the period from November 2017 to March 2019. Mean age of patients was 55.9±7.1 years. All patients had chronic heart failure NYHA class III and secondary coronary insufficiency. Results. Surgical correction of LVOT obstruction and mitral valve repair with elimination of systolic anterior motion were technically successful in all cases. There was no need for mitral valve replacement in all patients. Heart failure NYHA class I—II in early postoperative period was observed in all cases. Conclusion. Careful preoperative planning with a comprehensive analysis of hemodynamic and anatomical features of LV and certain surgical experience are essential for adequate correction of LVOT obstruction without atrioventricular node injury and mitral valve repair.

Keywords:

obstructive hypertrophic cardiomyopathy
LVOT obstruction
mitral insufficiency
SAM syndrome
surgical treatment
mitral valve repair

Authors:

Lysenko A.V.

Pervyĭ MGMU im. I.M. Sechenova;
Moskovskiĭ NII pediatrii i detskoĭ khirurgii

Lednev P.V.

Otdelenie kardiokhirurgii kliniki aortal'noĭ i serdechno-sosudistoĭ khirurgii Pervogo MGMU im. I.M. Sechenova

Salagaev G.I.

Chair of Cardiovascular Surgery and Interventional Cardiology, I.M. Sechenov First Moscow State Medical University (head — MD R.N. Komarov), acad. B.V. Petrovsky Russian Research Center for Surgery (director — acad. of RAS Yu.V. Belov), Moscow, Russia

Belov Yu.V.

RNTsKh im. akad. B.V. Petrovskogo RAMN

List of references:

  1. Gersh BJ, Maron BJ, Bonow RO, et al. 2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2011;58:e212‐e260.
  2. Elliott PM, Anastasakis A, et al. Task Force members, 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014;35:2733-2779.
  3. Nishimura RA, Holmes DR: Clinical practice. Hypertrophic obstructive cardiomyopathy. N Engl J Med. 2004;350:1320-1327.
  4. Ibrahim M, Rao C, Ashrafian H, Chaudhry U, Darzi A, Athanasiou T. Modern management of systolic anterior motion of the mitral valve. Eur J Cardiothorac Surg. 2012;41:1260-1270.
  5. Ferrazzi P, Spirito P, Iacovoni A, et al. Transaortic Chordal Cutting: Mitral Valve Repair for Obstructive Hypertrophic Cardiomyopathy With Mild Septal Hypertrophy. Journal of the American College of Cardiology. 2015;66(15):1687-1696.
  6. Brenes JC, Doltra A, Prat S. Cardiac magnetic resonance imaging in the evaluation of patients with hypertrophic cardiomyopathy. Glob Cardiol Sci Pract. 2018 Aug 12;2018(3):22.
  7. Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecci F, Charron P, et al. 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014;35:2733-2779.
  8. Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124:2761-2796.
  9. Afanasyev A, Bogachev-Prokophiev A, Lenko E, et al. Myectomy with mitral valve repair versus replacement in adult patients with hypertrophic obstructive cardiomyopathy: a systematic review and meta-analysis. Interactive CardioVascular and Thoracic Surgery. 2019;28:465-472. https://doi.org/10.1093/icvts/ivy269
  10. Wang S, Cui H, Yu Q, Chen H, Zhu C, Wang J, et al. Excision of anomalous muscle bundles as an important addition to extended septal myectomy for treatment of left ventricular outflow tract obstruction. The Journal of Thoracic and Cardiovascular Surgery. 2016;152(2):461-468.
  11. Musharbash FN, Schill MR, Henn MC, et al. Minimally Invasive Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy. Innovations (Phila). 2017;12(6):489-492. https://doi.org/10.1097/IMI.0000000000000421

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