Transapical beating-heart septal myectomy for recurrent left ventricular outflow tract obstruction after septal reduction therapy in hypertrophic obstructive cardiomyopathy

Eur J Cardiothorac Surg. 2023 Sep 7;64(3):ezad296. doi: 10.1093/ejcts/ezad296.

Abstract

We present a case of a 58-year-old man for surgical myectomy due to recurrent left ventricular outflow tract (LVOT) obstruction, who had prior transaortic septal myectomy and embolization of the septal branch. On admission, transthoracic echocardiography showed a typical hypertrophic obstructive cardiomyopathy (HOCM) with asymmetric septal hypertrophy, significant LVOT obstruction and severe mitral regurgitation due to the systolic anterior movement of the anterior mitral valve leaflet. We performed a novel procedure of the transapical beating-heart septal myectomy, following which the LVOT obstruction was resolved. And a decreased grade of systolic anterior movement and a reduction in the severity of mitral regurgitation were observed.

Keywords: Hypertrophic obstructive cardiomyopathy; Left ventricular outflow tract obstruction; Transapical beating-heart septal myectomy.

Publication types

  • Case Reports

MeSH terms

  • Cardiomyopathy, Hypertrophic* / complications
  • Cardiomyopathy, Hypertrophic* / surgery
  • Coronary Artery Bypass
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve
  • Mitral Valve Insufficiency* / etiology
  • Mitral Valve Insufficiency* / surgery
  • Ventricular Outflow Obstruction, Left*