PMID- 18818579
OWN - NLM
STAT- MEDLINE
DCOM- 20081016
LR  - 20161124
IS  - 1341-1098 (Print)
IS  - 1341-1098 (Linking)
VI  - 14
IP  - 4
DP  - 2008 Aug
TI  - Septal myectomy, papillary muscle resection, and mitral valve replacement for 
      hypertrophic obstructive cardiomyopathy: a case report.
PG  - 258-62
AB  - We report a case of hypertrophic obstructive cardiomyopathy (HOCM) successfully 
      treated with septal myectomy and mitral valve replacement (MVR) combined with a 
      resection of the hypertrophic papillary muscles. The patient, a 74-year-old 
      woman, first underwent the conventional septal myectomy through aortotomy. The 
      papillary muscles revealed a marked hypertrophy, but extended myectomy and 
      precise resection of the hypertrophic papillary muscles were thought to be 
      difficult through the aortotomy. Through the right-sided left atriotomy, MVR and 
      resection of the papillary muscles were additionally performed. The patient was 
      smoothly weaned from the cardiopulmonary bypass, and the postoperative course was 
      uneventful. The outflow pressure gradient was relieved to 0 mm Hg, from 94. The 
      mean pulmonary artery pressure was reduced to 27 mm Hg, from 42. The patient has 
      been doing well in the New York Heart Association (NYHA) functional class between 
      I and II during 45 months of follow-up, without complications related to the use 
      of a prosthetic valve. Septal myectomy is the procedure of choice in the surgical 
      treatment of HOCM for most cases, but some may require additional mitral valve 
      procedures. In patients with marked hypertrophic papillary muscles, MVR and 
      resection of the muscles may be an option of treatment to ensure a relief of the 
      outflow obstruction and to abolish systolic anterior movement in units with 
      limited experience.
FAU - Takahashi, Junichiro
AU  - Takahashi J
AD  - Division of Cardiovascular Surgery, Aishin Memorial Hospital, Sapporo, Japan.
FAU - Wakamatsu, Yutaka
AU  - Wakamatsu Y
FAU - Okude, Jun
AU  - Okude J
FAU - Gohda, Toshihiro
AU  - Gohda T
FAU - Sanefuji, Youichi
AU  - Sanefuji Y
FAU - Kanaoka, Tsuyoshi
AU  - Kanaoka T
FAU - Sasaki, Shigeyuki
AU  - Sasaki S
FAU - Matsui, Yoshiro
AU  - Matsui Y
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - Japan
TA  - Ann Thorac Cardiovasc Surg
JT  - Annals of thoracic and cardiovascular surgery : official journal of the 
      Association of Thoracic and Cardiovascular Surgeons of Asia
JID - 9703158
SB  - IM
MH  - Aged
MH  - Cardiomyopathy, Hypertrophic/complications/diagnostic imaging/*surgery
MH  - Cardiopulmonary Bypass
MH  - Echocardiography, Doppler, Color
MH  - Echocardiography, Transesophageal
MH  - Female
MH  - Heart Septum/*surgery
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Mitral Valve/*surgery
MH  - Mitral Valve Insufficiency/diagnostic imaging/etiology/*surgery
MH  - Papillary Muscles/*surgery
MH  - Treatment Outcome
MH  - Ventricular Outflow Obstruction/diagnostic imaging/etiology/*surgery
EDAT- 2008/09/27 09:00
MHDA- 2008/10/17 09:00
CRDT- 2008/09/27 09:00
PHST- 2007/01/05 00:00 [received]
PHST- 2007/07/30 00:00 [accepted]
PHST- 2008/09/27 09:00 [pubmed]
PHST- 2008/10/17 09:00 [medline]
PHST- 2008/09/27 09:00 [entrez]
AID - atcs/2008_14_4/258 [pii]
PST - ppublish
SO  - Ann Thorac Cardiovasc Surg. 2008 Aug;14(4):258-62.