PMID- 22529188
OWN - NLM
STAT- MEDLINE
DCOM- 20130918
LR  - 20161125
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 43
IP  - 1
DP  - 2013 Jan
TI  - Surgical correction of hypertrophic obstructive cardiomyopathy in patients with 
      simultaneous obstruction of left ventricular midcavity and right ventricular 
      outflow tract.
PG  - 67-72
LID - 10.1093/ejcts/ezs172 [doi]
AB  - OBJECTIVE: The classic Morrow technique for hypertrophic obstructive 
      cardiomyopathy (HOCM) in patients with simultaneous obstruction of left 
      ventricular (LV) midcavity and right ventricular outflow tract (RVOT) combined 
      with extreme left ventricular hypertrophy, is not effective. A new technique for 
      HOCM surgical correction in patients with severe hypertrophy is proposed. 
      METHODS: The excision of the asymmetrical hypertrophied area of the 
      interventricular septum (IVS) causing simultaneous midventricular and RVOT 
      obstruction was performed from the conal part of the right ventricle (RV) in the 
      middle part of the right side of the IVS. Conceptually, this approach offers a 
      number of advantages: it affords the excision of the asymmetrically hypertrophied 
      area of the ventricular septum without penetration into the left ventricular 
      cavity, it avoids mechanical damage to the heart conduction system and aortic 
      valve and, for the surgeon, it improves the visual inspection of the area to be 
      resected. Seven patients with the midventricular obstruction of the LV associated 
      with RVOT obstruction [mean New York Heart Association (NYHA) class 3.0] 
      underwent this procedure. The follow-up period was 24.8 +/- 11.3 months. RESULTS: 
      Six patients were free of symptoms (NYHA class I) and one was in NYHA class 2. 
      There were no early or late deaths. The mean value of the echocardiographic 
      intraventricular gradients in the LV decreased from 86.3 +/- 9.9 to 10.3 +/- 5.3 
      mmHg, the mean value of the gradients in the RVOT decreased to 44.9 +/- 9.6 versus 
      4.1 +/- 1.2 mmHg. Sinus rhythm without the block of the bundle of the right branch 
      was noted in all patients after surgery. No patients needed the implantation of a 
      cardioverter-defibrillator. CONCLUSION: This technique for the surgical 
      correction of HOCM provides the effective simultaneous elimination of LV 
      midventricular and RVOT obstruction. A major advantage is that injuries, in 
      particular to the conduction system, are easily avoided.
FAU - Borisov, Konstantin Valentinovitch
AU  - Borisov KV
AD  - Medical Department of the Executive Office, Moscow, Russia. dr.borisov@rambler.ru
LA  - eng
PT  - Journal Article
DEP - 20120423
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
CIN - Eur J Cardiothorac Surg. 2014 Apr;45(4):769. PMID: 23904129
CIN - Eur J Cardiothorac Surg. 2014 Apr;45(4):770. PMID: 23904135
MH  - Adolescent
MH  - Adult
MH  - Cardiac Surgical Procedures/*methods
MH  - Cardiomyopathy, Hypertrophic/complications/diagnostic imaging/*surgery
MH  - Echocardiography
MH  - Female
MH  - Heart Ventricles/diagnostic imaging/surgery
MH  - Humans
MH  - Hypertrophy, Left Ventricular/complications/diagnostic imaging/*surgery
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
MH  - Ventricular Outflow Obstruction/complications/diagnostic imaging/*surgery
MH  - Ventricular Septum/*surgery
EDAT- 2012/04/25 06:00
MHDA- 2013/09/21 06:00
CRDT- 2012/04/25 06:00
PHST- 2012/04/25 06:00 [entrez]
PHST- 2012/04/25 06:00 [pubmed]
PHST- 2013/09/21 06:00 [medline]
AID - ezs172 [pii]
AID - 10.1093/ejcts/ezs172 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2013 Jan;43(1):67-72. doi: 10.1093/ejcts/ezs172. Epub 
      2012 Apr 23.