PMID- 26792931
OWN - NLM
STAT- MEDLINE
DCOM- 20170321
LR  - 20220409
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 50
IP  - 1
DP  - 2016 Jul
TI  - Hypertrophic obstructive cardiomyopathy: the mitral valve could be the key.
PG  - 61-5
LID - 10.1093/ejcts/ezv473 [doi]
AB  - OBJECTIVES: As we strongly believe that treating the mitral valve abnormalities 
      is a key feature of hypertrophic obstructive cardiomyopathy (HOCM), we have 
      systematically corrected both the anterior and posterior leaflet (PL) size and 
      geometry. We have analysed our immediate results and at mid-term follow-up. 
      METHODS: From March 2010 until June 2015, 16 patients with HOCM underwent 
      surgical correction of obstruction. The mean age was 51 years old (range, 32-72 
      years). All were symptomatic being New York Heart Association (NYHA) class 3 (n = 
      4) or 4 (n = 12). All had systolic anterior motion at echocardiogram with severe 
      mitral regurgitation (MR). Intraventricular gradient preoperatively was 73.5 mmHg 
      (range, 50-120 mmHg). All patients underwent a double-stage procedure: first 
      septal resection through (i) the aortic valve and (ii) the detached anterior 
      leaflet (AL) of the mitral valve and at second, mitral valve repair by (i) 
      reducing PL height (leaflet resection or artificial neochordae) (ii) increasing 
      AL height with pericardial patch. RESULTS: There was no in-hospital or late 
      death. All patients were Class 1 NYHA at latest follow-up. Control 
      echocardiography showed no MR, mean rest intraventricular gradient was 15 mmHg 
      (range, 9-18 mmHg). CONCLUSIONS: Our good mid-term results support the concept 
      that HOCM is not only a septal disease and that the mitral valve pathology is a 
      key component that should be addressed. For most patients, the ideal surgical 
      treatment should consist in a two-step procedure. It is even necessary to be 
      studied whether treating the mitral valve alone could not suffice.
CI  - (c) The Author 2016. Published by Oxford University Press on behalf of the European 
      Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Dulguerov, Filip
AU  - Dulguerov F
AD  - Cardiothoracic Center of Monaco, Monaco Cedex, Monaco.
FAU - Marcacci, Cecilia
AU  - Marcacci C
AD  - Cardiothoracic Center of Monaco, Monaco Cedex, Monaco.
FAU - Alexandrescu, Clara
AU  - Alexandrescu C
AD  - Cardiothoracic Center of Monaco, Monaco Cedex, Monaco.
FAU - Chan, K M John
AU  - Chan KM
AD  - Cardiothoracic Center of Monaco, Monaco Cedex, Monaco National Heart and Lung 
      Institute, Imperial College London, London, UK Sarawak General Hospital Heart 
      Center, Kuching, Sarawak, Malaysia.
FAU - Dreyfus, Gilles D
AU  - Dreyfus GD
AD  - Cardiothoracic Center of Monaco, Monaco Cedex, Monaco National Heart and Lung 
      Institute, Imperial College London, London, UK gdreyfus@ccm.mc.
LA  - eng
PT  - Journal Article
DEP - 20160119
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
MH  - Adult
MH  - Aftercare
MH  - Aged
MH  - Cardiomyopathy, Hypertrophic/diagnosis/*etiology/surgery
MH  - Coronary Artery Bypass/methods
MH  - Echocardiography
MH  - Female
MH  - Humans
MH  - Length of Stay
MH  - Magnetic Resonance Angiography
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/*complications/diagnosis/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Aortic approach
OT  - Extensive myectomy
OT  - Hypertrophic obstructive cardiomyopathy
OT  - Mitral approach
OT  - Mitral valve repair
OT  - Systolic anterior motion
EDAT- 2016/01/23 06:00
MHDA- 2017/03/23 06:00
CRDT- 2016/01/22 06:00
PHST- 2015/10/11 00:00 [received]
PHST- 2015/12/04 00:00 [accepted]
PHST- 2016/01/22 06:00 [entrez]
PHST- 2016/01/23 06:00 [pubmed]
PHST- 2017/03/23 06:00 [medline]
AID - ezv473 [pii]
AID - 10.1093/ejcts/ezv473 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2016 Jul;50(1):61-5. doi: 10.1093/ejcts/ezv473. Epub 
      2016 Jan 19.