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Thorac Cardiovasc Surg Rep 2016; 05(01): 30-32
DOI: 10.1055/s-0036-1580601
Case Report: Cardiac
Georg Thieme Verlag KG Stuttgart · New York

Surgical Myectomy after Failed Ablation for Hypertrophic Obstructive Cardiomyopathy

Ioannis Bougioukas
1   Department of Thoracic and Cardiovascular Surgery, Georg-Agust University, Goettingen, Germany
,
Uta Hoppe
2   Department of Cardiology, Paracelsus Medical University, Salzburg, Austria
,
Bernhard Danner
1   Department of Thoracic and Cardiovascular Surgery, Georg-Agust University, Goettingen, Germany
,
Friedrich A. Schoendube
1   Department of Thoracic and Cardiovascular Surgery, Georg-Agust University, Goettingen, Germany
› Author Affiliations
Further Information

Publication History

16 December 2015

08 February 2016

Publication Date:
04 April 2016 (online)

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Abstract

Background Hypertrophic cardiomyopathy is a genetic disease of the myocardial sarcolemma characterized by left ventricular hypertrophy. When obstruction to the left ventricular outflow tract is present and symptoms are refractory to medication, surgical myectomy or alcohol septal ablation is indicated.

Case Description We report a case of a patient presented for myectomy due to recurrence only 1 year after alcohol ablation. Interesting findings were a firm subaortic membrane and a direct insertion of the papillary muscle into the mitral valve.

Conclusion After myectomy and extensive papillary muscle mobilization, a significant relief of obstruction was achieved.

Keywords

hypertrophic obstructive cardiomyopathy - septal myectomy - alcohol septal ablation
 

  • References

  • 1 Richardson P, McKenna W, Bristow M , et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation 1996; 93 (5) 841-842
    CrossrefPubMedGoogle Scholar
  • 2 Maron BJ, Braunwald E. Evolution of hypertrophic cardiomyopathy to a contemporary treatable disease. Circulation 2012; 126 (13) 1640-1644
    CrossrefPubMedGoogle Scholar
  • 3 Sigwart U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy. Lancet 1995; 346 (8969): 211-214
    CrossrefPubMedGoogle Scholar
  • 4 Schoendube FA, Klues HG, Reith S, Flachskampf FA, Hanrath P, Messmer BJ. Long-term clinical and echocardiographic follow-up after surgical correction of hypertrophic obstructive cardiomyopathy with extended myectomy and reconstruction of the subvalvular mitral apparatus. Circulation 1995; 92 (9, Suppl) II122-II127
    CrossrefPubMedGoogle Scholar
  • 5 Hess OM, Sigwart U. New treatment strategies for hypertrophic obstructive cardiomyopathy: alcohol ablation of the septum: the new gold standard?. J Am Coll Cardiol 2004; 44 (10) 2054-2055
    CrossrefPubMedGoogle Scholar
  • 6 Dearani JA, Ommen SR, Gersh BJ, Schaff HV, Danielson GK. Surgery insight: septal myectomy for obstructive hypertrophic cardiomyopathy—the Mayo Clinic experience. Nat Clin Pract Cardiovasc Med 2007; 4 (9) 503-512
    CrossrefPubMedGoogle Scholar
  • 7 Gersh BJ, Maron BJ, Bonow RO , et al; American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines; 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; Society of Thoracic Surgeons. 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. Circulation 2011; 124 (24) e783-e831
    CrossrefPubMedGoogle Scholar