An innovative minimally invasive approach for hypertrophic obstructive cardiomyopathy: Transaortic septal myectomy via right infra-axillary incisionCentral MessagePerspective

An innovative minimally invasive approach for hypertrophic obstructive cardiomyopathy: Transaortic septal myectomy via right infra-axillary incisionCentral MessagePerspective

Objective: To assess the short-term outcomes of the transaortic modified Morrow procedure when performed via a minimally invasive right infra-axillary incision. Methods: We conducted a retrospective observational study at a single center of patients diagnosed with hypertrophic obstructive cardiomyop...

Full description

Saved in:
Bibliographic Details
Main Authors: Zhiqiang Dong, MD, Shuwei Wang, MD, Zhifang Liu, MD, Erlei Han, MD, Changhao Wu, MD, Chentao Luo, MD, Weikang Chen, MD, Fuyang Mei, MD, Xiaofeng Lu, MD, Meijuan Yan, MD, Zhenzhen Wang, MD, Bing Zhou, MD, Yong Cui, MD, PhD
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:JTCVS Techniques
Subjects:
hypertrophic cardiomyopathy
septal myectomy
minimally invasive
Online Access:http://www.sciencedirect.com/science/article/pii/S2666250724003687
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective: To assess the short-term outcomes of the transaortic modified Morrow procedure when performed via a minimally invasive right infra-axillary incision. Methods: We conducted a retrospective observational study at a single center of patients diagnosed with hypertrophic obstructive cardiomyopathy from September 2021 to July 2023. Results: The cohort comprised 148 patients (mean age 47.2 ± 15.0 years; 59.5% male). A majority (137/148, 92.6%) presented with systolic anterior motion. All procedures were successfully completed through a 4- to 5-cm right infra-axillary incision, without requiring conversion to sternotomy. Transthoracic echocardiography demonstrated a significant reduction in maximum septal thickness from 20.9 ± 5.0 mm to 14.4 ± 3.5 mm (95% confidence interval, 5.66-7.28; P < .001), and in left ventricular outflow tract gradient from 85.1 ± 50.9 mm Hg to 11.7 ± 10.3 mm Hg (95% confidence interval, 65.1-81.6; P < .001). The systolic anterior motion phenomenon was completely eliminated, with no severe mitral regurgitation was observed postoperatively. No iatrogenic ventricular septal defects occurred. One hundred twenty-four (83.8%) patients were extubated in the operating room. Eight (5.4%) patients received permanent pacemaker implantation. Unfortunately, 1 patient (0.7%) died of an intraoperative subarachnoid hemorrhage. Conclusions: The transaortic modified Morrow procedure, performed through a minimally invasive right infra-axillary incision, shows favorable short-term outcomes.
ISSN:2666-2507

Similar Items