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Application of cryoenergy to improve septal exposure during transaortic septal myectomy in hypertrophic obstructive cardiomyopathy

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Abstract

For the past few decades, the transaortic septal myectomy (Morrow’s procedure) has been the gold standard for treating severe left ventricular outflow tract obstruction in hypertrophic obstructive cardiomyopathy (HOCM) patients. 30-day mortality has been reported at less than 1% in dedicated centers. However, in a subgroup of patients, the interventricular septal obstruction is localized very distally, below the aortic valve plane, and the transaortic approach can be very challenging. A subset of these patients can present with residual obstruction after surgery, due to inadequate length of septal excision, leading to reoperation. The aim of this work is to illustrate an original application of cryoenergy to improve the transaortic exposure of the interventricular septum and thus enable surgeons to perform very distal myectomies in HOCM patients.

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References

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Authors and Affiliations

  1. Heart Surgery Unit, San Raffaele University Hospital, Via Olgettina 60, 20132, Milan, Italy

    Alberto Pozzoli, Luca Vicentini, Elisabetta Lapenna & Ottavio Alfieri

  2. Thoracic and Cardiovascular Surgery Unit, Uppsala University Hospital, 75124, Uppsala, Sweden

    Stefan Thelin & Leif Nilsson

Authors
  1. Alberto Pozzoli
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  2. Luca Vicentini
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  3. Stefan Thelin
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  4. Elisabetta Lapenna
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  5. Leif Nilsson
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  6. Ottavio Alfieri
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Corresponding author

Correspondence to Alberto Pozzoli.

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None declared.

Conflict of interest

Alberto Pozzoli reports no conflict of interest; Luca Vicentini reports no conflict of interest; Stefan Thelin reports no conflict of interest; Elisabetta Lapenna reports no conflict of interest; Leif Nilsson reports no conflict of interest; Ottavio Alfieri reports no conflict of interest.

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Pozzoli, A., Vicentini, L., Thelin, S. et al. Application of cryoenergy to improve septal exposure during transaortic septal myectomy in hypertrophic obstructive cardiomyopathy. Gen Thorac Cardiovasc Surg 66, 243–245 (2018). https://doi.org/10.1007/s11748-017-0815-8

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  • DOI: https://doi.org/10.1007/s11748-017-0815-8

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