Skip to main content

Techniques and complications of transaortic subvalvular myectomy in patients with hypertrophic obstructive cardiomyopathy (HOCM)

  • Conference paper
New Aspects of Hypertrophic Cardiomyopathy

Abstract

Studies on the natural history of patients with hypertrophic obstructive cardiomyopathy (HOCM) demonstrate a slowly continuing deterioration, characterized additionally by development of mitral insufficiency, atrial fibrillation, congestive heart failure, and sudden death (10, 25, 27, 35, 38, 41). This development can be partly interrupted with different medical therapeutic regimens for HOCM using β-blocking agents and/or calcium antagonists, as demonstrated by recent clinical investigations (7, 15, 20). However, there are some patients who do not respond adequately on a long-term basis to conservative treatment, or they deteriorate again after an initially impressive clinical improvement. These patients may become candidates for surgical treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Agnew TM, Barratt-Boyes GB, Brandt PT, Roibe AHG, Loewe JB, O’Brian KP (1977) Surgical resection in idiopathic hypertrophic subaortic stenosis with a combined approach through aorta and left ventricle. A long-term follow-up study in 49 patients. J Thorac Cardiovasc Surg 74: 307–316

    PubMed  CAS  Google Scholar 

  2. Alvarez-Diaz F, Cabo J, Cordovilla G, Greco R, Sanz E, Berches D, Alvarado F, Garcia-Aguado A (1984) Surgical correction of diffuse subaortic stenosis by an infundibular septal resection. 33th Congress of the European Society of Cardiovascular Surgery, Madrid, Abstract Book

    Google Scholar 

  3. Beahrs MM, Tajik AJ, Seward JB, Giuliani ER, McGoon DC (1983) Hypertrophic Obstructive Cardiomyopathy: Ten to 21 year follow-up after partial septal myectomy. Am J Cardiol 51: 1160–1166

    Article  PubMed  CAS  Google Scholar 

  4. Bentall HH (1966) The place of surgery in hypertrophic bostructive cardiomyopathy (idiopathic hypertrophic subaortic-stenosis). J Thorac Cardiovasc Surg 51: 49–52

    PubMed  CAS  Google Scholar 

  5. Bernhard FW, Poirer V, La Farge CG (1975) Relief of congenital obstruction to left ventricular outflow with a ventricular-aortic prosthesis. J Thorac Cardiovasc Surg 69: 223–229

    PubMed  CAS  Google Scholar 

  6. Bigelow WG, Trimble AS, Wigle DE, Adelman AG, Felderhof SE (1974) The treatment of muscular subaortic stenosis. J Thorac Cardiovasc Surg 68: 384–390

    PubMed  CAS  Google Scholar 

  7. Binet JP, David P, Piot JD (1983) Surgical treatment of hyper trophic obstructive cardiomyopathies. Europ Heart J 4, Suppl F: 191–195

    Google Scholar 

  8. Bircks W, Schulte HD (1983) Surgical treatment of hypertrophicobstructive cardiomyopathy with special reference to complications and to atypical hypertrophic obstructive cardiomyopathy. Europ Heart J 4, Suppl F: 187–190

    Google Scholar 

  9. Björk VO, Radegran K (1976) Obstructive cardiomyopathy. J Cardiovasc Surg 17: 376–379

    Google Scholar 

  10. Bonow R (1986) Effects of verapamil on abnormalities of LV distensibility and relaxation in hypertrophic obstructive cardiomyopathy and relation to improved exercise capacity. 2nd International Workshop on Hypertrophic Cardiomyopathy, Badenweiler, FRG

    Google Scholar 

  11. Braunwald E, Lambrew CT, Morrow AG, Pierce EG, Rockoff SD, Ross jr. J (1964) Idiopathic hypertrophic subaortic stenosis. Am Heart Ass Monog 10. Circulation 30, Suppl 4

    Google Scholar 

  12. Cooley DA, Norman JC, Mullins CE, Grace RR (1975) Left ventricle to abdominal aorta conduits for relief of aortic stenosis. Cardiovasc Disc 2: 376–381

    Google Scholar 

  13. Cooley DA, Wukasch DC, Leachman RD (1976) Mitral valve replacement for idiopathic sub-aortic stenosis. Results in 27 patients. J Cardiovasc Surg 17: 380–387

    CAS  Google Scholar 

  14. Dobell ARC, Scott AJ (1964) Hypertrophic subaortic stenosis. Evolution of a surgical technique. J Thorac Cardiovasc Surg 47: 26–31

    Google Scholar 

  15. Epstein SE, NIH Cardiology Branch (personal communication)

    Google Scholar 

  16. Goodwin JF, Hollman A, Cleland WP, Teare D (1960) Obstructive cardiomyopathy simulating aortic stenosis. Br Heart J 22: 403–408

    Article  PubMed  CAS  Google Scholar 

  17. Hopf R (1986) Effects of combined therapy with propranolol and nifedipin. 2nd Intern Workshop on Hypertrophic Cardiomyopathy, Badenweiler, FRG

    Google Scholar 

  18. Johnson J (1964) Discussion of Dobell and Scott (13)

    Google Scholar 

  19. Julian OC, Dye WS, Javid H, Hunter JA, Muenster JJ, Najafi H (1965) Apical left ventriculotomy in subaortic stenosis due to fibromuscular hypertrophy. Circulation 31, Suppl I: 45

    Google Scholar 

  20. Kirklin JW, Ellis FW (1961) Surgical relief of diffuse subvalvular aortic stenosis. Circulation 24: 739–742

    PubMed  CAS  Google Scholar 

  21. Kober G (1986) Results of a multicenter study on hypertrophie cardiomyopathy comparing propranolol and verapamil. 2nd Intern Workshop on Hypertrophic Cardiomyopathy, Badenweiler, FRG

    Google Scholar 

  22. Konno S, Imai Y, Jida Y, Makajima M, Tetsuno K (1975) A new method for prosthetic valve replacement in congenital aortic stenosis associated with hypoplasie of the aortic ring. J Thorac Cardiovasc Surg 70: 909–917

    PubMed  CAS  Google Scholar 

  23. Kuhn H, Gietzen F, Mercier J, Lösse B, Köhler E, Schulte HD, Bircks W, Loogen F (1983) Studies of the clinical picture, course, and prognosis of different forms of hypertrophie cardiomyopathy. Z Kardiol 72: 83–98

    PubMed  CAS  Google Scholar 

  24. Lillehei CW, Levy MJ (1963) Transatrial exposure for correction of subaortic stenosis. J Am Med Ass 186: 8–12

    Article  CAS  Google Scholar 

  25. Lösse B, Kuhn H, Loogen F, Schulte HD (1983) Exercise performance in hypertrophic cardiomyopathies. Europ Heart J 4, Suppl F: 197–208

    Google Scholar 

  26. Lösse B (1986) Hemodynamic long-term results after medical andsurgical therapy. 2nd Intern Workshop on Hypertrophic Cardiomyopathy, Badenweiler, FRG

    Google Scholar 

  27. Loogen F, Kuhn H, Gietzen F, Lösse B, Schulte HD, Bircks W (1983) Clinical course and prognosis of patients with typical and atypical hypertrophic obstructive and with hypertrophic non-obstructive cardiomyopathy. Europ Heart J 4, Suppl F: 145–153

    Google Scholar 

  28. Maron BJ, Epstein SE, Morrow AG (1983) Symptomatic status and prognosis of patients after operation for hypertrophic obstructive cardiomyopathy: efficacy of ventricular septal myotomy and myectomy. Europ Heart J 4, Suppl F: 175–185

    Google Scholar 

  29. McKenna W, Borggrefe M, England D, Deanfield J, Oakley CM, Goodwin JF (1981) Prognosis in hypertrophic cardiomyopathy: role of age and clinical, electrocardiographic and haemodynamic features. Am J Cardiol 47: 532–538

    Article  PubMed  CAS  Google Scholar 

  30. Morrow AG (1981) Hypertrophic aortic stenosis. Operative methods utilized to relieve left ventricular outflow obstruction. J Thorac Cardiovasc Surg 76: 423–430

    Google Scholar 

  31. Morrow AG, Brockenbrough EC (1961) Surgical treatment of idiopathic hypertrophic subaortic stenosis: Technique and hemodynamic results of subaortic ventriculotomy. Ann Surg 154: 181–189

    Google Scholar 

  32. Rastan H, Koncz J (1975) Plastische Erweiterung des linken Ausflußtraktes — eine neue Operationsmethode. Thoraxchir 3: 169–175

    Google Scholar 

  33. Reis RL, Hannah III H. Carley JE, Pugh DM (1977) Surgical treatment of idiopathic hypertrophic subaortic stenosis (IHSS): postoperative results in 30 patients following ventricular septal myotomy or myectomy (Morrow procedure). Circulation 56, Suppl II, No 3: 128–132

    Google Scholar 

  34. Rothlin ME, Gobet D, Haberer T, Krayenbuehl HP, Turina M, Senning A (1983) Surgical treatment versus medical treatmentin hypertrophic obstructive cardiomyopathy. Europ Heart J 4, Suppl F: 215–223

    Google Scholar 

  35. Schulte HD, Bircks W, Körfer R, Kuhn H (1981) Surgical aspects of typical subaortic and atypical midventricular hypertrophic obstructive cardiomyopathy ( HOCM ). Thorac Cardiovasc Surg 29: 375–380

    Google Scholar 

  36. Schulte HD, Bircks W, Lösse B (1985) Ursachen und Bedeutung der Mitralklappeninsuffizienz bei der chirurgischen Behandlung der hypertrophischen obstruktiven Kardiomyopathie. Wiener klin Wschr 135: 489–493

    CAS  Google Scholar 

  37. Schulte HD, Lösse B (1985) Hypertrophische obstruktive Kardiomyopathie: Chirurgische Behandlung und Ergebnisse. Herz 10: 102–111

    Google Scholar 

  38. Stinson EB, Shumway NE (1978) Transplantation of the heart. In: Longmore DB: Modern cardiac surgery. MTP-Press Limited, Lancaster, England, pp 3–18

    Google Scholar 

  39. Tajik AJ, Guiliani ER, Weidmann WH, Brandenburg RO, McGoon DC (1974) Idiopathic hypertrophic subaortic stenosis, long-term surgical follow-up. Am J. Cardiol 34: 815–822

    Google Scholar 

  40. Van der Wall E (1985) Recent views on left ventricular function in hypertrophic cardiomyopathy: Hemodynamic concepts and their clinical implications. In: Van der Wall E, Lie KI (Eds.). Recent views on hypertrophic cardiomyopathy. Martinus Nijhoff Publishers, Boston, Dordrecht Lancester, pp 71–99

    Google Scholar 

  41. Von der Lohe E, Müller-Hake C, Minale C, von Essen R, Effert S, Messmer BJ (1984) Septumresektion bei hypertropher obstruktiver Kardiomyopathie. Langzeitergebnisse bei 33 Patienten. Dtsch med Wschr 109: 1749–1753

    Article  PubMed  Google Scholar 

  42. Vouhé PR, Poulain H, Block G, Loisance DY, Gamain J, Lombaer M, Ouiret JC, Lesbre JP, Bernasconi P, Pietri J, Cachera JP (1984) Aortoseptal approach for optimal resection of diffuse subvalvular aortic stenosis. J Thorac Cardiovasc Surg 87: 887–893

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1988 Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt

About this paper

Cite this paper

Schulte, H.D., Bircks, W., Lösse, B. (1988). Techniques and complications of transaortic subvalvular myectomy in patients with hypertrophic obstructive cardiomyopathy (HOCM). In: Kaltenbach, M., Hopf, R., Kunkel, B. (eds) New Aspects of Hypertrophic Cardiomyopathy. Steinkopff. https://doi.org/10.1007/978-3-642-85369-2_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-85369-2_23

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-85371-5

  • Online ISBN: 978-3-642-85369-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics